Subperitoneal layer of elastic fibers in the female pelvis

Abstract

A preliminary report from this group described a unique layer of subperitoneal elastic fibers in the female pelvis. The current study was undertaken to better characterize this elastic layer in the female and determine if it exists in the male pelvis. Thirty-seven hemipelves were used in this study and were employed for one of two purposes: dissection and/or sampling for histologic study. The following histologic stains were employed: Verhoeff's hematoxylin for elastic fibers, Masson's trichrome for collagen, and hematoxylin and eosin for general morphology. In some areas (broad ligament) the subperitoneal elastic layer was very thin with dispersed fibers while in other areas (uterosacral fold) the layer was thick with tightly packed fibers. A subperitoneal layer of elastic fibers was not detected in samples from the greater omentum; however, a dense but poorly organized layer of elastic fibers was noted between the posterior layer of the rectus sheath and the peritoneum. While a similar layer of elastic fibers was found in the male pelvis, the layer was less dense and less well organized than in the female. These findings indicate that in addition to the well-accepted pelvic ligaments, in the female there may be a layer of elastic fibers that assists in supporting pelvic viscera in a more dynamic manner than the ligaments. Proper alignment or manipulation of this layer during reconstructive surgery may enhance postoperative results.