The female uterus is the central organ of the reproductive system. It is where the birth of a new life, development and maturation of the fetus occurs. The uterus, together with its appendages, forms a unique complex that regulates the functioning of other organs and systems of the body and determines the overall well-being of a woman.
How does the female uterus work?
The internal structure of the female uterus is unique. With the onset of puberty, the organ undergoes monthly cyclic changes. According to the histological structure, the organ contains three types of tissue:
- The top layer is the perimeter. It covers the organ from the outside, preventing injury.
- The middle layer is the myometrium. It is represented by bundles of muscle and connective fibers that are highly elastic. This property explains the ability of the reproductive organ to significantly increase in size during the period of bearing a child. Physiologists say that myometrial fibers are the strongest in female body muscles that can withstand heavy loads.
- The inner layer is endometrial (functional). This layer itself plays a vital role during pregnancy - it is introduced into it and grows in it. If pregnancy does not occur, endometrial cells begin to die and leave the uterine cavity along with menstruation.
Where is a woman's uterus located?
It should be noted that the female reproductive organs, including the uterus, have some mobility. Taking this into account, the topography of the organ may vary somewhat and depends on the specific stage of life (childbirth, pregnancy). Normally, the uterus is located in the pelvic cavity, between the rectum and the bladder. It is slightly tilted forward, and on both sides it is supported by ligaments that prevent the organ from descending and ensure the mobility of the organ.
Thanks to the ligamentous apparatus, the female uterus is able to slightly change its location. So, when the bladder is full, the organ tilts backward, and when the rectum is full, it tilts forward. A significant change in the location of the uterus is observed during pregnancy. The growth of the embryo leads not only to an increase in the volume of the reproductive organ, but also causes it to extend beyond the pelvic cavity.
What does a woman's uterus look like?
Having briefly examined the structure of the uterus in women, it should be noted that the organ itself externally resembles an inverted pear. In the structure of the organ it is customary to distinguish:
- body;
- neck
The bottom is the upper part of the organ, convex in shape, located above the line of confluence with the uterus fallopian tubes. The body has a cone shape and is the middle large part of the organ. The lower part of the uterus - the cervix - is divided into 2 sections: the vaginal part - it protrudes into the vaginal cavity, and the supravaginal part - the upper section located above the vaginal cavity. At the junction of the body and the neck there is a narrowing called the isthmus. On the vaginal part there is an opening of the cervical canal.
Functions of the uterus
The main function of the uterus is reproductive. This organ is continuously connected with the process of procreation. Directly in it the development of a small organism from two germ cells occurs. In addition, there are a number of other functions that the uterus performs:
- Protective. The organ is a barrier to spread pathogenic microorganisms, viruses from the vagina to the appendages.
- Cleansing - monthly, along with menstruation, self-cleaning of the cervical canal and vagina occurs during menstrual flow.
- Participation in the process of fertilization is a connecting link on the path of sperm from the vaginal cavity to the fallopian tube.
- Participates in the implantation process.
- Strengthens the pelvic floor along with its own ligamentous apparatus.
Woman's uterus - dimensions
It should be noted that such a parameter as the size of the female uterus has a special diagnostic value. Thus, based on an increase in the volume of an organ, the doctor can make the first assumptions about pathology or pregnancy already at the first stage of the examination, without the use of equipment. The size of the uterus can vary and depends on several factors:
- the presence of pathologies and diseases of the reproductive system;
- presence of pregnancy and childbirth;
- woman's age.
Normal size of the uterus of a nulliparous woman
Diagnosis of diseases of the uterus and determination of the size of the organ is carried out using ultrasound. This hardware method helps to accurately determine structural changes in an organ and establish its exact location. The normal dimensions of the uterus in a woman who does not have children are as follows:
- length – 7–8 cm;
- maximum width – 5 cm;
- weight – about 50 g.
Sizes of the uterus at different stages of pregnancy
Pregnancy is a complex and lengthy process, accompanied by the growth and development of the fetus. The immediate increase in the size of the unborn baby causes the growth of the uterus and its volume. At the same time, structural changes in the composition of the walls of the organ are observed: not only a qualitative, but also a quantitative increase in muscle fibers occurs. At the same time, the female uterus increases throughout the entire period of pregnancy.
In the first weeks of gestation, the reproductive organ retains its pear-shaped shape and practically does not change its size, since the embryo is still small. However, by the second month the organ acquires a rounded shape, and the size of the uterus during pregnancy by this time increases several times. The weight of the uterus itself also increases, and by the end of the gestation period it reaches almost 1 kg! At each examination of a pregnant woman, the doctor determines the height of the uterine fundus. The change in this parameter by week of pregnancy is shown in the table below.
Dimensions of the uterus after childbirth
After delivery, the female uterus begins to gradually recover. It decreases in size and its weight decreases. This process takes on average 6–8 weeks. At the same time, the process is proceeding at a rapid pace. So, by the end of the first week, on days 6–7 after birth, the uterus weighs approximately 500–600 g, and already on the 10th day after the baby is born – 300–400 g. Normally, at the end of the third week, the organ already weighs 200 G.
