A retroverted uterus is a uterus that is tilted backwards instead of forwards. Most women have a slightly anteverted uterus that is tipped forward toward the bladder. Some women have a vertical uterus where the fundus (top of the uterus) is straight up. One in three to five women (depending on the source) has a retroverted uterus, which is tipped backwards towards the spine. A retroverted uterus is commonly referred to as a tilted uterus or a tipped uterus and is also medically referred to as a retroflexed uterus.

Causes

In most cases, a retroverted uterus is congenital, but some cases are caused by pelvic surgery, pelvic adhesions, endometriosis, fibroids, pelvic inflammatory disease, or the labor of childbirth.

Diagnosis

A retroverted uterus is usually diagnosed during a routine pelvic examination. It usually does not pose any medical problems, though it can be associated with dyspareunia (pain during sexual intercourse) and dysmenorrhea (pain during menstruation).

Fertility & Pregnancy

Uterin position has no effect on fertility. A tipped uterus will usually right itself during the 10th and 12th week of pregnancy.

If a uterus does not right itself, it may be labeled persistent. "Persistent retroflexion of the pregnant uterus is incompatible with advanced pregnancy. If spontaneous or artificial reposistion does not occur, the patient either aborts or develops symptoms caused by incarceration of the uterus before the end of the fourth month. In exceptional instances, however, pregnancy may proceed, resulting in uterine sacculation. Spontaneous delivery is impossible, and rupture of the uterus may occur." (Gant NF. Cunningham FG. Basic Gynecology and Obstetrics, 1995, p 375 - chapter 48)

Treatment

Treatment options are rarely needed, and include exercises, a pessary, manual repostioning, and surgery.