Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-19T13:49:09.563Z Has data issue: false hasContentIssue false

Chapter 2 - Anatomy and Physiology of the Uterus

Published online by Cambridge University Press:  10 September 2020

By
Christopher Guyer ,
Sree Rajesh  and
Mary E. Connor
Edited by
Mary E. Connor  and
T. Justin Clark
Mary E. Connor
Affiliation:
Royal Hallamshire Hospital, Sheffield
T. Justin Clark
Affiliation:
Birmingham Women’s Hospital
Get access

Summary

The uterus is the primary female reproductive organ. It is situated within the pelvis and measures approximately 8 cm in length, 4 cm in width and 5 cm in depth in the normal, non-pregnant state. Though relatively quiescent in pre-pubertal and post-menopausal years, the uterus possesses a variety of functions during a woman’s reproductive years. It responds to the production of female hormones, creating changes to allow for implantation of a fertilised egg, or menstruation when pregnancy does not occur. It is also able to rapidly expand with the development of a pregnancy and has a contractile function for labour and delivery during childbirth [1].

Type
Chapter
Information
Diagnostic and Operative Hysteroscopy , pp. 6 - 19
Publisher: Cambridge University Press
Print publication year: 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Standring, S. (ed.) Gray’s Anatomy: the Anatomical Basis of Clinical Practice, 39th edn. Edinburgh: Churchill Livingstone; 2005.Google Scholar
Acién, P, Acién, M. The presentation and management of complex female genital malformations. Hum Reprod Update 2016; 22: 48–69.Google Scholar
Sadler, TW. Urogenital system. In Langman’s Medical Embryology, 9th edn. Philadelphia, PA: Lippincott, Williams & Wilkins; 2003: 246–62.Google Scholar
Sánchez-Ferrer, ML, Acién, MI, Sánchez del Campo, F, Mayol-Belda, MJ, Acién, P. Experimental contributions to the study of the embryology of the vagina. Hum Reprod 2006; 21: 1623–8.CrossRefGoogle Scholar
Bulmer, D. The development of the human vagina. J Anat 1957; 91: 490–509.Google ScholarPubMed
Cai, Y. Revisiting old vaginal topics: conversion of the Müllerian vagina and origin of the ‘sinus’ vagina. Int J Dev Biol 2009; 53: 925–34.Google Scholar
Lawrence-Watt, D, Montgomery, J, Johnston, M. Applied anatomy and imaging of the pelvis, femoral triangle and inguinal canal. In Fiander, A, Thilaganathan, B, eds., Your Essential Revision Guide: MRCOG Part One: The Official Companion To The Royal College Of Obstetricians And Gynaecologists Revision Course. Cambridge: Cambridge University Press; 2016: 7–27.Google Scholar
Bajaj, SK, Misra, R, Thukral, BB, Gupta, R. OHVIRA: uterus didelphys, blind hemivagina and ipsilateral renal agenesis: advantage MRI. J Hum Reprod Sci 2012; 5: 67–70.CrossRefGoogle ScholarPubMed
American Fertility Society. The American Fertility Society classifications of adnexal adhesions, distal tubal occlusion, tubal occlusion secondary to tubal ligation, tubal pregnancies, Müllerian anomalies and intrauterine adhesions. Fertil Steril 1988; 49: 944–55.Google Scholar
Grimbizis, GF, Campo, R, Gordts, S, et al. Scientific Committee of the Congenital Uterine malformations (CONUTA) common ESHRE/ESGE working group. Clinical approach for the classification of congenital uterine malformations. Gynecol Surg 2012; 9: 119–29.Google Scholar
Grimbizis, GF, Di Spiezio Sardo, A, Saravelos, SH, et al. The Thessaloniki ESHRE/ESGE consensus on diagnosis of female genital anomalies. Gynecol Surg 2016; 13: 1–16.Google Scholar
Ludwin, A, Ludwin, I. Comparison of the ESHRE-ESGE and ASRM classifications of Müllerian duct anomalies in everyday practice. Hum Reprod 2015; 30: 569–80.CrossRefGoogle ScholarPubMed
Ferenczy, A, Bergeron, C. Histology of the human endometrium: from birth to senescence. Ann N Y Acad Sci 1991; 622: 6–27.Google Scholar
