Comprehensive Review of the Cardinal Ligament

Abstract

The cardinal ligament is thought to be one of the important structures in providing support and stabilization for the pelvic organs e.g., the uterus. However, many discrepancies exist in the literature regarding terminology, anatomy, and histology. The cardinal ligament attaches the lateral side of the vagina and cervix to the lateral pelvic wall, which provides support to the vagina and cervix. Studies have shown variable findings in the collagen content and distribution in the cardinal ligaments of women with a prolapsed uterus. Uterine vessels and the branches of the inferior hypogastric plexus travel in the cardinal ligament, which is of great importance during pelvic surgeries. Cervical cancer may lead to metastatic spread to the lymph nodes juxtaposed to the cardinal ligaments. This review aims to highlight the clinical significance and surgical importance of the cardinal ligament with a comparison with previous studies.

Chinese Expert Consensus on Recommended Standardized Terminology for the Pelvic Membrane Anatomy

“…The cardinal ligament refers to the anatomical structure located between the lateral pelvic wall and the lateral side of the cervix/vagina, formed by loose connective tissue surrounding the nerves, blood vessels and lymphatic vessels [3,6,105].…”