A 45-year-old woman is admitted to the hospital with lower abdominal and pelvic discomfort. Combined laparoscopic and MRI examinations reveal tears of the ligaments supporting the uterus with moderate uterine prolapse. Which of the following ligaments provides direct support to the uterus and thereby resists prolapse?
The uterosacral ligaments and the transverse cervical (cardinal) ligaments are the two main ligaments stabilizing the uterus. They help to inhibit the uterus from prolapsing into the vagina. The round ligament of the uterus is related to the descent of the ovaries in embryologic development and continues into the inguinal canal. The broad ligament is the peritoneal covering over the uterine tubes, uterus, and vessels. The arcus tendineus fascia pelvis joins the muscle fascia of the levator ani to the pubocervical fascia on the vagina and is not directly associated with the uterus or its ligaments. The levator ani muscles contribute to the floor of the pelvis and support all of the pelvic viscera indirectly; it does not, however, prevent prolapse of the uterus into the vagina.
Uterosacral
Round ligament of the uterus
Broad ligament
Arcus tendineus fascia pelvis
Abdomen & Pelvis