Kunz, G, Leyendecker, G. Uterine peristaltic activity during the menstrual cycle: characterization, regulation, function and dysfunction. Reprod Biomed Online 2002; 4(Suppl 3): 5–9.CrossRefGoogle ScholarPubMed
Brosens, JJ, Barker, FG, de Souza, NM. Myometrial zonal differentiation and uterine junctional zone hyperplasia in the non-pregnant uterus. Hum Reprod Update 1998; 5: 496–502.Google Scholar
Aguilar, HN, Mitchell, BF. Physiological pathways and molecular mechanisms regulating uterine contractility. Hum Reprod Update 2010; 16: 725–44.CrossRefGoogle ScholarPubMed
Noe, M, Kunz, G, Herbertz, M, Mall, G, Leyendecker, G. The cyclic pattern of immunocytochemical expression of oestrogen and progesterone receptors in human myometrial and endometrial layers: characterization of the endometrial-subendometrial unit. Hum Reprod 1999; 14: 190–7.CrossRefGoogle ScholarPubMed
Leyendecker, G, Kunz, G, Wildt, L, Beil, D, Delininger, H. Uterine hyperperistalsis and dysperistalsis as dysfunctions of the mechanism of rapid sperm transport in patients with endometriosis and infertility. Hum Reprod 1996; 11: 1542–51.CrossRefGoogle ScholarPubMed
Yoshino, O, Hayashi, T, Osuga, Y, et al. Decreased pregnancy rate is linked to abnormal uterine peristalsis caused by intramural fibroids. Hum Reprod 2010; 25: 2475–9.CrossRefGoogle ScholarPubMed
Kido, A, Ascher, SM, Kishimoto, K, et al. Comparison of uterine peristalsis before and after uterine artery embolization at 3-T MRI. AJR Am J Roentgenol 2011; 196: 1431–5.CrossRefGoogle ScholarPubMed
Koyama, T, Togashi, K. Functional MR imaging of the female pelvis. J Magn Reson Imaging 2007; 25: 1101–12.CrossRefGoogle ScholarPubMed
Watanabe, K, Kataoka, M, Yano, K, et al. Automated detection and measurement of uterine peristalsis in cine MR images. J Magn Reson Imaging 2014; 39: 609–16.Google Scholar
Ciavattini, A, Di Giuseppe, JP, Stortoni, P, et al. Uterine fibroids: pathogenesis and interactions with endometrium and endomyometrial junction. Obstet Gynecol Int 2013; 2013: 173184.Google Scholar
Munro, M, Critchley, H, Fraser, I. The FIGO systems for nomenclature and classification of causes of abnormal uterine bleeding in the reproductive years: who needs them? Am J Obstet Gynecol 2012; 207: 259–65.Google Scholar
Whitaker, L., Critchley, H. Abnormal uterine bleeding. Best Pract Res Clin Obstet Gynaecol 2015; 34: 54–65.Google Scholar
Paik, DY, Janzen, DM, Schafenacker, AM, et al. Stem-like epithelial cells are concentrated in the distal end of the fallopian tube: a site for injury and serous cancer initiation. Stem Cells 2012; 30: 2487–97.Google Scholar
Barrett, KE, Barman, SM, Boitano, S, Brooks, HL. Ganong’s Review of Medical Physiology, 24th edn. New York: McGraw-Hill; 2012: 410.Google Scholar
National Institute for Health and Care Excellence. Heavy Menstrual Bleeding: Assessment and Management. NICE Guideline NG88. London: NICE; 2018. www.nice.org.uk/guidance/ng88 (accessed November 2019).Google Scholar
Lethaby, A, Farquhar, C, Cooke, I. Antifibrinolytics for heavy menstrual bleeding. Cochrane Database Syst Rev 2000; (4): CD000249.Google Scholar
Lethaby, A, Duckitt, K, Farquhar, C. Non-steroidal anti-inflammatory drugs for heavy menstrual bleeding. Cochrane Database Syst Rev 2013; (1): CD000400.Google Scholar
Lethaby, A, Irvine, GA, Cameron, IT. Cyclical progestogens for heavy menstrual bleeding. Cochrane Database Syst Rev 2008; (1): CD001016.Google Scholar
Lumsden, MA, Gebbie, A, Holland, C. Managing unscheduled bleeding in non-pregnant premenopausal women. BMJ 2013; 346: f3251.CrossRefGoogle ScholarPubMed
Lethaby, A, Hussain, M, Rishworth, JR, Rees, MC. Progesterone or progestogen-releasing intrauterine systems for heavy menstrual bleeding. Cochrane Database Syst Rev 2015; (4): CD002126.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×