This presentation of Retro-version of uterus is very interesting topic and easy to understand and learn.

2. Retroversion is the term
used when the long axis of the corpus and
cervix are in line and the whole organ
turns backwards in relation to the long axis
of the birth canal.
Retroflexion signifies a
bending backwards of the corpus on the
cervix at the level of internal OS . The two
conditions are usually present together and
are loosely called RETROVERSION or
RETRODISPLACEMENT.

3. Conventionally, three degree are
described .
 First degree:- The fundus is vertical and
pointing towards the sacral promontory.
 Second Degree:- The fundus lies in the
sacral hollow but not below the internal
OS.
 Third Degree:- The fundus lies below

4.  DEVELOPMENTAL.
 ACQUIRED.
 DEVELOPMENTAL:- Due to
development defect ,there is lack of
tone of the uterine muscles. The
infantile position is retained. This is
often associated with short vagina
with shallow anterior vaginal fornix.

5.  ACQUIRED:-
 PUERPERAL:-The stretched ligaments caused by
child birth fail to keep the uterus in its normal
position.
 PROLAPSE:-Retroversion is usually implicated in
the pathophysiology of prolapse which is
mechanically caused by traction following
cystocele.
 TUMOR:- Fibroid, either in the anterior or posterior
wall produces heaviness of the uterus and hence it
falls behind.
 PELVIC ADHESIONS:- Adhesions either
inflammatory , operative or due to pelvic
endometriosis pull the uterus posterior.

6. INCIDENCE
Retroversion is present in
about 15-20 % of normal
women.

7. 1. Mobile Retroverted Uterus:-
 Symptoms:- Mobile retroverted uterus is quite
common and almost always remains asymptomatic.
 Chronic premenstrual pelvic pain.
 Dyspareunia.
 Infertility.
 Signs:-
 Bimanual Examination Reveals:-
a) The cervix is directed upwards and forwards.
b) The body of the uterus is felt through the posterior
fornix.
 Speculum examinataion reveals
The cervix comes in view much
easily and external os points forwards.
 Rectal examination :- It is help to confirm the
diagnosis.

8. The symptoms are related to the
associated pelvic pathology,
1. Menstrual abnormalitis .
2. Congestive dysmenorrhea .
3. Chronic pelvic pain.

9.  To empty the bladder regularly.
 To increase the tone of the pelvic muscles by
regular exercise.
 To encourage lying in prone position for half
an hour once or twice daily between 2 and 4
weeks postpartum.

10. I. Pessary treatment .
II. Surgical treatment .
1.pessary treatment= pessary is less commonly
used in present day gynecologic practice.
1 ) for pessary test .
2) In subinvolution of uterus.
3) In pregnancy when spontaneous correction to
antiversion fails by 12th week.
usually, Hodge – smith pessary is used .
The pessary acts by streching the uterosacral
ligaments so as to be pull the cervix back
wards .

11. 1. Surgical correction is indicated in case, where the
pessary test is positive indicating that the
symptoms are due to retroversion.
2. Fixed retroverted uterus producing symtoms like
backache or dyspareunia.
The principle of surgical
correction is ventrosuspension of the uterus by
plicating the round ligament of both the sides
extraperitoneally to the under surface of the
anterior rectus sheath, this will pull the uterus
forwards and maintains it permanently in the same
position.