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Uterine veins !

The uterine veins form a network along the sides of the uterus that drains its blood into the internal iliac veins.

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What it is

A network of veins beside the uterus that drains into the internal iliac veins.

What it does

Drain the uterus; tied together with the artery in a hysterectomy.

Key facts

Drains
Uterus via the uterine venous plexus in the broad ligament (connects with the vaginal and ovarian plexuses)
Into
Internal iliac vein

Relations

Course
From the plexus beside the uterus and cervix they run laterally through the base of the broad ligament and the cardinal ligament, close to the ureters, to the internal iliac vein
Medial
Lateral border of the uterus and the cervix
Lateral
Pelvic side wall and the internal iliac vessels
Above
Ovarian venous plexus near the uterine tube, with which it communicates
Below
Vaginal venous plexus, continuous with it around the cervix

How to find it

Transvaginal Doppler shows them as tubular channels with slow flow beside the uterus. In surgery they are clamped together with the uterine artery at the base of the broad ligament.

On imaging

Colour Doppler shows them in the parametrium as channels with slow venous flow. Dilated, tortuous veins here and in the ovarian veins, with reflux, suggest pelvic venous congestion; CT or MR venography and catheter venography confirm it. After a birth, contrast CT can show thrombus in these veins and in the ovarian vein in a woman with persistent fever.

Common problems

  • Bleeding after birth when the uterus does not contract.
  • Feeds fibroids.

How it is diagnosed

Doppler ultrasound; angiography before an embolisation.

Treatment

  • Clamped and tied in a hysterectomy, away from the ureter.
  • Blocked from inside (uterine artery embolisation) to shrink fibroids or stop bleeding.

Clinical notes

  • In nerve-sparing radical hysterectomy the deep uterine vein is a landmark: the pelvic splanchnic nerves run just below it in the parametrium
  • Pelvic venous congestion: dilated, refluxing veins beside the uterus, often fed by an incompetent ovarian vein, are linked to chronic pelvic pain
  • After birth or pelvic surgery, infection can spread to the uterine and ovarian veins as septic pelvic thrombophlebitis
  • During caesarean section, a lower-segment incision that tears sideways can reach the uterine vessels at the edge of the uterus and cause heavy bleeding; the ureter lies close by when these vessels are sutured

Test yourself

Think of the answer, then tap the question to see it.

Where do the uterine veins drain, and with which plexuses do they connect?

Into the internal iliac vein; the plexus connects with the vaginal, ovarian and vesical plexuses.

Why is the deep uterine vein a landmark in nerve-sparing radical hysterectomy?

The pelvic splanchnic nerves run just below it in the parametrium.

What is pelvic venous congestion?

Dilated, refluxing veins beside the uterus, often fed by an incompetent ovarian vein, linked to chronic pelvic pain.

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Educational information, not medical advice. For any symptom, see a health professional.

Its names

Official Latin (TA2)
venae uterinae; plexus venosus uterinus TA2 5046
Official Spanish (DeCS)
Venas uterinas
English (TA2)
Uterine veins

Sources: Terminologia Anatomica (TA2); Anatomy, Abdomen and Pelvis: Female Pelvic Cavity; Anatomy, Abdomen and Pelvis: Uterine Arteries.

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Representative model, for educational purposes only.

Uterine veins highlighted on the Durgical 3D model