Abstract
During the anatomical dissection of the pelvis, a duplication of the uterine artery was identified unilaterally on the left side in a 59-year-old Korean female cadaver. The first uterine artery was found to arise directly from the anterior division of the internal iliac artery and supply the upper uterine body and tube. The second uterine artery shared a common stem with the superior and inferior vesical arteries, supplying the lower uterine body. The external diameter of each uterine artery at its origin on the left side was smaller than that of the right uterine artery. One vaginal artery was identified to arise from the left internal pudendal artery. Embryologically, a duplicated uterine artery could imply the presence of two primordial arteries separately supplying the cranial and caudal parts of the Müllerian duct during the early fetal period. This case of variational anatomy is noteworthy: clinicians could elucidate it and successfully perform uterine artery embolization or hysterectomy with minimal complications.
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References
Albulescu D, Constantin C, Constantin C (2014) Uterine artery emerging variants—angiographic aspects. Curr Health Sci J 40:214–216. https://doi.org/10.12865/chsj.40.03.11
Ambekar A, Vogelzang RL (2001) Aberrant uterine artery as a cause of uterine artery embolization treatment failure. Int J Gynaecol Obstet 74:59–60. https://doi.org/10.1016/s0020-7292(00)00376-3
Arfi A, Arfi-Rouche J, Barrau V, Nyangoh Timoh K, Touboul C (2018) Three-dimensional computed tomography angiography reconstruction of the origin of the uterine artery and its clinical significance. Surg Radiol Anat 40:85–90. https://doi.org/10.1007/s00276-017-1941-9
Barth MM, Spies JB (2003) Ovarian artery embolization supplementing uterine embolization for leiomyomata. J Vasc Interv Radiol 14:1177–1182. https://doi.org/10.1097/01.rvi.0000085772.71254.cf
Braf ZF, Koontz WW Jr (1977) Gangrene of bladder. Complication of hypogastric artery embolization. Urology 9:670–671. https://doi.org/10.1016/0090-4295(77)90319-3
Chantalat E, Merigot O, Chaynes P, Lauwers F, Delchier MC, Rimailho J (2014) Radiological anatomical study of the origin of the uterine artery. Surg Radiol Anat 36:1093–1099. https://doi.org/10.1007/s00276-013-1207-0
Gomez-Jorge J, Keyoung A, Levy EB, Spies JB (2003) Uterine artery anatomy relevant to uterine leiomyomata embolization. Cardiovasc Intervent Radiol 26:522–527. https://doi.org/10.1007/s00270-003-2652-7
Jagielski G, Bruska M, Woźniak W (1997) Origin of the uterine artery in human fetuses. Folia Morphol (Warsz) 56:117–121
Lee KH, Park TC, Park JS (2008) Duplicated uterine arteries in laparoscopic hysterectomy. J Minim Invasive Gynecol 15:3. https://doi.org/10.1016/j.jmig.2007.05.006
Liapis K, Tasis N, Tsouknidas I et al (2020) Anatomic variations of the uterine artery. Review of the literature and their clinical significance. Turk J Obstet Gynecol 17:58–62. https://doi.org/10.4274/tjod.galenos.2020.33427
Maclaran KA, Edmonds DK, Tait P (2009) Absence of uterine arteries discovered at fibroid embolisation. Br J Radiol 82:e228–e230. https://doi.org/10.1259/bjr/15564157
Naguib NN, Nour-Eldin NE, Hammerstingl RM et al (2008) Three-dimensional reconstructed contrast-enhanced MR angiography for internal iliac artery branch visualization before uterine artery embolization. J Vasc Interv Radiol 19:1569–1575. https://doi.org/10.1016/j.jvir.2008.08.012
Pelage JP, Le Dref O, Soyer P et al (1999) Arterial anatomy of the female genital tract: variations and relevance to transcatheter embolization of the uterus. AJR Am J Roentgenol 172:989–994. https://doi.org/10.2214/ajr.172.4.10587133
Roberts WH, Krishingner GL (1967) Comparative study of human internal iliac artery based on Adachi classification. Anat Rec 158:191–196. https://doi.org/10.1002/ar.1091580208
Roman H, Zanati J, Friederich L, Resch B, Lena E, Marpeau L (2008) Laparoscopic hysterectomy of large uteri with uterine artery coagulation at its origin. JSLS 12:25–29
Rott G, Boecker F (2016) The extremely rare vascular variant of a segmental duplicated uterine artery and its relevance for the interventionist and gynecologist: a case report. J Med Case Rep 10:162. https://doi.org/10.1186/s13256-016-0943-2
Saraiya PV, Chang TC, Pelage JP, Spies JB (2002) Uterine artery replacement by the round ligament artery: an anatomic variant discovered during uterine artery embolization for leiomyomata. J Vasc Interv Radiol 13:939–941. https://doi.org/10.1016/s1051-0443(07)61779-5
Song JY, Hwang SJ, Kim MJ et al (2010) Comparison of selective uterine artery double ligation at the isthmic level of uterus and bipolar uterine artery coagulation in total laparoscopic hysterectomy. Minim Invasive Ther Allied Technol 19:224–230. https://doi.org/10.3109/13645706.2010.497012
Standring S (2016) Gray’s anatomy: the anatomical basis of clinical practice. Elsevier, Saint Louis, Missouri
Uflacker A, Sopata CE, Haskal ZJ (2017) Inferior epigastric uterine artery. J Vasc Interv Radiol 28:23. https://doi.org/10.1016/j.jvir.2016.04.035
Worthington-Kirsch RL (2000) Anatomy of the uterine artery. AJR Am J Roentgenol 174:258. https://doi.org/10.2214/ajr.174.1.1740258
Acknowledgements
This work was supported by the Soonchunhyang University Research Fund (Grant No.20220448). The authors sincerely thank Sojin Moon for drawing illustrations and those who donated their bodies to science so that anatomical research could be performed. Results from such research can potentially increase mankind’s overall knowledge that can then improve patient care. Therefore, these donors and their families deserve our highest gratitude.
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This study was funded by the Soonchunhyang University Research Fund (No.20220448).
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HK contributed to the conception, dissection, data collection, drafting of the manuscript, and review, editing, and approval of the final manuscript.
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Kim, H. Anatomic variation of a duplicated uterine artery. Anat Sci Int 99, 221–224 (2024). https://doi.org/10.1007/s12565-023-00752-4
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DOI: https://doi.org/10.1007/s12565-023-00752-4