Morphometric Study of the Female Pelvic and Lower Abdominal Retroperitoneum in Cadavers (RETRO-PELVIS)

Systematic Anatomical Description of the Female Pelvic and Lower Abdominal Retroperitoneum: A Descriptive and Morphometric Cadaveric Study Oriented to Gynecologic Surgery

This study aims to provide a systematic anatomical and morphometric description of the female pelvic and lower abdominal retroperitoneum using cadaveric dissection, with direct application to gynecologic surgery.

Standardized dissections will be performed in adult female cadavers obtained from a body donation program. Key anatomical structures, including the ureter, iliac vessels, aorta, inferior vena cava, hypogastric plexuses, and lymphatic territories, will be identified and measured. Spatial relationships, distances, and anatomical variations will be recorded using direct measurements and standardized photographic documentation.

The study will quantify anatomical variability and asymmetry between right and left hemipelves, focusing on ureteral, vascular, and neural structures. The results are expected to improve surgical planning, particularly in nerve-sparing techniques and pelvic and para-aortic lymphadenectomy, and to support the development of an applied anatomical atlas for educational and clinical use.

Study Overview

• Status: Recruiting
• Conditions: Pelvic Anatomy; Retroperitoneum; Cadaveric Study; Surgical Anatomy
• Intervention / Treatment: Other: Anatomical Dissection

Detailed Description

This is an observational, descriptive, and morphometric cadaveric study designed to analyze the anatomy of the female pelvic and lower abdominal retroperitoneum with direct application to gynecologic surgery.

The study will be conducted in adult female cadavers obtained from an institutional body donation program. Approximately 20 cadavers are expected to be included, depending on availability. Each hemipelvis will be considered an independent unit of analysis for side-to-side comparison.

Standardized anatomical dissections will be performed following a predefined protocol. The retroperitoneum will be systematically exposed to identify and analyze key structures, including the ureter, iliac vessels and their branches, abdominal aorta, inferior vena cava, hypogastric plexuses, pelvic splanchnic nerves, and lymphatic territories.

Morphometric measurements will be obtained using millimetric instruments and predefined anatomical reference points to ensure reproducibility. Variables will include distances between anatomical structures, vessel diameters, nerve relationships, and spatial organization of pelvic surgical spaces. All measurements will be performed at least twice, and standardized photographic documentation will be obtained.

Primary outcomes include quantitative morphometric parameters and spatial relationships between key anatomical structures, as well as the frequency of anatomical variations. Secondary outcomes include characterization of ureteral variants, iliac branching patterns, presence and morphology of corona mortis, organization of the pelvic autonomic nervous system, and assessment of right-left anatomical asymmetry.

Statistical analysis will be descriptive, including measures of central tendency and dispersion for continuous variables, and frequency distributions for categorical variables. Comparative analyses between hemipelves will be performed using paired statistical tests.

This study does not involve living human participants, clinical interventions, or identifiable personal data. All procedures will be conducted in accordance with institutional and ethical standards for the use of donated human bodies for research and education.

The expected outcome is the development of a clinically oriented anatomical dataset and an illustrated anatomical atlas to support surgical training, improve understanding of pelvic anatomy, and optimize surgical approaches in gynecologic oncology.

• Study Type: Observational
• Enrollment (Estimated): 20

Contacts and Locations

• Study Contact: Name: Jorge Garcia Fernandez Principal Investigator, Gynecologist; Phone Number: +34622595644; Email: jorgarciafernan@gmail.com

Study Locations

• Spain
  • Barcelona, Spain, 08028
    • Not yet recruiting
    • Universitat de Barcelona - Department of Anatomy and Human Embryology
    • Contact: Josep Maria de Anta Vinyals Chief of Department Anatomy and Embriology, Anatomist; Email: janta@ub.edu
  • Barcelona
    • Barcelona, Barcelona, Spain, 08007
      • Recruiting
      • Universitat de Barcelona - Department of Anatomy and Human Embryology

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

Adult female cadavers obtained from an institutional body donation program, used for anatomical dissection and morphometric analysis of the pelvic and upper abdominal retroperitoneum.

Description

Inclusion Criteria:

• Female cadavers from an institutional body donation program
• Age ≥ 18 years at time of death
• Adequate preservation of pelvic and abdominal retroperitoneal structures
• Anatomical integrity allowing identification of ureter, iliac vessels, hypogastric plexuses, aorta, and vena cava
• Availability of both hemipelves for comparative analysis
• Authorization for research use according to institutional body donation regulations

Exclusion Criteria:

• Male cadavers
• Prior major pelvic or abdominal surgery significantly altering retroperitoneal anatomy (e.g., hysterectomy, lymphadenectomy, vascular surgery)
• History of pelvic or abdominal radiotherapy
• Advanced pelvic or abdominal malignancy with retroperitoneal involvement
• Severe trauma affecting pelvic or abdominal anatomy
• Poor preservation or significant tissue degradation
• Absence of one or both hemipelves
• Advanced pregnancy at time of death

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Cadaveric Specimens; Adult female cadavers obtained from an institutional body donation program. Specimens will undergo standardized anatomical dissection of the pelvic and lower abdominal retroperitoneum for identification of anatomical structures, morphometric measurements, and photographic documentation.	Other: Anatomical Dissection; Standardized anatomical dissection of the pelvic and lower abdominal retroperitoneum in cadaveric specimens, including systematic identification of anatomical structures, direct morphometric measurements, and standardized photographic documentation.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Global Morphometric Characterization of the Female Pelvic and Lower Abdominal Retroperitoneum	Systematic morphometric measurement (millimeters, mm) of anatomical structures in the female pelvic and lower abdominal retroperitoneum, including distances, diameters, lengths, and spatial relationships between ureter, vascular structures (iliac vessels, aorta, inferior vena cava), and pelvic autonomic nerves. Measurements will be obtained using standardized cadaveric dissection and predefined anatomical reference points.	Baseline

