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OB Images

Photos of the Uterus

The uterus, sometimes called the womb, is a muscular organ located at the very top of the vagina. The cervix, which is really the bottom part of the uterus, connects the vagina and the uterus. During pregnancy the baby grows within the lining of the uterus. The uterus grows from it's normal size of a pear to the size of a watermelon during pregnancy. When labor starts, contractions within the uterine muscle fibers help the cervix dilate and the baby deliver. When not pregnant, the uterus goes through a monthly menstrual cycle that depends on hormones coming from the ovaries. These hormones mostly affect the lining of the uterus. The lining swells during the first few weeks of the cycle, then slowly dies off during the last few weeks. This causes the lining to "slough off" which creates menstrual flow. Since this lining is sensitive to hormones, any abnormality of these hormones can cause irregular bleeding. Furthermore, common, non-cancerous, tumors called fibroids can grow within the muscular layer of the uterus and cause symptoms like pain, pressure, heavy and irregular bleeding, and constipation. For a more thorough discussion of fibroids, please click here. Other conditions, like endometrial polyps (tiny growths within the lining of the uterus), pre-cancer, and even uterine cancer can cause heavy and abnromal bleeding.

Doctors evaluating abnormal bleeding or an enlarged uterus may perform a number of tests. These might include ultrasound, where sound waves are used to look at the uterus, hysteroscopy, where a lighted tube is inserted into the uterus to look at the uterine lining, or laparoscopy, where a lighted tube is inserted through the belly button (with the patient under anesthesia) to look at the uterus from the inside.

Click on the hyperlink below to view the larger JPG images

Normal Uterus as Seen by Laparoscopy
This laparoscopic photo shows a normal sized uterus as seen through a laparoscopy during surgery. The bladder is located above the uterus. The uterus in this photo is normal size, which is about that of a pear. The view is through a laparoscope, which is inserted into the belly button. Thus, we are looking towards the feet. Note the small (normal sized) left ovary at the bottom, left of the photo. Also note the yellow loop of intestine at the very bottom of the photo.

The Uterus and Uterine Cavity as Seen With Ultrasound
This is a photo taken during a saline infusion vaginal ultrasound (also called sonohysterography). It's a little dark, but you can see the tip of the probe at the top of the photo, which is in the vagina. The cervix and body of the uterus go from our right to left. The lining of the uterus and the uterine cavity are clearly visible as the black area in the center of the photo. The tiny, double white line within the cavity is the tip of the catheter used to instill saline. The cavity and lining are both normal. Note the thin lining, which is the whitish rim circling the black cavity. In this patient, the lining is only about a millimeter thick. However, that is all it takes to produce a period every month.

Uterine Fibroids as Seen Through a Laparoscope
This is a photo taken during laparoscopy. The uterus is slighlty larger than normal, and fills the photo. We are looking from the belly button towards the legs. At the lower right of the photo a small (about quarter size) fibroid is seen attached to the outer wall of the uterus. This is a serosal fibroid. It was too small to create any symptoms in this patient, who was undergoing laparoscopy for another problem. Fibroids are extremely common. The majority seem to be without symptoms. This fibroid could be left alone, as it may or may not grow larger. It could also be removed through the laparoscope (which I did), or through a larger cut in the abdomen. Removing the fibroid is called a myomectomy. The formal name of the procedure performed for this patient is "laparoscopic myomectomy."

Massive Uterine Fibroids
This photo was taken during surgery for uterine fibroids. The patient had a lot of discomfort from the enormous fibroids, which were above the level of her belly button, similar to a 6 month pregnancy! She also wanted to get pregnant. You can see my hand at the top of the photo, holding a scalpel. The largest fibroid was larger than a grapefruit, and the smallest was the size of a penny. We removed 30 different fibroids with a procedure called a myomectomy. She became pregnant and delivered a healthy baby about 1 1/2 years later. The baby was delivered by c/section because of the extensive surgery on the uterus necessary to remove all the fibroids.