• Vincent Balaya, Fabien Guimiot, Jean-François Uhl, Charlotte Ngo, Myriam Delomenie, Hélène Bonsang-Kitzis, Marie Gosset, Myriam Mimouni, Anne-Sophie Bats, Vincent Delmas, Richard Douard, and Fabrice Lécuru.
• Department of Gynecologic and Breast Oncologic Surgery, Georges Pompidou European Hospital, Paris, Francevbalaya@hotmail.com.
• Gynecol. Obstet. Invest. 2019 Jan 1; 84 (2): 196-203.

Background/AimsThis study aims to describe the autonomic nervous network of the female pelvis with a 3D model and to provide a safe plane of dissection during radical hysterectomy for cervical cancer.MethodsPelvises of 3 human female fetuses were studied by using the computer-assisted anatomic dissection.ResultsThe superior hypogastric plexus (SHP) was located at the level of the aortic bifurcation in front of the sacral promontory and divided inferiorly and laterally into 2 hypogastric nerves (HN). HN ran postero-medially to the ureter and in the lateral part of the uterosacral ligament until the superior angle of the inferior hypogastric plexus (IHP). IHP extended from the anterolateral face of the rectum, laterally to the cervix and attempted to the base of the bladder. Vesical efferences merged from the crossing point of the ureter and the uterine artery and ran through the posterior layer of the vesico-uterine ligament.ConclusionsThe SHP could be injured during paraaortic lymphadenectomy. Following the ureter and resecting the medial fibrous part of the uterosacral ligament may spare the HN. No dissection should be performed under the crossing point of the ureter and the uterine artery.© 2018 S. Karger AG, Basel.

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