Uterosacral Ligaments (USL)

Definition - What does Uterosacral Ligaments (USL) mean?

Uterosacral ligaments (USL) are tough bands of tissue that connect the uterus to either side of the sacrum (lower part of the spine). They are positioned behind the cervix. In combination with other uterine supports, these ligaments support the uterus and upper part of the vagina, holding these organs in place within the pelvis. Certain factors can weaken the ligaments, causing the uterus and vagina to prolapse.

FertilitySmarts explains Uterosacral Ligaments (USL)

The uterosacral ligaments (USL) are important for the following reasons:

They are one of the most common sites of pelvic endometriosis, a condition where cells from the inner uterine lining (endometrial tissue) are found outside of the uterus. These endometrial deposits reach the uterosacral ligaments by passing along the fallopian tubes. These deposits can block the tubes, causing infertility.

These ligaments are also traversed by blood vessels and nerves, which can be damaged during surgery such as a hysterectomy (removal of the uterus) or laparotomy.

The uterosacral ligaments can also be damaged during childbirth causing the uterus, cervix, and vagina to prolapse downward. If not damaged, the uterosacral ligaments can be used during pelvic reconstructive surgery for uterine prolapse as they can facilitate reattachment of the upper portion of the vagina within the pelvis.

A woman can still conceive despite the prolapse. However, a few cases have been reported where a woman with unexplained infertility had no obvious cause other than a uterovaginal prolapse. In these cases, surgically creating sling support can not only relieve the symptoms of the prolapse but may also help a woman get pregnant with successful results.

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