It should be noted that the process of involution has an individual character. By diagnosing the size of the uterus by ultrasound, the norm of which is given below, doctors draw conclusions regarding the speed of restoration of the reproductive system. Doctors call the determining factors:
- degree of uterine distension at;
- fetal body weight during pregnancy.
Size of the uterus at menopause
Menopause is a period of cessation of menstrual flow, accompanied by functional and structural changes in the uterus. The hormonal system produces fewer sex hormones, which is why the endometrium stops maturing and new cells are no longer formed. This leads to a decrease in the volume and size of the reproductive organ. This is confirmed by the smaller size of the uterus on ultrasound.
Thus, in the first 5 years from the onset of menopause, according to experts, the volume of the female uterus becomes 35% smaller. At the same time, its dimensions in length and width decrease by 1–2 cm. The reduction in the size of the reproductive organ stops 20–25 years after the onset of menopause (at 70–80 years). By this time, the organ is only 3–4 cm long.
Uterine diseases - list
Uterine diseases in women can occur at any age. However, according to the observations of doctors, hormonal changes in the body are often the trigger for their development. This confirms the high frequency of development of pathologies of the reproductive system during puberty, after childbirth and during menopause. Most pathologies of the uterus are inflammatory and infectious processes in the reproductive organ. Among the common diseases of this organ are:
- Inflammatory processes: metritis, adnexitis.
- Pathologies of the uterine cervix: ectopia, dysplasia, cervical cancer.
- Acute conditions associated with the uterus: ovarian apoplexy, spontaneous abortion.
- Tumor-like processes: myoma, fibroma.
Congenital pathologies of the uterus
Diseases of the uterus that occur at the stage of embryonic development of the reproductive system and the formation of the genital organs are called congenital. Among the common pathologies of this kind, the following should be noted:
- Bicornuate uterus - formed as a result of non-fusion of parts of the Müllerian canals. There are different types of pathology:
- – a case when only the bottom of the organ is divided.
- A uterus with an incomplete or complete septum - the shape does not change externally, but a septum appears in the cavity, partially or completely separating it.
- Separate body with a common neck - formed by the fusion of the Müllerian ducts in the neck area.
- Duplication of the uterus - not only the body of the uterus is divided, but also the cervix.
Infectious diseases of the uterus
Infectious female diseases of the uterus are the most common type of pathology of this organ. They can arise due to banal non-compliance with the rules of intimate hygiene. Often the spread of an infectious agent occurs through sexual contact, so women of reproductive age are more often exposed to diseases. Pathology is almost always accompanied by changes in microflora, so additional symptoms appear that make it possible to identify the disorder (itching, burning in the perineal area, hyperemia). Common infections in women include:
- candidiasis;
- chlamydia;
- ureaplasmosis;
- papilloma virus.
Oncological diseases of the uterus
Women's diseases of the uterus, accompanied by tumor-like processes, are separate from all pathologies of the reproductive system. In most cases, the provoking factor for their development is chronic inflammatory and infectious processes, hormonal imbalances. The difficulty in diagnosing these pathologies lies in the lack of obvious clinical picture, sluggish, hidden flow. Often a tumor is discovered during a random examination. Among the possible tumor-like diseases of the uterus, it is necessary to highlight:
- fibroma;
- polycystic disease
Prolapse of the female uterus
With age, the female genital organs and the uterus may change their location. Often in older women, uterine prolapse is recorded, caused by a violation of the ligamentous apparatus and age-related changes. In most cases, the organ moves downwards, towards the vagina. The disease is accompanied by specific symptoms:
- feeling of pressure;
- discomfort in the groin area;
- pain in the lower abdomen;
- urination disorder (frequent urination, urinary incontinence).
The danger of the pathology lies in the possibility of complications by prolapse of the uterus from the vagina. This situation requires emergency medical care, so you should consult a doctor when the first symptoms appear. Treatment consists of surgical restoration of the integrity of the ligamentous apparatus of the pelvic floor and suturing of the vaginal muscles.
A woman’s uterus is an organ designed by evolution for bearing and giving birth to a child. What does a woman's uterus look like? The shape is similar to a pear or has the appearance of a truncated cone, hollow inside, and is an organ of the reproductive system. The place where the uterus is located is the central part of the female pelvic cavity, reliably protected by the pelvic bone frame, muscles, and fatty tissue for complete and reliable protection during pregnancy. The structure of a woman’s uterus is so well thought out that it is difficult to find a more protected organ.
Topography
Where is a woman's uterus located? It is located inside the pelvic cavity behind the bladder and in front of the rectum. In the place where a woman’s uterus is located, sheets of peritoneum cover its front wall up to the cervix, and the back including the cervix, which helps to divide the space into separate anatomical zones. Along the edges, two peritoneal layers unite and participate in the formation of ligaments. Topographically stands out:
- The anterior surface is the part of the organ located in front of the bladder. In front of it there is a vesical tissue space filled with fatty tissue, in which lymph nodes and lymphatic ducts are located.
