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It goes antero-medially while crossing the uterine artery (water under the bridge) afterwards, it enters the ureteric tunnel (web tunnel) within the cardinal ligament. The ureter passes lateral to the antero-lateral vaginal fornix within the bladder pillar and enters the trigone of the bladder.
(6) In doing so, the surgeon must skeletonize and mobilize the distal ureters, cardinal ligament webs, and uterosacral ligaments.
Besides, lymph and a few lymph nodes are also included.13 Sensory nerves of the uterus and oviduct enter pelvic plexus through sacrospinous ligament and cardinal ligament. The pains stimulation from pelvic cavity is transmitted to cerebral center to cause pain, suggesting that cutting off relevant nerves can mitigate endometriosis-caused pain.14 Thus, during the treatment of deeply infiltrative endometriosis-induced pain, cutting off invaded sacrospinous ligament or blocking relevant nerves can effectively alleviate clinical pain.
They are pubocervical fascia, rectovaginal fascia, Waldeyer fascia, rectosacral fascia, mesorectum, paracolpium, pubourethral ligament, cardinal ligament, uterosacral ligament, and umbilical ligament.
Thick adhesion band was seen connecting the right posterior surface of the uterus to the right cardinal ligament in close proximity to uterus.
The upper third of the vagina (level I) is suspended from the pelvic walls by vertical fibers of the paracolpium, which is a continuation of the cardinal ligament. (2) The uterosacral and sacrospinous ligament suspension seek to restore the level 1 vaginal support.
In postmenopausal patients uterosacral and cardinal ligament complex is not able to support the vault so it increases chances of uterovaginal prolapse.