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Iliac Artery Morphometry and Branching Patterns	Measurement (mm) of ureteral distances relative to major vascular structures, length of the ureteral tunnel, and classification of anatomical variants including duplication and abnormal course.	Baseline
Iliac Artery Morphometry and Branching Patterns	Measurement (mm) of diameter and length of common, external, and internal iliac arteries, and characterization of branching patterns including uterine, obturator, pudendal, vesical, rectal, and gluteal branches.	Baseline
Iliac Venous Anatomy and Variations	Measurement (mm) of iliac venous diameters and lengths, description of venous relationships with arterial structures, and identification of relevant variants including deep circumflex iliac vein and uterine venous plexus.	Baseline
Presence and Morphometric Characteristics of Corona Mortis	Corona mortis diameter (mm) and length (mm).	Baseline
Pelvic Autonomic Nervous System Anatomy	Measurement (mm) of spatial relationships between hypogastric plexuses, hypogastric nerves, pelvic splanchnic nerves, ureter, and iliac vessels.	Baseline
Distribution of Pelvic and Abdominal Lymphatic Territories	Presence or absence of pelvic and paraaortic lymphatic regions, including iliac, obturator, presacral, paraaortic, paracaval, and interaortocaval territories.	Baseline
Morphometry of Pelvic Surgical Spaces	Measurement (mm) of width and depth of pelvic spaces including paravesical, pararectal (medial and lateral), and obturator fossa.	Baseline
Abdominal Vascular Morphometry and Spatial Relationships	Measurement (mm) of distances between aorta, inferior vena cava, iliac bifurcation, and anatomical landmarks such as the sacral promontory.	Baseline
Frequency of Anatomical Variations	Percentage (%) distribution of anatomical variations across ureteral, vascular, and neural structures.	Baseline
Right-Left Anatomical Asymmetry	Comparison of morphometric parameters between right and left hemipelves, including absolute and relative differences.	through study completion, an average of 1 year

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Development of an Applied Anatomical Atlas	Integration of morphometric measurements and standardized photographic documentation to develop a clinically oriented anatomical atlas of the female pelvic and lower abdominal retroperitoneum for educational and surgical applications.	through study completion, an average of 1 year

Collaborators and Investigators

• Sponsor: Hospital Universitari de Bellvitge
• Collaborators: University of Barcelona
• Investigators: Principal Investigator: Jorge García Fernández, Gynecologist, Hospital Universitari de Bellvitge

Publications and helpful links

General Publications

• Cibula D, Abu-Rustum NR. Pelvic lymphadenectomy in cervical cancer--surgical anatomy and proposal for a new classification system. Gynecol Oncol. 2010 Jan;116(1):33-7. doi: 10.1016/j.ygyno.2009.09.003. Epub 2009 Oct 17.
• Sanna B, Henry BM, Vikse J, Skinningsrud B, Pekala JR, Walocha JA, Cirocchi R, Tomaszewski KA. The prevalence and morphology of the corona mortis (Crown of death): A meta-analysis with implications in abdominal wall and pelvic surgery. Injury. 2018 Feb;49(2):302-308. doi: 10.1016/j.injury.2017.12.007. Epub 2017 Dec 9.
• Sienkiewicz-Zawilinska J, Zawilinski J, Kaythampilla LN, Jankiel M, Urbaniak J, Bereza T, Kowalski W, Loukas M, Walocha J. Autonomic nervous system of the pelvis - general overview. Folia Med Cracov. 2018;58(2):21-44. doi: 10.24425/fmc.2018.124656.
• Ripperda CM, Jackson LA, Phelan JN, Carrick KS, Corton MM. Anatomic relationships of the pelvic autonomic nervous system in female cadavers: clinical applications to pelvic surgery. Am J Obstet Gynecol. 2017 Apr;216(4):388.e1-388.e7. doi: 10.1016/j.ajog.2016.12.002. Epub 2016 Dec 9.
• Kostov S, Slavchev S, Dzhenkov D, Mitev D, Yordanov A. Avascular Spaces of the Female Pelvis-Clinical Applications in Obstetrics and Gynecology. J Clin Med. 2020 May 13;9(5):1460. doi: 10.3390/jcm9051460.

Helpful Links

• University of Barcelona WebPage

Study record dates

Study Major Dates

• Study Start (Actual): April 14, 2026
• Primary Completion (Estimated): September 28, 2026
• Study Completion (Estimated): November 30, 2026

Study Registration Dates

• First Submitted: March 26, 2026
• First Submitted That Met QC Criteria: April 3, 2026
• First Posted (Actual): April 13, 2026

Study Record Updates

• Last Update Posted (Actual): April 17, 2026
• Last Update Submitted That Met QC Criteria: April 14, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: Dissection; retroperitoneum; Gynecologic surgery; cadaver; Nerve-sparing surgery; Pelvic anatomy; female pelvis; cadaveric model; surgical anatomy; Morphometric analysis; Anatomical variability; Pelvic vessels; Ureter anatomy; Hypogastric plexus; Pelvic lymphatic anatomy
• Additional Relevant MeSH Terms: Pathologic Processes; Death; Pathological Conditions, Signs and Symptoms; Cadaver
• Other Study ID Numbers: UB-RETROPERITONEO-2026

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data (IPD) will not be shared because this study does not involve living participants or identifiable individual-level clinical data. The study is based on anonymized cadaveric specimens and generates aggregate anatomical and morphometric data.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No