ABSTRACT

Background and Aim:

The uterosacral ligament (USL) has become an increasing focus of interest in terms of its use for surgical support in the management of pelvic organ prolapse. Description of an equivalent ligament in males is lacking. Our aim is to describe a new Ligament in males which was found during rectal resection using the trans-anal Total mesorectal excision “Ta TME” which we called Prostatosacral ligament and its clinical significance.

Methods:

The Transanal Total Mesorectal Excision “TaTME” technique was done in 46 patients from January 2017 till April 2018 for rectal resection. The group included 27 males and 19 Females “Age range = 31 - 72 years , Mean= 34.13 years. In the present work we describe a new ligament in males – which we encounter during the operation- that has the same anatomic orientation to the female anatomy.

Results:

Histologic studies revealed the musclo-tendinous structure of the newly described ligament with abundant blood vessels, elastic fibers and nerves with great similarity to female Utero-sacral ligament. It forms a very important landmark for rectal resection using the new TaTME approach. It can also explain the cause of chronic pelvic pain as a striking similarity to female utero-sacral ligament was noticed.

Conclusion:

To the best of the authors’ knowledge this is the first time for this ligament to be described and histologically studied in the Literature. The Surgical and medical significance had been discussed.