Pelvis
Harold Ellis, Adrian Kendal Dixon, Bari M. Logan, David J. Bowden in Human Sectional Anatomy, 2017
This section traverses the tip of the coccyx (27) and passes through the pubic symphysis in its upper part (1). Note that the vagina (31) is transected in its upper part so that the external os of the cervix (30) can be seen peeping through, with the posterior fornix of the vagina behind it. Alongside the vagina are the vaginal vessels (29). The vaginal artery usually corresponds to the inferior vesical artery in the male and is a branch of the internal iliac artery. It is frequently double or triple. It supplies the vagina as well as the fundus of the bladder and the adjacent part of the rectum and anastomoses with branches of the uterine artery.
Uterine Devascularization
Sanjeewa Padumadasa, Malik Goonewardene in Obstetric Emergencies, 2021
Internal iliac artery ligation is useful either as a therapeutic or prophylactic measure when there is a desire to preserve fertility, or when hysterectomy alone fails to control the haemorrhage. It is used to manage haemorrhage due to placenta praevia, PAS disorders, uterine atony refractory to medical treatment and genital tract trauma. It is effective in arresting blood loss in cases of deep tears of the vaginal fornices and haematomas, because the vaginal artery is a direct branch of the anterior division of the internal iliac artery. It is also used to control haemorrhage from areas of diffuse bleeding within the pelvis without a clearly identifiable vascular bed.
Anatomy & Embryology
Manit Arya, Taimur T. Shah, Jas S. Kalsi, Herman S. Fernando, Iqbal S. Shergill, Asif Muneer, Hashim U. Ahmed in MCQs for the FRCS(Urol) and Postgraduate Urology Examinations, 2020
The blood supply to the female organs mainly originates from branches of the internal iliac artery; the vaginal artery provides the main supply to the vagina whilst the uterine artery, which runs in front of the ureter and in the cardinal ligament, supplies the proximal vagina, uterus and part of the fallopian tubes. The ovarian arteries usually arise from the aorta below the renal arteries at the level of L1, but in a small number may originate from the renal artery. It descends over the psoas and in the pelvis runs in the suspensory ligament to anastomose with the ovarian branch of the uterine artery supplying the ovary.
Advanced Interventional Procedures after Intrauterine Tamponade Balloon Insertion in a Tertiary Care Center
Published in Journal of Investigative Surgery, 2021
Nassir Habib, Dominique Luton, Gabriele Centini, Isabelle Renuit, Christian Birbarah, Pierre-François Ceccaldi
The success rate of PPH management in Group II (pelvic arterial embolization) was 74.13%. The study reported significant worst outcome in terms of transfusions in the AIP subgroup. The hypothesis used for this retrospective observation is a late correction of hemostasis disorders with minimal persistent bleeding indicating embolization. One case of uterine necrosis after pelvic arterial embolization for PPH was observed. According to the Brotman theory described in 1981, uterus is widely vascularized by multiple vessels coming different districts (uteroovarian artery, round ligament artery, uterine artery, and crevice vaginal artery), therefore, uterine necrosis is very rare after selective uterine artery embolization. In the case reported, the embolization was performed selectively in the uterine artery bilaterally, using resorbable gelfoam slurry. Other procedure-related complications were described after pelvic arterial embolization, including buttock necrosis requiring surgical debridement, puncture site hematoma, and fever higher than 38.5 °C without a focus of infection [25]. In addition to the risk of severe complications, even though embolization procedures have demonstrated to have lower costs in terms of procedural materials and recovery compared to standard surgery and other surgical invasive hemostatic techniques, it remains an invasive technique with high cost, not available in all hospitals, compared to ITB, thus requiring high and appropriate resources [26].
Related Knowledge Centers
- Anastomosis
- Bladder
- Internal Iliac Artery
- Mucous Membrane
- Uterine Artery
- Artery
- Vagina
- Rectum
- Vaginal Branches of Uterine Artery
- Vulval Vestibule