These conditions include (but are not limited to) endometriosis, an ectopic pregnancy, and pelvic inflammatory disease. The anterior cul-de-sac is a pouch that sits between the bladder and the uterus.

A ramp lesion tear often occurs with other injuries, though, notably the anterior cruciate ligament (ACL) tear. Repair also is recommended when the lesion is larger than 2 centimeters in length. 7.