- The posterior surface is located anterior to the rectum. Between it and the intestine, a retrouterine space is formed, filled with fiber with lymphatic collectors.
- Right and left ribs of the uterus.
The adipose tissue surrounding on all sides - parametric tissue - is the place where feeding arterial vessels, veins pass, and lymph nodes and ducts can be located.
The volume of the female uterus is about 4.5 cubic centimeters, the average size is 7x4x3.5 cm. What a woman’s uterus can look like, its shape, size, volume depends on how many births the woman has had. The organ parameters of women who have given birth and women who have not given birth differ. The uterus of a woman who has given birth weighs almost twice as much as that of a nulliparous woman. On average, the weight ranges from 50 to 70 g. In order to show how the main physiological function of this small organ is carried out, let us consider the main structural features.
Anatomical structure
The anatomy of the uterus is determined by the main physiological function of the organ. Different parts of the organ are supplied with blood differently, lymph flows into different collectors, which is important to consider during surgical interventions on the organ. This plays a key role in determining treatment tactics for pathological processes. Anatomically, there are three areas:
- The body of the uterus is the largest part by volume and forms the uterine cavity. The section has a triangular truncated shape.
- The fundus is an anatomical part of the organ that forms an elevation above the place where the fallopian tubes open.
- The cervix is a cylindrical, up to three centimeters long, hollow tube that connects the body to the vagina.
Body
The body of the uterus is the most voluminous anatomical part of the organ; it accounts for approximately two-thirds of the total volume. It is here that the implantation of a fertilized egg, the formation of the placenta, and the growth and development of the child occur. It has the shape of a truncated cone, with the base facing upward, forming a physiological bend.
In the upper part of the body, on the right and left edges, the fallopian tubes flow into its lumen, through which the egg from the ovary enters the organ cavity.
Bottom
The uppermost part of the organ. If you mentally connect the points where the fallopian tubes open with a straight line passing through the body of the uterus, then the dome-shaped overhang of a part of the body forms the bottom. It is by the height of the bottom that the gestational age is determined.
Neck
Topographically, the place where the cervix is located in front and behind is surrounded by cellular spaces: in front - vesical, in back - rectal. The cervix is covered with a sheet of peritoneum only along its posterior surface. The structure of the cervix is determined by the physiological functions performed. This is a hollow tube that connects the uterine cavity to the vagina. It accounts for a third of the length of the entire organ. The neck has different structural parts:
- Isthmus. This is a small area of physiological narrowing in the lower part of the uterine body, the place of transition to the cervical part.
- The vaginal section of the cervical part directly faces the inside of the vagina and communicates with it through an opening - the external os. The vaginal part is clearly visible during a gynecological examination.
- The supravaginal area is the part of the cervix facing the uterine cavity.
- The cervical canal connects the vagina through the os to the uterine cavity.
The identification of various anatomical areas in a small part of the organ, which is the cervical part, is due to the peculiarities of its structure.
The structure of the walls of the organ
The structure of the uterine wall has clearly defined three layers:
- External serous - it is formed by a layer of peritoneum lining the organ on the outside - the perimeter.
- The middle muscle, representing several layers of muscle tissue - the myometrium.
- The internal, lining organ from the inside, which is a mucous membrane, is the endometrium.
The layers of the uterus have some differences depending on the functional purpose of its individual parts.
Perimeter shell
Covers the body from the outside, is a layer of peritoneum lining all the organs of the abdominal cavity. The perimetry is a continuation of the serous membrane of the bladder, continuing and covering the uterine surface.
Muscularis
The middle membrane, represented by muscle fibers, has a rather complex structure. Its thickness varies in different parts of the organ. In the fundus area, the muscular lining of the uterus is thickest. This is due to the need for the muscle to contract and expel the fetus during labor. The severity of the muscle layer of the fundus area is also different in the pregnant and non-pregnant uterus, reaching a thickness of four centimeters at the time of birth.
The fibers of muscle tissue have a three-dimensional direction, are tightly intertwined with each other, forming a fairly reliable frame, between the components of which elastin and connective tissue fibers are located.
The size and volume of the uterus changes over time due to changes in the thickness and size of the fibers of the muscle layer. This process is influenced by many factors, but the changing level of sex hormones at different periods of a woman’s life is of primary importance. Significantly increasing during pregnancy and childbirth, the uterus contracts again, acquiring its previous size, 6–8 weeks after the birth of the child.
Only thanks to such a complex structure of the myometrium is it possible to maintain pregnancy, pregnancy and childbirth.
Inner lining of the uterus
The endometrium is represented by a cylindrical epithelium with a large number of glands and is two-layered:
- Superficially located functional layer.
- The basal layer, located under the functional one.
The surface layer of the endometrium is represented by a glandular cylindrical epithelium containing a large number of glands; receptors for sex hormones are located on the surface of its cells. Capable of changing in thickness at different periods of a woman’s reproductive cycle under the influence of changing hormonal levels. It is this layer of epithelial cover that is rejected during menstrual bleeding, and implantation of a fertilized egg occurs into it.
