Retroverted, retroflected or retroversoflexed uterus

Under normal conditions, the uterus assumes an antiflex and anti-ventrum position in the pelvic cavity that receives it. However, women in whom the uterus takes an inverted, retroflexed or retroversoflex position are not uncommon.

To clarify the meaning of these purely medical terms and evaluate their repercussions on women's fertility, it is first of all necessary to clarify some basic concepts.

Uterus

From the macroscopic point of view, the uterus is didactically divided into at least two regions, which have different structures, functions and diseases:

• body of the uterus : upper portion, more expanded and voluminous

• cervix or uterine cervix : lower portion, more curved and smaller, which continues inferiorly with the vagina

in addition to these regions, they also identify:

• isthmus of uterus: narrowing that divides body and cervix
• bottom or base of the uterus: portion of the uterine cavity located above the imaginary line that connects the two fallopian tubes, facing towards the front

Flexion and version

As anticipated, in normal conditions, the uterus assumes an antiflex and anti-ventrum position in the pelvic cavity that receives it. To understand these concepts it is necessary to observe laterally the uterus of an adult woman

• flexion : angle that is established between the axis of the body of the uterus and the axis of the cervix → anti-flexion: the angle between these two axes is opened forward, towards the pubic symphysis. As shown in the figure, normally the uterus is in anti-flexion of about 120-140 ° → retroflexion: the angle between these two axes is open backwards (facing the rectum)

• version : angle established between vagina and cervix → anteversion: in normal conditions the angle between these two axes is about 90 ° → retroversion: the angle between these two axes is> 90 °
  • first degree: angle> 90 ° and <180 °
  • second degree: around 180 ° retroversion: uterus and vagina are on the same axis
  • third degree: angle> 180 °

By simplifying the concepts to the maximum, we can therefore talk about:

• retroflected uterus: instead of towards the abdomen, the uterus is inclined towards the back
• backward uterus: the angle between the cervix and the vagina is greater than 90 degrees

Changes in the position of the uterus are important for fertility disorders; for example, a retroverted uterus can give painful symptoms during sexual intercourse and can have a certain importance when this is the result of inflammatory events and is blocked in this position (over the years it can favor the appearance of constipation and hemorrhoids ).

Looking at the figure, it is easy to see how, by increasing the abdominal pressure (eg with a cough), a retroflected and retroventous uterus of degree two (180 °) tends to go down more easily into the vagina, creating the prerequisite for prolapse uterus.

In general, the position of the uterus does not, in itself, have important repercussions on the fertility of the woman, since the uterus is a very flexible organ, it changes and changes shape and position with the growth of the fetus. Rarely, the compressive effect of the gravidic uterus retracted on the bladder neck can give rise to urinary retention.

Retrospective Uterus - Causes and Symptoms