Retroverted uterus

Apr 15, 2012 , Vladislava Králová

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A retroverted uterus is a situation, where the uterus is tilted backwards. A retroverted uterus is a fairly common occurrence, which causes no complications in most cases. Rarely, complications may arise while trying to get pregnant, but spending half an hour on your stomach tends to suffice to solve them. Further complications may occur during the pregnancy itself, when the uterus can be strangulated, which needs to be resolved surgically in the worst cases.

Retroverted uterus

A retroverted uterus is a fairly common situation, present in nearly every fifth woman. Usually, the uterus is tilted forward withing the pelvis. With retroverted uterus its tilt is reversed, pointing backwards. Retroverted uterus generally doesn't mean any difficulties or complications and doesn't require any treatment, however, some unpleasant symptoms may sometimes occur. Among the complications can be difficulties with getting pregnant and with pregnancy in general. In this cases either conservative or surgical treatment is needed.

Uterus

The uterus is a pear shaped female sex organ located in the pelvis. It is suspended on a wide uterine ligament. The walls of the uterus have three layer, the mucous layer, musculature and a layer of connective tissue. The mucous layer (mucosa) undergoes changes called the menstruation cycle, under the influence of female sex hormones. One cycle lasts 28 days on average and its importance is in preparing the mucosa for accepting and subsequently nurturing the egg. If the egg is not fertilized, the prepared mucosa, or its surplus is removed together with blood during the menstruation. The musculature forms the majority of the uterine walls, the muscle fibers are arranged in several layer and maintain the uterus's firmness. They have the ability of increasing their volume several times, which is necessary for the womb's growth during pregnancy. During birth the musculature rhythmically contracts, helping to expel the fetus from the womb.

Development of retroverted uterus

Under normal conditions the uterus is tilted forwards. The term retroverted uterus signifies the condition where the uterus is tilted backwards. It is a fairly common situation, occurring in 15-20 % of women. This change of the uterus's position generally causes no problems, but if any occur, they tend to be easy to treat. A retroverted uterus can be congenital, in other cases it can be caused by inflammations, adhesions or endometriosis.

Inflammation of the uterus

An inflammation of the uterus is an unpleasant infectious disease caused by bacteria. The infection can enter the uterus from the vagina or the pelvis, based on where the inflammation occurs. In some cases, uterine inflammation can also by caused by an IUD. Women after birth or abortion are especially prone to infection. Having many sexual partners or lowered immunity are also risk factors. The inflammation manifests by a raised temperature, abdominal pain, pain during urination, defecation and sometimes by lengthy or irregular menstrual bleeding. Antibiotics are used as a treatment. Should any of these symptoms appear or should you have any suspicion, it is important to visit a gynecologist. This is because uterine inflammation can spread onto the fallopian tubes and the ovaries and in this case antibiotics will not suffice. If the inflammation is not adequately treated, it often leads to adhesions, which pull the uterus backwards.

Adhesions

Adhesions are unnatural connections between the surfaces of two or more organs, which are not naturally connected. Most commonly they occur in women who suffered inflammations of the sex organs, surgery, or as complications of endometriosis. Adhesions are the main reason for infertility. In some cases the can have no symptoms. In other cases the can cause abdominal pain, intestinal blockage and the above mentioned infertility. Treatment of adhesions consists of their surgical removal coupled with the use of anti-adhesives during the operation.

Endometriosis

Endometriosis is the occurrence of uterine mucosa outside of the uterus, for example on the ovaries, the fallopian tubes or the urinary bladder. This mucosa is influenced by hormones just like the uterine mucosa and changes during the menstrual cycle as well. Small scars appear around the areas with endometriosis and these then lead to adhesions. Why does endometriosis develop has not been clarified so far. The main symptom of endometriosis is a long lasting abdominal pain, which gets worse during menstruation. During treatment, a surgical procedure is combined with a hormonal treatment which inhibits the female sex hormones to prevent endometriosis from reoccurring.

Influence of retroverted uterus on fertility

In some cases it can be more difficult to become pregnant with a retroverted uterus, since the sperm has to travel a greater distance. Fertility problems are mainly caused by a combination of several factors however. Sex from the back helps with retroverted uterus, as does lying on your stomach for up to 30 minutes after intercourse. There are certain exercises designed to help in certain cases of both male and female infertility. These exercises need to be practices with a trained physiotherapist to be effective. Ask your doctor for closer information. 

If a retroverted uterus is discovered during pregnancy, it often tends to correct itself. No need to worry about it. It is recommended to sleep on your stomach during the first trimester, and to perform certain exercises.

Symptoms of retroverted uterus

Among the possible symptoms of a retroverted uterus are back pains, pain before and during menstruation, pain during sexual intercourse, trouble defecating and possible infertility.

Retroverted uterus and troubles during pregnancy

In normal condition the uterus grows together with the fetus and the uterus straightens out towards the end of the first trimester, growing past the pelvic edge and further into the abdominal cavity. If the uterus is heavily tilted however, it cannot leave the pelvis during its growth. During further growth it fills out the pelvis completely and eventually becomes strangulated. The cervix is pushed forwards toward the pubic bone. This causes pressure on the urethra, causing trouble with urination. The symptoms may develop gradually. First come the urination problems, then a complete stop of urination or involuntary leakage of urine. Other times the symptoms may occur all at once. If the uterus is strangulated, it obviously cannot develop any further. This state needs to be resolved. At first a so called bloodless reposition is attempted, which tends to be successful. The first step is emptying the bladder via catheter. Then a gynecologist inserts his fingers into the vagina, attempting to push the womb upwards. If this fails, a surgery is required..

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