The basal layer is a thin layer of connective tissue, tightly connected to the muscle layer, participating in the formation of a single, functionally coherent mechanism.
Features of the internal structure of the neck
The internal structure of this small part of the uterus has its own differences, due to the functional loads performed:
- The cervix is covered with an outer serous membrane only at the back.
- It has a thin, not very pronounced layer of smooth muscle fibers and a sufficient amount of collagen. This structure contributes to changes in the size of the canal during childbirth. Cervical dilatation during labor reaches 12 cm.
- A large number of mucous glands produce a secretion that closes the lumen of the canal, which helps to perform a barrier and protective function.
- The inner epithelial layer of the canal is represented by columnar epithelium, the area of the outer pharynx is covered with stratified squamous epithelium. Between these parts of the cervix there is a so-called transition zone. Pathological changes in the structure of the epithelial cover of this area often occur and lead to the occurrence of dysplasia and cancer. Particular close attention to this area during an examination by a gynecologist is absolutely recommended.
Functions
The functions of the uterus in a woman’s body are difficult to overestimate. Being a barrier to infection, it is involved in the direct regulation of hormonal conditions. The key purpose is to perform the reproductive function. Without it, the process of implantation, gestation and birth of a child is impossible. The birth of a new person, an increase in population size, and ensuring the transfer of genetic material are possible only thanks to a woman and the coordinated work of the organs of her reproductive system.
That is why the problems of preserving women’s health in all countries of the world are not only of purely medical, but also social significance.
Not every woman understands exactly where the organs of her reproductive system are located. Therefore, when pain occurs, representatives of the fair sex often cannot understand what is bothering them. Many of them do not know where the uterus is. But this is one of the most important organs of a woman, performing many functions. Let's look at this issue in more detail.
Structure and physiological changes of the uterus
The pelvic cavity is where the uterus is located. It is located in the lower part of the abdominal region. What does the uterus look like? Normally, it looks like an inverted pear. This is a cavity organ, the wall of which consists mainly of muscle tissue up to 3 cm thick. In front of it is the bladder. The posterior part is in contact with the anterior surface of the rectum.
The pelvic and uterine axis are in the same plane, which is considered normal. In addition, it may be slightly inconsistent. This is also not a pathology and does not require action.
The location of the uterus is influenced by the ligaments located on the sides and performing the function of holding it in the required position. Pathology is considered to be a strong deviation of the organ from the pelvic axis. It can descend, fall out, be located behind the rectum, or bend.
The weight of the uterus in a nulliparous woman does not exceed 50 grams. After the birth of a child, it increases one and a half to two times, reaching 100 g. In addition, the size of the organ matters. Its length in women who do not have children is approximately 7 cm and its width is 4 cm. During pregnancy, the uterus stretches. After childbirth, it shrinks, but it no longer decreases to its previous size. The longitudinal and transverse dimensions increase by 2-3 cm.
The uterus consists of the fundus, body and cervix. The fundus is the area located above the conventional line passing through the fallopian tubes. The body of the organ in a triangular section starts from the fundus and continues to the uterine constriction.
The cervix is a continuation of the previous part and makes up the entire rest of the uterus. It opens into the vagina and consists of three parts - anterior, posterior and a section located above the vagina. The latter, in women who do not have children, resembles a cut cone, and in those who have given birth, it is cylindrical in shape.
The inside of the neck is covered by a layer of epithelium. The part that is visible in the vaginal cavity is covered with stratified squamous epithelium, which is not prone to keratinization. The remaining segment is lined with glandular epithelial cells.
The place of transition from one type to another is of important clinical significance. Dysplasia often occurs in this area, which, if left untreated, can turn into a cancerous tumor.
The frontal section of the organ is similar to a triangle. Its acute angle is directed downwards. A fallopian tube opens into the uterus on each side. The base of the triangle passes into the cervical canal, preventing the release of mucus produced by the glandular epithelium. This secretion has antiseptic properties and kills bacteria heading into the abdominal cavity. The cervical canal has two openings. One protrudes into the uterus, the second into the vaginal cavity.
The cervical canal is round or resembles a transverse slit. The place where the body meets the neck is called the isthmus. Here, a woman's uterus often ruptures during the birthing process.
The uterine wall has three layers: the outer layer is the serous membrane, the middle layer is the muscle fibers that form the basis of the organ, and the inner layer is the mucous membrane. In addition, the parametrium is distinguished - this is fatty tissue that is located in front and on the side of the uterus, in the space between the sheets of the largest ligament. It contains vessels that provide nutrition to the organ.
Contractility is influenced by sex hormones. It is the muscle layer that ensures the birth of a child. The internal pharynx and isthmus also play a certain role in this process.
The mucous layer (endometrium) is covered with epithelial cells. It is smooth and divided into two sublayers. The surface sublayer has a variable thickness. Before menstruation, it is rejected, which is accompanied by bleeding.
The surface layer is also important for gestation. The fertilized egg is attached to it. The basal sublayer is like the base of the mucous layer. Its function is to ensure the restoration of the surface epithelium. It contains tubular glands that reach the muscle fibers.
