Systematic Anatomical Description of the Female Pelvic Retroperitoneum in Cadavers (RETRO-PELVIS)

Systematic Anatomical Description of the Female Pelvic Retroperitoneum in Cadavers: A Descriptive Study for Gynecologic Surgery

This observational descriptive cadaveric study aims to describe the main anatomical relationships of the female pelvic retroperitoneum using standardized anatomical dissection. Adult female cadavers obtained from an institutional body donation program will undergo pelvic retroperitoneal dissection. Ten predefined anatomical relationships involving the ureter, pelvic vessels and nerves will be evaluated using a standardized anatomical checklist. Anatomical variability will be described for each item. Standardized photographs will also be obtained to develop an anatomical atlas for educational purposes.

Study Overview

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

Detailed Description

This is an observational, descriptive cadaveric study designed to characterize the main anatomical relationships of the female pelvic retroperitoneum with direct application to gynecologic surgery.

The study will be conducted using adult female cadavers obtained from an institutional body donation program. Approximately 20 cadavers will be included, depending on availability, providing a total of 40 hemipelves. Each hemipelvis will be considered an independent unit of analysis.

Standardized anatomical dissections of the pelvic retroperitoneum will be performed following a predefined protocol. The main anatomical structures relevant to gynecologic surgery will be identified, including the pelvic ureter, iliac vessels and their branches, obturator nerve, and other predefined anatomical landmarks.

Each hemipelvis will be evaluated using a standardized 10-item anatomical checklist. For every item, the reference anatomical pattern will be classified as present ("Yes"), absent ("No"), or not evaluable ("Not evaluable"). Anatomical variability will be calculated as the proportion of anatomical variants among all evaluable hemipelves for each item.

Standardized photographic documentation will be obtained throughout the dissections. Anatomical variants will be qualitatively described and illustrated whenever possible.

Statistical analysis will be descriptive. Categorical variables will be presented as absolute frequencies and percentages. Anatomical variability will be reported for each checklist item, excluding non-evaluable observations from the denominator.

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 governing the use of donated human bodies for research and education.

The expected outcome is a systematic description of the principal anatomical relationships of the female pelvic retroperitoneum and their anatomical variability, together with the development of a photographic anatomical atlas to support surgical training and gynecologic education.

• 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 from the institutional body donation program.

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 the pelvic ureter, iliac vessels and their main branches, obturator nerve, and other structures included in the anatomical checklist.
• 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 pelvic retroperitoneal dissection, completion of a predefined 10-item anatomical checklist, and photographic documentation.	Other: Anatomical Dissection; Standardized pelvic retroperitoneal dissection with completion of a 10-item anatomical checklist, observations and photographic documentation.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Frequency of anatomical variation	Percentage of anatomical variation for each of the ten predefined anatomical relationships evaluated using a standardized anatomical checklist.	Baseline

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Development of an anatomical atlas	Standardized photographic documentation of anatomical structures and variants for educational purposes.	Baseline

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): July 21, 2026
• Last Update Submitted That Met QC Criteria: July 18, 2026
• Last Verified: July 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