Table of Content
- What is a Retroverted uterus
- Retroverted uterus Symptoms
- Causes of Retroverted uterus
- Treatment of Retroverted Uterus
- Retroverted uterus and Fertility
A retroverted uterus is one of two forms of “Tilted uterus”. A retroverted uterus can also be known as; Tipped uterus, uterine retroversion, and Retroflexed uterus.
In a retroverted uterus, the fundus ( the deepest part of the uterus ) is tipped backward to the cervix in a position that it faces the rectum meaning that the anterior aspect of the uterus is concave
Another form of “Tilted uterus” is the anteverted uterus ( the fundus is pointing backward. the Anterior aspect of the uterus is convex). Research has shown that 3 out of 10 women have a retroverted uterus.
Most women with retroverted uterus experience no symptoms, some are not even aware because there is no discomfort. Nevertheless, they may experience some symptoms such as;
⦁ Urinary tract infections (UTI)
⦁ Pain during menstruation
⦁ Frequent urinary pressure on the bladder
⦁ Pain in the vagina during sexual intercourse
⦁ difficulty in inserting tampon
⦁ less incontinence
Causes of Retroverted Uterus
A retroverted uterus is a normal variation present from birth. There are other factors, however, that can cause the uterus to become retroverted as the person matures such as;
⦁ Genetics: Some persons are born with a retroverted uterus.
⦁ Pregnancy: pregnancy can cause a retroverted uterus due to the stretching and weakening of the ligaments(Bands of connective tissues that hold the uterus) and muscles that support the uterus over 9 months. As a result, the uterus may become tipped following pregnancy and childbirth, Normally the uterus returns to its normal forward position after childbirth, but sometimes it doesn’t.
⦁ Fibroids: these small, non-cancerous lumps can make the uterus susceptible to tipping backward.
⦁ Pelvic Surgery: Pelvic surgery can cause adhesions to form, an adhesion is a band of scar tissue that joins two (usually) separate anatomic surfaces together, when adhesions form it can pull the uterus to a retroverted position.
⦁ Pelvic inflammatory disease (PID): When left untreated, PID can cause scarring, which may lead to adhesion thereby moving the uterus to a retroverted position
⦁ Endometriosis: the endometrium is the lining of the uterus. Endometriosis is the growth of endometrial cells outside the uterus. These cells can cause retroversion by ‘gluing’ the uterus to other pelvic structures.
A retroverted uterus can be easily detected during a routine pelvic exam. A doctor will insert two fingers into the vagina to feel and push against the cervix slightly.
Next, the other hand is placed on top of the abdomen and pushed in gently to capture the uterus between the two hands. This allows the doctor to feel the uterus to determine its shape, size, and position and to feel for abnormal growths.
Alternatively, the doctor can diagnose the retroverted uterus through ultrasound After inserting the ultrasound wand into the vagina, the doctor will be able to tell within seconds the position of the uterus.
Treatment of Retroverted Uterus
You may not require any treatment if you’re asymptomatic. If you do have symptoms or are concerned about the condition, discuss treatment options with your doctor. In many cases, there’s no need for treatment.
⦁ Exercises: Most times your doctor may be able to manually manipulate your uterus and place it into an upright position if the movement of the uterus isn’t hindered by endometriosis or fibroids, However, the medical profession is divided over whether or not pelvic exercises are worthwhile as a long-term solution. In many cases, the uterus simply tips backward again. certain types of exercises designed to strengthen the ligaments and tendons that hold the uterus in an upright position such as;
i. Knee-to-chest stretches: Lie on your back with both knees bent and your feet on the floor. Slowly raise one knee at a time up to your chest, gently pulling it with both hands. Hold this position for 20 seconds, release, and repeat with the other leg.
ii. Pelvic contractions: These exercises work to strengthen the pelvic floor muscles. Lie on your back with your arms at your sides in a relaxed position. Inhale as you lift your buttocks off the ground. Hold and release as you exhale. Repeat 10-15 times.
iii. Kegels exercise
⦁ Pessary Device: Pessaries are made from silicone or plastic. They are small devices that can be inserted into the vagina to prop the uterus into an upright position. However, pessaries have been linked with an increased risk of infection and inflammation. Another drawback is that sexual intercourse is still painful for the woman, and the pessary may cause discomfort for her partner too.
⦁ Surgery: In some instances, surgery may be required to reposition the uterus, and reduce or eliminate pain. There are several different types of procedures. They include:
i. Uterine suspension procedure: This type of surgery can be done laparoscopically, vaginally, or abdominally.
ii. Uplift procedure: This is a laparoscopic procedure that takes around 10 minutes to perform.
NOTE: the surgical removal of the uterus (hysterectomy) may be considered.
Retroverted Uterus and Fertility
Rarely, a retroverted uterus is due to a disease such as endometriosis, infection, or prior surgery. Those conditions, but not the position of the uterus itself, can reduce fertility in some cases. A retroverted uterus will usually move to the middle of the pelvis during the 10th to 12th week of pregnancy. Rarely (1 in 3,000 to 8,000 pregnancies), a retroverted uterus will cause painful and difficult urination and can cause severe urinary retention. Treatment for this condition (called “incarcerated uterus”) includes manual anteversion of the uterus and usually requires intermittent or continuous catheter drainage of the bladder until the problem is rectified or spontaneously resolves by the natural enlargement of the uterus, which brings it out of the tipped position. In addition to manual anteversion and bladder drainage, treatment of urinary retention due to a retroverted uterus can require the use of a pessary, or even surgery, but often is as simple as having the pregnant person sleep on their stomach for a day or two, to allow the retroverted uterus to move forward. If a uterus does not reposition, it may be labeled persistent.