The serosa is the outer covering layer of a woman's uterus. It lines the muscles of the bottom and body outside. On the sides it passes to other organs.
It forms a vesicouterine cavity near the bladder. The connection with it is carried out through fiber. At the back, the peritoneum passes onto the vagina and rectum, forming the rectouterine cavity. It is closed by serous folds, which consist of connective tissue cells. They also contain some smooth muscle fibers.
Functions of the uterus and deviations in its structure
The main function of a woman's uterus is the ability to bear a fetus. It is provided by the muscles of the middle layer. It contains smooth muscle fibers that intertwine with each other. This structure allows the muscles to stretch during pregnancy as the fetus grows. In this case, there is no violation of tone.
The female uterus and the ligaments surrounding it are supplied by the uterine and ovarian arteries. The outflow is carried out by the venous uterine plexus, which is located in the broad ligament. From it, blood flows into the ovarian, uterine and internal sacral veins.
During gestation, these vessels can expand significantly, allowing the absorption of placental blood. Lymph flows into the external iliac and inguinal nodes. Innervation is carried out by many nerves.
In addition to ensuring implantation and fetal development, a healthy uterus performs the following functions:
- protects other organs of the pelvic cavity from infection through the vagina;
- provides menstrual function;
- participates in sexual intercourse, creating conditions for fertilization of the egg;
- strengthens the pelvic floor.
Along with the normal (pear-shaped) uterus, there are also abnormal types. These include:
A unicornuate uterus occurs in every tenth woman with a developmental anomaly. It is formed as a result of slowing down the growth of the Müllerian ducts on one side. Half of patients with this diagnosis cannot have children. They also experience pain during intimacy.
A bicornuate uterus develops due to incomplete fusion of the Müllerian ducts. Often it is bilobed. In rare cases, two cervixes are observed. The vagina sometimes has a septum. In appearance, such a uterus resembles a heart.
The saddle shape is quite common. In this case, a saddle-shaped depression is formed in the bottom. This abnormal structure often does not cause any symptoms. May appear during pregnancy. Sometimes patients with a saddle uterus bear a child without problems. But there are also miscarriages or premature birth.
A double uterus usually does not cause much trouble. The presence of two vaginas can be observed at the same time. Fetal development is possible in both uteruses.
A uterus whose length does not exceed 8 cm is considered small. At the same time, the proportions of the body and cervix, as well as all functions of the uterus, are preserved.
The infantile uterus is 3-5 cm long. The relationship between the body and the cervix is incorrect, the latter is elongated. The rudimentary uterus is the remains of an organ that in most cases does not perform its function.
The uterus is one of the main organs of the female body. In its cavity, fertilization and development of the unborn child occurs. Thanks to this, she actually ensures continuation of the family.
The length of the uterus in an adult woman is on average 7-8 cm, width - 4 cm, thickness - 2-3 cm. The weight of the uterus in nulliparous women ranges from 40 to 50 g, and in those who have given birth reaches 80-90 g. The volume of the uterine cavity is 4-6 cm.
The uterus as an organ is largely mobile and, depending on the condition of neighboring organs, can occupy different positions. Normally, the longitudinal axis of the uterus is oriented along the axis of the pelvis. Most of the surface of the uterus is covered by the peritoneum, with the exception of the vaginal part of the cervix. The uterus is pear-shaped and flattened in the anteroposterior direction.
Anatomy
Parts of the uterus
Parts of the uterus
The uterus consists of the following parts:
- Fundus of the uterus- This is the upper convex part of the uterus, protruding above the line where the fallopian tubes enter the uterus.
- Body of the uterus- The middle (larger) part of the organ has a cone-shaped shape.
- Cervix- The lower narrowed rounded part of the uterus.
Functions
The uterus is the organ in which embryo development and gestation occur. Due to the high elasticity of the walls, the uterus can increase in volume several times during pregnancy. Being an organ with developed muscles, the uterus actively participates in the expulsion of the fetus during childbirth.
Pathologies
Developmental anomalies
- Aplasia (agenesis) of the uterus- extremely rarely, the uterus may be completely absent. There may be a small infantile uterus, usually with a pronounced anterior incursion.
- Duplication of the uterine body- a defect in the development of the uterus, which is characterized by doubling of the uterus or its body, which occurs due to the incomplete fusion of two Müllerian ducts at the stage of early embryonic development. As a result, a woman with a double uterus may have one or two cervixes and one vagina. With complete nonfusion of these ducts, two uteruses with two cervixes and two vaginas develop.
- Intrauterine septum- incomplete fusion of the embryonic rudiments of the uterus in various variants, can lead to the presence of a septum in the uterus - a “bicornuate” uterus with a clearly visible sagittal depression at the bottom or a “saddle-shaped” uterus without a septum in the cavity, but with a notch at the bottom. With a bicornuate uterus, one of the horns may be very small, rudimentary, and sometimes unlaced.
