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Uterus female reproductive system :Position linea ligaments

The uterus is in the middle of the pelvic cavity in frontal plane (due to ligamentum latum uteri). The fundus does not surpass the linea terminalis, while the vaginal part of the cervix does not extend below interspinal line. The uterus is mobile and moves under the pressure of the full bladder or full rectum anteriorly, whereas if both are full it moves upwards. Increased intraabdominal pressure pushes it downwards. The mobility is conferred to it by musculo-fibrous apparatus that consists of suspensory and sustentacular part. Under normal circumstances the suspensory part keeps the uterus in anteflexion and anteversion (in 90% of women) and keeps it "floating" in the pelvis. The meaning of these terms are described below:
Distinction                         More common                   Less common
Position tipped           "Anteverted": Tipped forward     "Retroverted": Tipped backwards
Position of fundus     "Anteflexed": Fundus is pointing forward relative to the cervix     "Retroflexed": Fundus is pointing backwards


Sustentacular part supports the pelvic organs and comprises the larger pelvic diaphragm in the back and the smaller urogenital diaphragm in the front.

The pathological changes of the position of the uterus are:

    retroversion/retroflexion, if it is fixed
    hyperanteflexion - tipped too forward; most commonly congenital, but may be caused by tumors
    anteposition, retroposition, lateroposition - the whole uterus is moved; caused by parametritis or tumors elevation, descensus, prolaps  rotation (the whole uterus rotates around its longitudinal axis), torsion (only the body of the uterus rotates around) inversion

In cases where the uterus is "tipped", also known as retroverted uterus, women may have symptoms of pain during sexual intercourse, pelvic pain during menstruation, minor incontinence, urinary tract infections, difficulty conceiving, and difficulty using tampons. A pelvic examination by a doctor can determine if a uterus is tipped.

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