It passes through the following structures in the following order: gracilis, adductor brevis muscle, obturator externus
muscle, obturator membrane, and beneath or through the obturator internus muscle and periurethral endopelvic connective tissue; it finally exits through the opened vagina.
The adductor muscle group consists of six different muscles: pectineus, gracilis, obturator externus
, adductor brevis, adductor longus, and adductor magnus.
Once placed, the ends of the mesh penetrate the obturator membrane and obturator externus
but not the adductor compartment of the thigh and groin.
The gluteals (maximus, medius, and minimus) and the "deep six" muscles of the hip (piriformis, quadratus femoris, obturator internus, obturator externus
, gemellus superior, and gemellus inferior) serve to flex, extend, abduct, adduct, and medially or laterally rotate the hip.
The anchor goes not only into the obturator internus, but into the membrane and the obturator externus
Among the muscles traversed, the adductor brevis is the first, followed by obturator externus
and then internus.
After preparation of the space between the anteroinferior capsule and the psoas tendon, the ischium is approached proximal to the obturator externus