Diseases
- Prolapse and prolapse of the uterus- Prolapse of the uterus or a change in its position in the pelvic cavity and its displacement down the inguinal canal is called complete or partial uterine prolapse. In rare cases, the uterus slips directly into the vagina. In mild cases of uterine prolapse, the cervix protrudes forward at the bottom of the genital opening. In some cases, the cervix prolapses into the genital slit, and in especially severe cases the entire uterus prolapses. Uterine prolapse is described based on how much of the uterus protrudes. Patients often complain of the sensation of a foreign body in the genital fissure. Treatment can be either conservative or surgical, depending on the specific case.
- Uterine fibroids- Benign tumor that develops in the muscular lining of the uterus. Consists mainly of elements of muscle tissue, and partly of connective tissue, also called fibromyoma.
- Uterine polyps- Pathological proliferation of the glandular epithelium, endometrium or endocervix against the background of a chronic inflammatory process. Hormonal disorders play a role in the genesis of polyps, especially uterine ones.
- Uterine cancer- Malignant neoplasms in the uterine area.
- Cancer of the uterus- Uterine cancer refers to endometrial cancer (the lining of the uterus) that spreads to the walls of the uterus.
- Cervical cancer- a malignant tumor, localized in the cervix area.
- Endometritis- Inflammation of the uterine mucosa. In this case, the disease affects the functional and basal layers of the uterine mucosa. When it is accompanied by inflammation of the muscular layer of the uterus, they speak of endomyometritis.
- Cervical erosion- This is a defect in the epithelial lining of the vaginal part of the cervix. There are true and false erosions of the cervix:
- True erosion- refers to acute inflammatory diseases of the female genital organs and is a frequent companion to cervicitis and vaginitis. It usually occurs against the background of general inflammation in the cervix, caused by sexually transmitted infections or conditionally pathogenic vaginal flora, under the influence of mechanical factors, malnutrition of the cervical tissue, menstrual cycle disorders, and hormonal imbalance.
- Ectopia (pseudo-erosion)- there is a common misconception that ectopia is the body’s response to the appearance of erosion, since the body is trying to replace a defect in the mucous membrane of the vaginal (outer) part of the cervix with columnar epithelium lining the uterine (inner) part of the cervical canal. Often this confusion arises due to the outdated point of view of some doctors. In fact, ectopia is an independent disease that has little to do with true erosion. The following types of pseudo-erosions are distinguished:
- Congenital ectopia- in which the columnar epithelium can be located outside the external os of the cervix in newborns or move there during puberty.
- Acquired ectopia- cervical ruptures during abortion lead to deformation of the cervical canal, resulting in post-traumatic ectopia of the columnar epithelium (ectopion). Often (but not always) accompanied by an inflammatory process.
Diagnostics
Operations
- Abortion(not to be confused with the term “spontaneous abortion”, meaning “miscarriage”) - an operation aimed at terminating a pregnancy, performed in its first 12 weeks in a hospital setting at the request of the woman. It is a mechanical destruction of the embryo with further curettage of the uterine cavity. There are clinical (in a hospital setting) and criminal abortions. Any abortion can lead to serious complications. Criminal abortion can cause a woman's death.
- Vacuum aspiration or the so-called “mini-abortion” - an intervention aimed at terminating a pregnancy beyond early- from twenty to twenty-five days of absence of expected menstruation. Refers to minimally invasive operations and can be performed on an outpatient basis.
- C-section(Latin caesarea “royal” and sectio “incision”) - carrying out childbirth using abdominal surgery, in which the newborn is removed not through the natural birth canal, but through an incision in the abdominal wall of the uterus. Previously, a caesarean section was performed only for medical reasons, but now, increasingly, the operation is performed at the request of the woman in labor.
- Hysterectomy- (Greek hystera uterus + Greek ectome ectomy, removal; possibly spelled hysterectomy; another common name is hysterectomy) - a gynecological operation in which a woman’s uterus is removed.
Links
- BSE.sci-lib.com. - The meaning of the word “Uterus” in the Great Soviet Encyclopedia. Retrieved September 2, 2008.
The internal female genital organs include: ovary, fallopian tube, uterus and vagina.
A) UTERUS(uterus, metra, hyster)
The uterus is an unpaired, hollow, pear-shaped muscular organ.
Functions of the uterus:
Bearing a fetus;
Expulsion of the fetus during delivery.
The uterus is located in the pelvic cavity between the rectum and bladder.
In this position it is fixed by ligaments: wide, round, pubic-cervical and rectal-uterine, sacral-uterine.
The length of the uterus in an adult woman is 7-8 cm, width – 4 cm, thickness – 2-3 cm.
The weight of the uterus in nulliparous women ranges from 40 to 50 g, and in women who have given birth reaches 80-90 g.
During pregnancy, the uterus rises from the pelvic cavity into the abdominal cavity and
at 9 months it reaches the costal arches and the xiphoid process of the sternum. Towards the end of pregnancy, the uterus drops somewhat.
During pregnancy, the uterus enlarges, takes on an ovoid shape, its weight increases 20 times and by the end of pregnancy reaches up to 1 kg.
