La retroversión uterina, útero ladeado o útero invertido es una condición de la anatomía pélvica femenina en la que la posición del útero se encuentra alterada y su orientación apunta hacia la espalda en lugar de hacia adelante.
Se trata de una variante anatómica normal que padece una de cada cinco mujeres aproximadamente (20-25%), según la Sociedad Española de Ginecología y Obstetricia (SEGO), pudiendo su útero acomodarse en varias posiciones y moverse con el paso del tiempo. De hecho, muchas mujeres pueden tener el útero inclinado y ni siquiera darse cuenta”, afirma la doctora Shree Datta, ginecóloga y obstetra, colaboradora de Intimina.
Por lo tanto, hablamos de una condición bastante común, aunque no sea muy conocida entre las mujeres, y que no presenta ninguna manifestación clínica. Un examen pélvico es suficiente para determinar la posición del útero, bien a través del tacto bimanual o exploración vaginal, o simplemente con una ecografía.
Por qué aparece
Puede constituir una alteración congénita o adquirida, o bien surgir durante el embarazo para volver después a su posición habitual, generalmente después del tercer trimestre. También suele aparecer durante el postparto, fruto de la distensión de los ligamentos del suelo pélvico o debido al agrandamiento del útero propio del embarazo. En otras ocasiones puede ser una condición ligada a la menopausia o producirse a consecuencia de algunas enfermedades previas como la endometriosis.
Aunque suele ser asintomático, en algunos casos provoca:
- Dolor en las relaciones sexuales debido al choque del pene con el cuello uterino.
- Reglas más dolorosas o síntomas menstruales más intensos.
- Estreñimiento crónico o dolor al evacuar por la presión del útero sobre el recto.
- Incontinencia urinaria o retención de líquidos por la interferencia del útero con la vejiga.
¿Puedo quedarme embarazada si tengo útero invertido?
Es la duda más frecuente en la consulta farmacéutica y la respuesta es sí, con total normalidad. No es una enfermedad ni una malformación que impida la concepción. Es fundamental entender que el útero invertido no es una enfermedad, sino una variante anatómica bastante común, que afecta a entre el 20% y el 25% de las mujeres. Aunque en el pasado se consideraba una anomalía menor, la ginecología moderna lo trata como una característica física (como ser zurdo) que, en la inmensa mayoría de los casos, no interfiere con la salud reproductiva.
Desde el punto de vista de la fertilidad, los espermatozoides tienen la misma capacidad para alcanzar el óvulo, independientemente de la inclinación del útero. Por lo tanto, no afecta a la capacidad reproductiva ni aumenta el riesgo de aborto. Durante el primer trimestre de embarazo, el útero suele expandirse y situarse en una posición central de forma espontánea. Pero no siempre ocurre así y si la presión del útero sobre las paredes de la pelvis puede provocar dolores intensos y dificultades en la micción, en estos casos puede realizarse una recolocación manual.
Solo en casos muy específicos, donde la posición invertida es consecuencia de patologías como la endometriosis o enfermedades inflamatorias pélvicas, podría haber una relación con la dificultad para concebir.
Útero invertido
¿Necesita tratamiento?
Se considera que el hecho de tener un útero en retroversión no implica ninguna anomalía especialmente importante, por lo que no se ha descrito tratamiento o protocolo para ello. Si existen reglas dolorosas o molestias durante las relaciones sexuales el especialista puede iniciar un tratamiento para reducir los síntomas, aunque es posible que puedan deberse a múltiples factores que poco o nada tienen que ver con la posición del útero.
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