Anatomy

The uterus is situated in the pelvic cavity between the rectum posteriorly and the urinary bladder anteriorly. The body of the uterus (uterine corpus) comprises the superior part and this is joined to the cervix, which comprises the inferior portion of the uterus (Figure 23.1). The length of the uterus varies widely depending on the parity and the menopausal status but generally ranges from 5-15 cm in those uteri which are not involved by any specific pathologic process. The weight of the uterus also varies widely between 20 and 120 g. Multigravid uteri are considerably larger than nul-ligravid uteri. The uterus is lined by an inner endometrium composed of endometrial glands and stroma. Most of the wall is composed of myometrial smooth muscle. The lumen of the uterus is connected to the lumen of the fallopian tubes. The part of the uterine body above the level of the

Figure 23.1. Uterine anatomy. Reproduced from Hermanek P, Hutter RVP, Sobin LH, Wagner G, Wittekind Ch (eds.). TNM Atlas: illustrated guide to the TNM/pTNM classification of malignant tumours, 4th edition. Springer-Verlag: Berlin and Heidelberg, 1997.

fallopian tubes is the fundus. The lower portion of the uterus which merges with the cervix is known as the isthmus. The anterior surface of the uterus is covered by peritoneum which reflects forwards onto the bladder. The peritoneal surface extends lower posteriorly before being reflected onto the rectosigmoid. The lower peritoneal reflection on the posterior aspect can be used as a means to distinguish the anterior and posterior surfaces of the uterus. The anterior and posterior peritoneal linings merge laterally to form the broad ligaments which extend to the pelvic side wall.

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