After childbirth, the uterus quickly decreases in size and descends to the navel; on the 10th day it is at the level of the pubic symphysis.
Surfaces of the uterus:
Front surface – cystic , facing the bladder;
Back surface – intestinal , facing the rectum.
There is a space between the posterior surface of the uterus and the rectum - douglas pocket (utero-rectal cavity). With perforation of the uterine wall, with ectopic pregnancy, trauma, or peritonitis, blood, pus, and serous fluid can accumulate in this place, which leads to the development of inflammatory processes in the abdominal cavity and in the pelvic cavity.
Uterine edges(lateral)
Parts of the uterus:
1. DBut– this is the upper thickened convex part of the uterus, rising in the form of a vault above the openings of the fallopian tubes and forming angles with them - uterine horns.
2. Tate- This is the middle section of the uterus.
3. ShEika– this is the lower narrowed part of the uterus, it makes up 1/3 of the length of the uterus and consists of 2 parts.
Parts of the cervix:
- supravaginal part - the upper part of the cervix, makes up 2/3 of the cervix;
- vaginal part (stigma of the uterus) - lower part of the cervix.
The place where the body of the uterus passes into the cervix is narrowed and is called isthmus uterus .
Position of the uterus in the pelvis
The uterus has significant mobility and, depending on the condition of neighboring organs, can occupy different positions.
Normally, the fundus of the uterus is directed forward - the uterus is tilted anteriorly.
This position of the uterus is called anterior tilt - anteversio , in this case, the body of the uterus forms an angle with the cervix, open anteriorly - the anterior bend of the uterus - anteflexio .
Uterine cavity
The uterine cavity in the frontal section has the shape of a triangle, with its apex facing downwards and passing into the narrow canal of the cervix.
In the corners of the base of the triangle, the fallopian tubes open - oviducts.
The apex of the triangle faces down and passes into the cervical canal - cervical canal .
The cervical canal at the top opens into the uterine cavity through the internal opening of the uterus - this is internal os of the uterus.
Below, the cervical canal opens into the vagina through the external opening of the uterus– outer os of the uterus , this opening of the uterus is limited by the lips: front and back(more subtle).
In a nulliparous woman, the external opening of the uterus (external os of the uterus) is round, and in a woman who has given birth, it has the shape of a transverse slit.
Uterine wall
The wall of the uterus is thick and consists of 3 membranes.
The lining of the uterine wall:
1.C lysoid membrane (endometrium) - this is the inner membrane lining the uterus from the inside, covered with a single-layer cylindrical ciliated (ciliated) epithelium.
The mucous membrane has many uterine glands.
The endometrium has 2 layers:
The basal layer is the lower one, lies at the base;
The functional layer is the top (surface). It is rejected during menstruation.
2. Mmuscle layer (myometrium ) - this is the middle lining of the uterus, consists of 3 layers of smooth muscle - external and internal longitudinal, middle - circular (circular).
The thick muscular lining of the uterus ensures the expulsion of the fetus during delivery.
3.C erosa (perimetry) - this is the outer shell of the uterus, formed by the peritoneum, which covers the uterus from above, in front and behind (except for the lateral edges and part of the cervix in front).
On the sides of the uterus, the anterior and posterior layers of the peritoneum join and form the broad ligament of the uterus.
Around the cervix under the peritoneum there is an accumulation of fatty connective tissue - parametrium (peri-uterine fiber)
Inflammatory processes in the uterus: endometritis, myometritis, perimetritis, parametritis.
b) FALLOPY TUBES(tubae uterinae, salpinx)
Inflammation of the fallopian tubes is called salpingitis.
The fallopian tubes (fallopian tubes, oviducts) are paired cylindrical organs, 10 - 12 cm long and 2 - 4 mm in diameter.
The fallopian tubes are located in the pelvic cavity on both sides of the uterine fundus, at the upper edge of the broad ligament of the uterus.
The fallopian tubes start from the corners of the uterus, at first they are located at right angles to the uterus, almost horizontally, then, having reached the wall of the pelvis, they are located in an arc around the lateral side of the ovary, forming a bend, and end at the medial surface of the ovary.
The narrow end of the fallopian tube opens into the uterine cavity, and the widened end opens into the peritoneal cavity next to the ovary. Thus, in women, the peritoneal cavity communicates with the external environment through the lumen of the fallopian tubes, the uterine cavity and the vagina.
The causative agents of sexually transmitted infections and other microorganisms in the female reproductive system spread upward - through the vagina into the uterus, then into the fallopian tubes and ovaries. This can lead to inflammatory processes in the female genital organs and infertility.
Functions of the fallopian tubes:
Carrying the egg from the ovary into the uterine cavity (that’s why they are also called oviducts);
The fallopian tubes are the site of fertilization of the egg by sperm.
Fallopian tube openings:
Abdominal opening (d 2 mm) – connects it with the abdominal cavity;
Uterine opening (d 1 mm) – connects it with the uterine cavity.
