Clinical Anatomy of the Puboprostatic Ligament for the Safe Guidance for the Prostate Surgery

Hyun Min Choi, So Young Jung, Soo Jung Kim, Hee Jun Yang, Jang Hwan Kim, Young Tae Kim, Ji Cheol Shin, Hye Yeon Lee

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


Objective: To provide the anatomy of the puboprostatic ligament and related structures to save urogenital competence after prostatectomy. Materials and Methods: Pelvic areas of 31 adult cadavers were dissected to figure out the shape, number, and location of the puboprostatic ligaments. Results: The puboprostatic ligament was the most important support structure between the pubic bone and prostate gland. Puboprostatic ligaments were bilaterally single (61.3%), bilaterally double (19.4%), or mixed (19.4%). Ligaments were mostly I-shaped (53.8%). If ligaments had extra attachment to or from the arcuate line, the ligaments were λ-shaped (36.3%), or Y-shaped (8.8%). In one case, the ligament had a central fusion with an irregular shape. I-shaped puboprostatic ligaments were observed more frequently in specimens with double ligaments, while λ-shaped puboprostatic ligaments were observed more frequently in the cases with single ligaments. The average distance between both puboprostatic ligaments was 8.1 mm at the pubic site and 14.2 mm at the prostate site. The distance was narrower when the specimen had double puboprostatic ligaments on both sides. The neurovascular bundle ran beneath the puboprostatic ligament. If the ligament was the λ-shaped type, the neurovascular bundle frequently pierced the lateral band of the ligament. Conclusion: Puboprostatic ligaments hold and stabilize the prostate against the pubic bone. It is believed that a pelvis with bilateral, double puboprostatic ligaments would have advantages in urogenital competence. The morphologic data of the shape, multiplicity, and location of the PPLs would help to make a plan to approach the prostate.

Original languageEnglish
Pages (from-to)190-195
Number of pages6
Publication statusPublished - 2020 Feb

Bibliographical note

Funding Information:
Financial Support: This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (#2017 R1A2B4010234).

Publisher Copyright:
© 2019 The Authors

All Science Journal Classification (ASJC) codes

  • Urology


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