Retroversion of the uterus

Alternative names
Uterus retroversion; Malposition of the uterus; Tipped uterus

Definition
Retroversion of the uterus is a normal variation of female pelvic anatomy in which the body of the uterus is tipped toward the back rather than forward.

Causes, incidence, and risk factors

Retroversion of the uterus is common and is found to be the normal uterine position in about 20% of all women. Laxness of the supporting pelvic ligaments associated with menopause may cause retroversion in women who previously did not have a retroverted uterus.

Enlargement of the uterus, either as the result of a pregnancy or a tumor, may also change the relative position of the uterus within the pelvis. Pelvic adhesions (scar tissue that forms in the pelvis) resulting from salpingitis, pelvic inflammatory disease, or endometriosis have also been associated with holding the uterus in a retroflexed position.

Symptoms

     
  • Uterine retroversion by itself almost never causes any symptoms.  
  • Rarely, retroversion of the uterus caused by an enlarging pregnancy or tumor may cause pelvic pain or discomfort.  
  • Retroversion of the uterus resulting from other causes such as endometriosis may be associated with the symptoms of the underlying disorder.

Signs and tests

A pelvic examination reveals the position of the uterus. However, a tipped uterus can sometimes be mistaken for a pelvic mass or an enlarging fibroid. A rectovaginal exam may be used to distinguish between a mass and a retroverted uterus.

An ultrasound examination can be used to determine the exact position of the uterus, if necessary.

Treatment

Treatment is usually not necessary. Any underlying disorders (such as endometriosis or adhesions) may be treated as needed.

Expectations (prognosis)

Usually this condition does not cause problems.

Complications

Atypical positioning of the uterus may be caused by endometriosis, salpingitis, or pressure from a growing tumor. These conditions should be ruled out in a patient with pain or other symptoms.

Calling your health care provider

Call your health care provider if you develop persistent pelvic pain or discomfort.

Prevention

There is no known prevention. However, early treatment of PID or endometriosis may reduce the chances of a change in the position of the uterus.

Johns Hopkins patient information

Last revised: December 4, 2012
by Amalia K. Gagarina, M.S., R.D.

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