Lymph Vessels of the Uterus

The lymph vessels of the uterus (Figure 29: c, d) drain to the lumbar aortic lymph nodes (Figure 29: 2, 3), the medial iliac lymph nodes (Figure 29: 1), the hypogastric lymph nodes (Figure 29: 4), and the lateral sacral lymph nodes (Figure 29: 7). From the cranial half of the uterine horn, lymph vessels drain to 1 to 2 lumbar aortic lymph nodes, with a preference for the lymph nodes that are located on the renal artery and vein (Figure 29: 2, 3), as well as to the medial iliac lymph node (Figure 29: 1).

Lymph vessels of the caudal half of the uterine horn drain to the medial iliac lymph node (Figure 29: 1) and to the hypogastric lymph nodes (Figure 29: 4), and those from the uterine body drain to the hypogastric lymph nodes, and into the lateral sacral lymph node (Figure 29: 7), if one is present.

The lymph vessels of the uterus form rich, coarsely meshed networks under the serosa and adjacent to the uterus in the uterine broad ligaments. The lymph vessels emerging from these networks usually initially run in the broad ligament of the uterus, proximate and parallel to the uterus and uterine horn. They then curve quite sharply away from the uterus and uterine horn and run in the broad ligament of the uterus to drain to the lymph nodes mentioned above.

Macroscopically, I have not been able to make any definite conclusions about the relationship between the lymph vessels of the individual layers of the uterine wall (mucous membrane, muscular layer) (see Baum [6], page 155). Occasionally, one of the lymph vessels may curve from one surface of the uterus and uterine horn towards the opposite surface (Figure 29: 8), travelling around the side opposite to the insertion of the broad ligament.