The pubovesical ligaments are paired condensations of the endopelvic fascia connecting the anteroinferior bladder neck and proximal urethra to the posterior pubic bone, providing the anterior urethral support.
Suspend the bladder neck and proximal urethra from the pubic bone, maintain the urethrovesical angle, contribute to urinary continence by supporting the proximal urethra in the high-pressure zone, and are deficient in stress urinary incontinence.
Pubovesical ligament laxity contributes to urethral hypermobility and stress urinary incontinence — the pubovesical support fails, allowing the proximal urethra to descend below the pelvic floor with increased abdominal pressure. Mid-urethral sling procedures (TVT, TOT) restore urethral support indirectly by augmenting the pubovesical ligament function.
Laxity of the pubovesical ligaments producing urethral hypermobility and stress urinary incontinence, managed by mid-urethral sling surgery restoring urethral support.
Open retropubic suture suspension of the periurethral tissue to Cooper's ligament at the pubovesical ligament level for stress incontinence — the gold standard against which sling procedures are compared.
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