In retroflexion the cervix of the uterus continues to point downwards,
into the pelvic cavity, in almost the same direction as in the natural
position, while the body is directed backwards, or backwards and
downwards. We seldom, if ever, find this condition as a congenital
affection, but as an acquired displacement it is undoubtedly more
frequently met with in gynecological practice than all other
displacements combined. The round ligaments of the uterus were at one
time, and are even yet by some, supposed to be the means that retain
the womb in its normal anteflected position. Upon this theory a new
surgical operation sprung into prominence for the relief of this class
of cases. It was reasoned, that if the round ligaments actually tied
the uterus down, and retained it in its natural anteflected position,
that to shorten these ligaments by opening the inguinal canal in the
groin, and drawing them out, would remedy a displacement of the womb,
whether a prolapsus or a retroflexion. This operation was performed,
it was claimed successfully, and if the view that the round ligaments
retain and support the uterus were a correct one, it must be admitted
that the operation would have been _ideal_. I convinced myself,
however, of the utter fallacy of this position, in dissections on the
cadaver, where in several instances the round ligaments could not be
reached without opening the abdominal cavity, and even then it was
impossible to trace them. These views were expressed in an article
in the _American Journal of Obstetrics and Diseases of Women and
Children_, and as the operation fell shortly afterwards into merited
disrepute, I partly claim the credit of having been instrumental in
bringing that about. I said:
“That this ligament has nothing to do in fixing the uterus in its
normal anteverted position, is proven from many facts which occur in
daily practice. The insertion or origin, whichever one chooses to call
it, of these cords at the groin, is somewhat irregular and sometimes
so rudimentary that it cannot be found upon a most careful and tedious
dissection. It may be found divided into a number of processes, one
being connected with Poupart’s ligament in the inguinal canal, the
other being lost in the labia majora, and another may be traced to the
sheath of the rectus muscle.