A normal variation of pelvic anatomy in which the body of the uterus is tipped toward the back rather than forward.

Alternative Names

Uterus retroversion; Malposition of the uterus; Tipped uterus

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. In women near menopause , a laxity of the supporting pelvic ligaments may actually cause retroversion. 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 , endometriosis , have been associated with holding the uterus in a retroflexed position.

Signs and tests

A pelvic examination reveals the position of the uterus. However, this can sometimes be mistaken for a pelvic mass or enlarging fibroid. Because some confusion may exist, a rectovaginal exam should also be included. This helps identify the tipped uterus.

Treatment

Treatment is usually not necessary. In some cases, displacing the uterus from its retroverted position may relieve symptoms of pain, and this can be achieved by placing a pessary in the vagina. Treatment of other underlying disorders (such as endometriosis or adhesions) may be indicated if they are symptomatic.

Expectations (prognosis)

Usually this condition does not cause problems.

Complications

Malposition of the uterus may be caused by endometriosis , salpingitis , or pressure from a growing tumor . These conditions must be ruled out in the symptomatic patient.

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 position change of the uterus.