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de Treigny OM, Roumiguie M, Deudon R, de Bonnecaze G, Carfagna L, Chaynes P, Rimailho J, Chantalat E. Anatomical study of the inferior vesical artery: is it specific to the male sex? Surg Radiol Anat 2017; 39:961-965. [PMID: 28229186 DOI: 10.1007/s00276-017-1828-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Accepted: 01/30/2017] [Indexed: 12/14/2022]
Abstract
PURPOSE The aim of our study was to clarify the origin of the inferior vesical artery and determine its existence in women. METHODS This descriptive study is based on 25 dissections (6 male and 19 female cadavers). We dissected the internal iliac artery and its branches from the iliac bifurcation, bilaterally and comparatively. Each arterial branch supplying the bladder was identified and dissected as far as the bladder. RESULTS In total, 50 topographies of the bladder vascularization were visualised. The inferior vesical artery was observed in 92% of the male subjects and in 47.4% of the female subjects. In the male cadavers, it arose from the internal iliac artery in 72.7% of cases and from the umbilical artery in 27.3% of cases. In the female cadavers, it arose from a common trunk with the umbilical artery and the uterine artery in 33.3% of cases and directly from the umbilical artery in 33.3% with one terminal branch supplying the upper part of the vagina. In two female subjects, the inferior vesical artery arose from the first segment of the uterine artery (22.2%), and in one subject from the obturator artery (11.1%). CONCLUSIONS The inferior vesical artery is not specific to the male sex. The contradictions found in the literature of this artery are due to the variations observed in pelvic vascularization and to the close connections between vaginal and bladder vascularisation in women. However, surgeons should consider these variations, to prevent bladder devascularization by non-selective ligation.
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Affiliation(s)
- O Merigot de Treigny
- Laboratory of Applied Anatomy, Faculty of Medicine Toulouse, Toulouse, France.,Department of Urology, Rangueil Hospital, CHU Toulouse, Toulouse, France
| | - M Roumiguie
- Laboratory of Applied Anatomy, Faculty of Medicine Toulouse, Toulouse, France.,Department of Urology, Rangueil Hospital, CHU Toulouse, Toulouse, France
| | - R Deudon
- Department of Gynecological Surgery, Rangueil Hospital, CHU Toulouse, 1 avenue J Poulhès, TSA 50032, 31059, Toulouse Cedex 9, France
| | - G de Bonnecaze
- Laboratory of Applied Anatomy, Faculty of Medicine Toulouse, Toulouse, France.,Department of Head and Neck Surgery, Larrey Hospital, CHU Toulouse, Toulouse, France
| | - L Carfagna
- Laboratory of Applied Anatomy, Faculty of Medicine Toulouse, Toulouse, France.,Department of Pediatric Surgery, CHU Paule de Viguier, Toulouse, France
| | - P Chaynes
- Laboratory of Applied Anatomy, Faculty of Medicine Toulouse, Toulouse, France.,Neurosurgical Department, Pierre Paul Riquet Hospital, CHU Toulouse, Toulouse, France
| | - J Rimailho
- Laboratory of Applied Anatomy, Faculty of Medicine Toulouse, Toulouse, France.,Department of Gynecological Surgery, Rangueil Hospital, CHU Toulouse, 1 avenue J Poulhès, TSA 50032, 31059, Toulouse Cedex 9, France
| | - E Chantalat
- Laboratory of Applied Anatomy, Faculty of Medicine Toulouse, Toulouse, France. .,Department of Gynecological Surgery, Rangueil Hospital, CHU Toulouse, 1 avenue J Poulhès, TSA 50032, 31059, Toulouse Cedex 9, France.
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Koganemaru M, Nonoshita M, Iwamoto R, Kuhara A, Nabeta M, Kusumoto M, Kugiyama T, Kozuma Y, Nagata S, Abe T. Endovascular Management of Intractable Postpartum Hemorrhage Caused by Vaginal Laceration. Cardiovasc Intervent Radiol 2016; 39:1159-64. [PMID: 26902704 DOI: 10.1007/s00270-016-1309-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 02/08/2016] [Indexed: 11/30/2022]
Abstract
PURPOSE We evaluated the management of transcatheter arterial embolization for postpartum hemorrhage caused by vaginal laceration. MATERIALS AND METHODS We reviewed seven cases of patients (mean age 30.9 years; range 27-35) with intractable hemorrhages and pelvic hematomas caused by vaginal lacerations, who underwent superselective transcatheter arterial embolization from January 2008 to July 2014. Postpartum hemorrhage was evaluated by angiographic vascular mapping to determine the vaginal artery's architecture, technical and clinical success rates, and complications. RESULTS The vaginal artery was confirmed as the source of bleeding in all cases. The artery was found to originate from the uterine artery in three cases, the uterine and obturator arteries in two, or the internal pudendal artery in two. After vaginal artery embolization, persistent contrast extravasation from the inferior mesenteric artery as an anastomotic branch was noted in one patient. Nontarget vessels (the inferior vesical artery and nonbleeding vaginal arterial branches) were embolized in one patient. Effective control of hemostasis and no post-procedural complications were confirmed for all cases. CONCLUSION Postpartum hemorrhages caused by vaginal lacerations involve the vaginal artery arising from the anterior trunk of the internal iliac artery with various branching patterns. Superselective vaginal artery embolization is clinically acceptable for the successful treatment of vaginal laceration hemorrhages, with no complications. After vaginal artery embolization, it is suggested to check for the presence of other possible bleeding vessels by pelvic aortography with a catheter tip at the L3 vertebral level, and to perform a follow-up assessment.
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Affiliation(s)
- Masamichi Koganemaru
- Department of Radiology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.
| | - Masaaki Nonoshita
- Department of Radiology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Ryoji Iwamoto
- Department of Radiology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Asako Kuhara
- Department of Radiology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Masakazu Nabeta
- Department of Radiology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Masashi Kusumoto
- Department of Radiology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Tomoko Kugiyama
- Department of Radiology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Yutaka Kozuma
- Department of Obstetrics and Gynecology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Shuji Nagata
- Department of Radiology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Toshi Abe
- Department of Radiology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
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