The perimetrium is the outer covering of the uterus, a layer of peritoneum with a thin supporting connective tissue. It covers the fundus and body and continues sideways as the broad ligament. In front it reflects onto the bladder and behind it continues down to the vagina and onto the rectum.
| Location | Outer serous surface of the uterine fundus and body |
|---|---|
| Parts |
|
| Nerve Supply | Uterovaginal plexus (from the inferior hypogastric plexus); Sympathetic fibres T10-L1 (pain from the uterine body); Pelvic splanchnic nerves S2-S4 (parasympathetic, pain from the cervix) |
| Blood Supply | Uterine artery; Ovarian artery (anastomosing branches) |
| Venous drainage |
|
| Lymphatic drainage |
|
Provides a smooth outer surface that allows the uterus to move against neighbouring organs.
The peritoneal reflections of the perimetrium create the vesicouterine pouch in front and the rectouterine pouch (of Douglas) behind, the lowest point of the female peritoneal cavity where blood or pus collects. Endometriosis often implants on this surface. Spread of infection or cancer across it reaches the peritoneal cavity.
Endometriosis deposits on the uterine serosa and nearby peritoneum, causing pain and adhesions.
Scar bands between the uterus and nearby organs after infection or surgery, causing pain and infertility.
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