The correlation between retroverted/flexed uterus and endometriosis

Genital / Reproductive system female, MR, Imaging sequences, Epidemiology, Obstetrics Authors: G. Failla, P. V. Foti, A. Licciardello, M. Iraci, R. Farina, C. Ini', E. David, S. Palmucci, A. Basile DOI: 10.26044/ecr2025/C-13292 Learning objectives Endometriosis is a chronic gynecological disease characterized by the presence of endometrial tissue outside the uterus, causing pelvic pain and infertility [1]. Lesions can appear in various locations, most commonly affecting the ovaries, followed by the posterior broad ligament, the anterior cul-de-sac, the posterior cul-de-sac and the uterosacral ligament [2]. The clinical manifestation of the disease varies among women and can be unpredictable in both its presentation and duration. The disease in females typically manifests with symptoms such as dyspareunia (painful sexual intercourse), pelvic pain...

All the women with a diagnosis of endometriosis (105 patients) were retrospectively selected between June 2018 and May 2024, using pelvic magnetic resonance imaging (MRI). Currently, MRI is considered the best imaging technique for mapping endometriosis, since it provides a more reliable map of deep infiltrating endometriosis than physical examination and transvaginal ultrasound (TVUS) [9]. We also retrospectively selected 120 patients, extracted from our database, who had the finding of retroverted uterus on MRI report, examined in a time period from June 2018 to May... Findings and procedure details The prevalence of retroverted uterus in patients with endometriosis was 36%. This value is derived from the ratio of patients belonging to the first group of women with a retroverted-flexed uterus, or rather those with a diagnosis or strong clinical suspicion of endometriosis (38 patients) and the total number of women with endometriosis (105 patients). Women with a retroverted/retroflexed uterus were a total of 97 patients, because 23 patients (19,17%) were discarded from the study, due to menopause in 56.52% and for technical examination reasons...

In clinical practice, a retroverted uterus should not be dismissed as a mere anatomical variation but instead be seen as a potential indicator for further investigation, particularly in patients with unexplained pelvic pain or infertility. The incidental finding of a retroverted uterus should serve as a warning sign of endometriosis and lead to the earliest possible diagnosis.This can prevent the development of advanced clinical conditions that would inevitably require non-conservative and radical treatments, therefore impacting both the woman's fertility and her overall quality of life,... Personal information and conflict of interest G. Failla: Author: Author P. V. Foti: Nothing to disclose A. Licciardello: Nothing to disclose M. Iraci: Nothing to disclose R. Farina: Nothing to disclose C. Ini: Nothing to disclose E. David: Nothing to disclose S. Palmucci: Nothing to disclose A. Basile: Nothing to disclose

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