Mesometrium

The mesometrium is the largest portion of the broad ligament of the uterus, a reflective fold of peritoneum that helps attach the uterus to the pelvic walls and floor. It extends from the lateral border of the uterine body toward the side walls of the pelvis and forms the main peritoneal support for the uterus. The mesometrium is continuous with the other components of the broad ligament, the mesovarium and the mesosalpinx, near the uterine cornua.

In its course, the mesometrium encloses connective tissue, blood vessels, lymphatics, and nerves that supply the uterus. The uterine arteries and veins traverse the broad ligament within this region, making the mesometrium a key anatomic site during pelvic surgery. The round ligament of the uterus also travels within the broader tissue of the mesometrium as it courses toward the inguinal region.

Clinical relevance includes its involvement in procedures such as hysterectomy, where the uterine vessels are ligated within the broad ligament. Knowledge of the mesometrium and its relationships helps minimize injury to adjacent structures, including the ureter and pelvic autonomic nerves, during surgery. The mesometrium can also be a pathway for the spread of certain pelvic diseases, such as endometriosis, that involve the broad ligament.

See also: broad ligament, mesovarium, mesosalpinx, uterine vessels, pelvic floor ligaments.