Uccella et al reported a classification for large uteri. The type of large uterus correlates with surgical outcomes. The authors are from multiple institutions in Italy and the Cleveland Clinic.

Patient selection: uterine weight >= 1,000 grams



(1) adnexal arterial blood supply (via infundibulopelvic ligament and/or utero-ovarian ligament)

(2) distortion of other uterine arteries by asymmetry of the uterine corpus


Adnexal Arterial Blood Supply

Uterine Arteries


cephalad aspect remain at or below normal level

not distorted

Type 1

cephalad aspect displaced above normal level

not distorted

Type 2

cephalad aspect displaced above normal

course distorted by asymmetrical uterine pathology

Type 3



• The level of the fallopian tube is essentially unchanged in type 1, but it has a more cephalad position in types 2 and 3.


Type 1 large uterus was associated with better outcomes (shorter operative time, less blood loss, fewer complications, shorter length of stay) than type 2 or Type 3.

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