Pneumatised uncinate process was seen in 1 patient (1.16%) while
retroverted uncinate was present in 2 patients (2.32%) in our study while it was reported to be 2% and 16% respectively, by Gouripur K et al.
The risk factors predisposing transmigration of intrauterine device include: inadequacy of clinician's skills, history of abortion,
retroverted uterine axis, insertion in puerperium period and congenital uterine anomalies 7.
The mother-of-three has a
retroverted uterus, meaning it is tilted, increasing the risk of side effects for women who have contraceptive devices inserted.
Hereditary factors, hormonal influence, pelvic surgery,
retroverted uterus, history of varicose veins, and multiple pregnancies are considered as the risk factors.
These new findings supported spontaneous resolution of a
retroverted incarcerated uterus.
Intraoperative exploration showed a slightly enlarged
retroverted uterus with a wide fundus and a normal right fallopian tube.
A
retroverted uterus was identified in five patients of which one patient in addition demonstrated rotation of the
retroverted uterus with bilateral patent tubes (Figures 2A and 2B) while on HSG it appeared as a unicornuate uterus.
The uterine angle deviation, in relation to the longitudinal axis of the body, changes from a particularly
retroverted position to a more anteverted one.
Plain radiography and computed tomography (CT scan) showed L5 spina bifida occulta, bilateral L5 pars defect, dysplastic L5S1 facets, trapezoidal L5 vertebral body,
retroverted sacrum with rounding of proximal endplate, and complete anterior descent of the L5 vertebrae to the sacrum (Figures 2(a)-2(d)).
Caption: Figure 1: Endoscopic appearance before and after resection (
retroverted view).
Physical exam findings include tenderness or nodules in the cul-de-sac or uterosacral ligaments, pain with uterine movement, enlarged adnexal masses, or fixation of adnexa or uterus in a
retroverted position.