{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T08:03:06Z","timestamp":1789545786741,"version":"build-2803163510"},"reference-count":25,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2013,12,3]],"date-time":"2013-12-03T00:00:00Z","timestamp":1386028800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2014,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the impact of ultrasound\u2010estimated uterus position on the intensity of pelvic pain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Descriptive analytical study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary university gynecology unit.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>181 consecutive patients with pelvic pain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Each woman underwent physical examination, transvaginal sonography and filled self\u2010administered questionnaires on pain using a 10\u2010cm visual analog scale (<jats:styled-content style=\"fixed-case\">VAS<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Visual analog scale score of menstrual pain, intermenstrual pain and dyspareunia was related to uterine version (ante\u2010 or retroversion) and the angle of uterine flexion (actual angle between cervix and uterine body) evaluated by transvaginal sonography.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Estimated uterine version was not associated with the intensity of any type of pain. The estimated angle of flexion was higher in retroverted than in anteverted uteri (182.3\u00b0\u00a0\u00b1\u00a050.3\u00b0 vs. 142.3\u00b0\u00a0\u00b1\u00a024.2\u00b0, <jats:italic>p\u00a0<\/jats:italic>&lt;\u00a00.0001). Intensity of menstrual pain was lowest with flexion between 150\u00b0 and 210\u00b0 (4.9\u00a0\u00b1\u00a03.1) (<jats:italic>p\u00a0<\/jats:italic>=\u00a00.002), intermediate with flexion &lt;150\u00b0 (6.3\u00a0\u00b1\u00a02.8) and highest with flexion \u2265210\u00b0 (7.9\u00a0\u00b1\u00a02.3). Severe menstrual pain was more prevalent with flexion \u2265210\u00b0 (77.7%) than between 150\u00b0 and 210\u00b0 (31.4%; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.0008) or &lt;150\u00b0 (45.2%; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.005). The intensity of intermenstrual pain and dyspareunia were not associated with the angle of flexion. In multiple regression analysis, the angle of flexion was independently related only to the intensity of menstrual pain (<jats:italic>r<\/jats:italic>\u00a0=\u00a00.272; <jats:italic>p\u00a0<\/jats:italic>=\u00a00.002).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In women with pelvic pain, ultrasound\u2010estimated uterine flexion represents an independent risk for intense menstrual pain.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.12266","type":"journal-article","created":{"date-parts":[[2013,10,12]],"date-time":"2013-10-12T02:33:01Z","timestamp":1381545181000},"page":"58-63","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Intensity of menstrual pain and estimated angle of uterine flexion"],"prefix":"10.1111","volume":"93","author":[{"given":"Angelo","family":"Cagnacci","sequence":"first","affiliation":[{"name":"Obstetrics and Gynecology Unit Department of Obstetrics Gynecology and Pediatrics University Hospital of Modena Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Grandi","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Unit Department of Obstetrics Gynecology and Pediatrics University Hospital of Modena Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianna","family":"Cannoletta","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Unit Department of Obstetrics Gynecology and Pediatrics University Hospital of Modena Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anjeza","family":"Xholli","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Unit Department of Obstetrics Gynecology and Pediatrics University Hospital of Modena Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Piacenti","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Unit Department of Obstetrics Gynecology and Pediatrics University Hospital of Modena Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annibale","family":"Volpe","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Unit Department of Obstetrics Gynecology and Pediatrics University Hospital of Modena Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,12,3]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"285","volume-title":"Fundamentals of obstetrics and gynecology","author":"Llewellyn\u2010Jones DE","year":"1994"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-005-0051-0"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.2007.00745.x"},{"key":"e_1_2_8_5_1","first-page":"81","article-title":"Magnetic resonance imaging of uterine version in a multiethnic, nulliparous, healthy female population","volume":"50","author":"Rizk DE","year":"2005","journal-title":"J Reprod Med"},{"key":"e_1_2_8_6_1","first-page":"955","article-title":"Transvaginal ultrasonography","volume":"30","author":"Freimanis MG","year":"1992","journal-title":"Radiol Clin North Am"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.1095.1010-a"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.3851.760"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2005.11.026"},{"key":"e_1_2_8_10_1","first-page":"757","article-title":"Laparoscopic uterine suspension as an adjunctive procedure at the time of laser laparoscopy for the treatment of endometriosis","volume":"37","author":"Ivey JL","year":"1992","journal-title":"J Reprod Med"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016349609054674"},{"key":"e_1_2_8_12_1","first-page":"361","article-title":"Laparoscopic retroperitoneal hysteropexy: a randomized trial","volume":"43","author":"Ostrzenski A","year":"1998","journal-title":"J Reprod Med"},{"key":"e_1_2_8_13_1","first-page":"417","article-title":"Carter\u2010Thomason uterine suspension and positioning by ligament investment, fixation and truncation","volume":"44","author":"Carter JE","year":"1999","journal-title":"J Reprod Med"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1074-3804(05)60373-8"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1074-3804(00)80046-8"},{"key":"e_1_2_8_16_1","first-page":"211","article-title":"Laparoscopic uterine suspension by round ligament placation","volume":"47","author":"Ou CS","year":"2002","journal-title":"J Reprod Med"},{"key":"e_1_2_8_17_1","first-page":"878","article-title":"Laparoscopic uterine suspension","volume":"47","author":"Carter JE","year":"2002","journal-title":"J Reprod Med"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1159\/000072077"},{"key":"e_1_2_8_19_1","first-page":"567","article-title":"Laparoscopic uterine suspension for pain relief: a multicenter study","volume":"50","author":"Perry CP","year":"2005","journal-title":"J Reprod Med"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2010.07.015"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2010.08.693"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S30602"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(77)90464-1"},{"key":"e_1_2_8_24_1","volume-title":"Statistical Methods in Medical Research","author":"Armitage P","year":"1994"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2008.09.005"},{"key":"e_1_2_8_26_1","first-page":"514","article-title":"What significance has uterine retroversion?","volume":"48","author":"Shute E","year":"1943","journal-title":"Can Med Assoc J"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Faogs.12266","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.12266","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T20:39:42Z","timestamp":1695501582000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/aogs.12266"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,12,3]]},"references-count":25,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2014,1]]}},"alternative-id":["10.1111\/aogs.12266"],"URL":"https:\/\/doi.org\/10.1111\/aogs.12266","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,12,3]]},"assertion":[{"value":"2013-07-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-09-20","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-12-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}