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Title: [Variability of the course of the uterine artery and its branches within the broad ligament and vascularization of uterine walls depending on a woman's age in light of anatomical, radiologic and microangiographic studies].
Author: Pilarczyk K.
Journal: Ann Acad Med Stetin; 1995; 41():43-55. PubMed ID: 8615552.
Abstract:
The aim of the study was to perform uterus measurements in order to demonstrate variability of size, shape and proportions of each part of uterus. Topography, shape and dimensions of the uterine artery and its organic branches were also analyzed. The main part of the study was to analyze the arterial system in the walls of the human uterus. The study has been performed in order to find correlation between anatomic variety and age, and obstetric history of the investigated females. Internal genital organs taken at autopsy from 105 female cadavers (only unchanged pathologically) aged from 3 to 85, underwent evaluation (Table 1). Material consisted of 8 non menstruating girls, 30 nulliparas (20 premenopausal and 10 postmenopausal) and 67 multiparas (32 and 35, respectively). During postmortem examination topography of the origin sites of the uterine artery originating from the internal iliac artery, its diameters and its position towards ureter have been estimated. External measurements of the uterus have been performed. After excision of the uterus, uterine arteries have been injected with radiologic contrast medium. Radiography of the uterus has been taken using roentgenographic apparatus for structural research, and then arrangement of the uterine arteries in myometrium and their organic branches have been assessed. Uteri have been sectioned horizontally, and finally enlarged radiographs of each layer have been taken to estimate the arrangement of vessels at different levels of the myometrium. Fractionation itself made accurate measurements of the walls of the uterus possible at different levels. It has been stated that shape and size of the uterus changed considerably during the whole individual's life. Changes occurred not only within time, but they were connected with motherhood as well. Variability of the external dimensions of the uterus was always closely connected with variability of the uterus wall's thickness at different levels. Angiographic studies revealed that uterine arteries were present in every case, on both sides, regardless of the age and obstetric history. Topographic investigations proved that the vessels always crossed the ureter superficially on both sides. Considering each of the three segments of the uterine artery, it was stated that the length of the descending part of the vessel varied only within age, while the transverse and ascending parts were elongated within age and also after pregnancies. The number of the uterine artery branches running towards the body and cervix of the uterus was significantly variable and depended not only on age, but on pregnancies as well. Radiographic analysis revealed that connections between uterine vessels on both sides of the same uterus were not constant. Their absence was associated with the presence of the hypovascular, or even avascular zone in the medial part of the fundus and body of the uterus. This situation was evident at any age, regardless of the obstetric history. Artery of the fundus uteri, which had been previously described in many studies, was a rarely existing vessel. In the investigated material no azygos uterine artery has been found. Microangiographic studies (Fig. 1-4) revealed that angioarchitectonics of blood vessels in consecutive layers of the wall of the human uterus at different levels was variable to a great degree. It has been stated that situation depended not only on age, but also on past pregnancies.

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