Systematic Anatomical Description of the Female Pelvic Retroperitoneum in Cadavers

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.

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