Parts of the fallopian tube:
1. B funnel – this is the part of the fallopian tube facing the abdominal cavity, has an abdominal opening surrounded by a large number of fimbriae (fimbriae), one of which is ovarian fimbria (fimbria ovarica) attaches to the ovary (the egg moves along it into the fallopian tube).
2. A mpula - this is the longest and widest part of the fallopian tube, next to the funnel, which accounts for almost half of its entire length (d 3 - 5 mm), and has a curved shape.
3. Isthmus (isthmic part - from isthmus - isthmus) - this is the medial narrowest part of the fallopian tube (d 1.6–1.8 mm), located medial from the ampulla, approaching the angle of the uterus between its fundus and body.
4. Uterine part (interstitial - intramural) - This is a part of the fallopian tube, enclosed in the thickness of the wall of the uterus and opening into its cavity through the uterine opening of the tube.
Layers of the fallopian tube wall:
1. Mucous membrane - this is the inner membrane lining the tube from the inside, covered with a single-layer prismatic (cylindrical) ciliated epithelium, the cilia of which flicker towards the uterus.
The mucous membrane forms numerous branching folds, more developed in the infundibulum and ampulla, where they fill their entire lumen.
Some of the cells of the mucous membrane are devoid of cilia - secretory cells, they produce nutrients for the egg and sperm.
After an abortion, endometritis (postpartum or infectious), adhesions may form on the mucous membrane of the fallopian tubes and uterus, which lead to infertility and ectopic pregnancy, because the egg cannot penetrate the uterine cavity.
2. M muscle membrane - this is the middle lining of the fallopian tube, it thickens in the direction from the ampulla to the uterus, consists of 2 layers of smooth muscle - thick internal circular and thin external longitudinal
3. C erosa - This is the outer shell of the fallopian tube, formed by the peritoneum, which covers the fallopian tubes and the uterus from above and from the sides, forming the broad ligament of the uterus.
The anterior and posterior leaves of the broad ligament of the uterus, connecting under the fallopian tube, form the mesentery of the fallopian tube - mesosalpinx.
V) VAGINA(vagina)
Inflammation of the vagina is called vaginitis.
The vagina is an extensible tube 8-10 cm long, flattened in the anterior-posterior direction, which with its upper wide end covers the cervix, and with its lower end, penetrating through the genitourinary diaphragm of the pelvis, opens into the vestibule hole vagina.
This hole is closed for virgins virgin hymen, separating the vestibule from the vagina. The hymen separates the external and internal female genitalia.
The hymen is a semilunar or perforated plate, which is a double fold of the mucous membrane, which is torn during the first sexual intercourse, and its remains atrophy.
Ahead the vagina contains the bladder and urethra, behind- the rectum with which it fuses.
The vagina secretes front And back wall, touching each other.
The vaginal cavity is slit-like.
The walls of the vagina, covering the vaginal part of the cervix, form around it a dome-shaped depression called vaginal vault.
The vaginal vault is divided into an anterior, posterior and two lateral (right and left) fornix.
The posterior vault of the vagina is the deepest, and material is taken from it for examination for gynecological smears. In gynecological smears, there are 4 degrees of vaginal cleanliness.
The vaginal wall consists of three shells :
1) C lysosa- this is the inner lining that covers the vagina from the inside, lined with stratified squamous non-keratinizing epithelium, forms numerous transverse vaginal folds. The vaginal mucosa does not have glands.
Cytological smears of the vaginal mucosa make it possible to examine the condition of the epithelium, which depends on hormonal levels and the phases of the menstrual cycle.
The cells of the surface layer of the epithelium are rich in glycogen, which, under the influence of enzymatic processes, breaks down to form lactic acid. This gives the vaginal mucus an acidic reaction, which is bactericidal against pathogenic microbes.
2) Muscularis– this is the middle shell, consists of 2 layers of smooth muscle - the inner circular and outer longitudinal. At the top, the fibers of the muscular membrane of the vagina pass into the muscles of the uterus, at the bottom they are woven into the skeletal muscles of the perineum.
The striated skeletal muscles of the perineum around the opening of the vagina and urethra form an arbitrary urethro-vaginal sphincter.
3) Adventitia– this is the outer lining of the vagina, consists of loose fibrous connective tissue, equipped with elastic and muscle fibers, contains a venous plexus and nerves.
There is also an accumulation of connective fatty tissue around the vagina - paravaginal tissue.
G) OVARY(ovarium, oophorum)
The ovary is a paired female sex gland of mixed secretion, weighing 5-8 g. The ovary has an ovoid shape, somewhat flattened in the anteroposterior direction.
Near the ovaries there are rudimentary formations - epididymis.
Functions of the ovary:
Exocrine (exocrine) – production of female germ cells – eggs.
Endocrine (intrasecretory) - the production of female sex hormones - estrogens and the hormone of the corpus luteum of the ovary - progesterone.
Inflammation of the ovaries is called oophoritis .
The ovary is located vertically on the side walls of the pelvis, on both sides of the uterus, under the fallopian tubes.
Fixed own And suspensory ligaments ovary. The peritoneum forms the mesentery of the ovary, through which the organ is attached to broad ligament of the uterus.