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Anterior Resection of the Rectum
Published in P Ronan O’Connell, Robert D Madoff, Stanley M Goldberg, Michael J Solomon, Norman S Williams, Operative Surgery of the Colon, Rectum and Anus Operative Surgery of the Colon, Rectum and Anus, 2015
In females, the uterus, if present, should be lifted forward Figure 6.1.10. There is a similar condensation of fibrous fascia anteriorly, analogous to Denonvilliers’ fascia in the male. It is often difficult to access the plane anterior to the rectovaginal septum behind the cervix and posterior fornix and this plane is best approached, as in the male, by continuation of the anterolateral dissection from the side wall. Troublesome bleeding may be encountered from the vaginal venous plexus. Attempts to control the bleeding may be futile until the vagina has been fully mobilized off the anterior rectum allowing the stretched venous plexus to collapse down. The peritoneal reflection may be adherent to the posterior fornix and require to be dissected off by diathermy dissection.
Surgical aspects of venous pelvic pain treatment
Published in Current Medical Research and Opinion, 2019
S. G. Gavrilov, O. I. Efremova
Venous outflow from the pelvic organs occurs via the system of internal iliac and gonadal veins. Gonadal veins carry blood from the ovaries, and the left gonadal vein drains into the left renal vein, while the right one joins the inferior vena cava below the ostium of the right renal vein. Internal iliac veins are paired vessels with valvular apparatus that have visceral and parietal tributaries. Visceral tributaries are represented by uterine, bladder, upper, middle and lower rectal veins draining the same-named venous plexuses. In addition, there is a vaginal venous plexus, which has a direct connection with the veins of the uterus and external genital organs. Vein dilation and blood reflux in the gonadal veins and tributaries of the internal iliac veins result in blood stagnation in the intrapelvic venous plexus and the development of PCS.