Asymmetric sacrotuberous and sacrospinous ligament

Aim: To describe a case of medial asymmetry in the sacrotuberous/sacrospinous ligament complex (SSTL).

Methods: Description of the anatomical findings in a cadaver with an asymmetrical SSTL and comparison to five anatomically normal cadaveric dissections.

Results: Marked asymmetry with an atypical proximal origin and cord-like SSTL is described and contrasted to the more typical fan-shaped ligament complex. No vascular perforators traversed the SSTL in the atypical case and the vessels were relatively protected during SSTL release.

Conclusion: Significance variance and asymmetry within the SSTL can occur. Surgeons should be aware of this phenomenon and consider anatomical variations when performing a peri-sacral dissection.