Retroversion of the uterus

• Alternative Names

  Uterus retroversion; Malposition of the uterus; Tipped uterus

• Causes, incidence, and risk factors

  Retroversion of the uterus is common. It is the normal uterine position in about 20% of all women.

  Weakening pelvic ligaments associated with menopause may cause this condition 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 lead to retroversion.

  Scar tissue in the pelvix (pelvic adhesions) can also hold the uterus in a retroflexed position. Such scarring may result from:

  • Endometriosis
  • Pelvic inflammatory disease
  • Salpingitis
• Symptoms

  Retroversion of the uterus almost never causes any symptoms.

  Rarely, it may cause pain or discomfort.

• 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.

• References

  Lentz GM. Differential diagnosis of major gynecologic problems by age group: vaginal bleeding, pelvic pain, pelvic mass. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 8.

Review Date: 10/28/2008

Reviewed By: Linda Vorvick, MD, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington ; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.