The condition, which is known as retroverted uterus among people, is defined as a retroverted uterus in the medical language. When a baby girl is born, her uterus (womb) is in a certain position; normally, this position does not change until she dies. The uterus may be anteriorly (anteverted) or posteriorly (retroverted). Antevert uterus is more common. In 70-85% of women, the uterus is forward, while the rest is backward. The anterior or posterior aspect of the uterus is not a pathological finding, but a variation of normal anatomy. Just like using the right or left hand, or the differences in hair and eye colour, this anatomical posture is also normal.
Although it is a normal anatomical condition for the uterus to be retroverted, in some cases the forward-looking uterus may turn backwards. For example, depending on the birth, the ligaments holding the uterus in place may loosen and the uterus may turn backwards. Again, a similar situation may occur after menopause for the same reason.
More importantly, some diseases that disrupt the anatomy of the pelvis can pull the uterus backwards. The most important of these diseases is endometriosis. Infections of the tubes and adhesions due to pelvic inflammatory disease or after surgery may also cause the uterus to turn over. Very rarely, masses occupying space in the pelvis can also push the uterus backwards.
Retroverted uterus condition alone does not cause any symptoms in most cases. Rarely, a person may experience pain or discomfort during sexual intercourse. In some patients, the underlying cause of menstrual pain may be the retroverted uterus. Related complaints and findings may be seen if there is an underlying pathology such as endometriosis.
The diagnosis of the retroverted uterus is made incidentally during a gynaecological examination for any reason.
In the presence of a retroverted uterus, no treatment is required. Although some physicians prefer to apply a vaginal pessary due to chronic inguinal pain, this does not provide a permanent solution. The retroverted uterus cannot be rotated forward in any way during the examination. Although there are surgeries that can be done for this purpose, they have no use in modern gynaecology and are interventions that harm the patient. Adhesions that will occur after surgery can both cause infertility and increase groin pain.
If a retroverted uterus is detected in the examination, when an underlying pathology is detected, attempts should be made to treat it.
Many women all over the world think that a retroverted uterus will cause difficulties in conceiving a child. The source of this false belief is unknown. Infertility may occur if there is another underlying condition, such as endometriosis. However, a retroverted uterus alone is not an obstacle to pregnancy.
A study examining 807 women undergoing IVF treatment for various reasons showed that a retroverted uterus does not have any positive or negative effect on pregnancy outcomes.
When women with a retroverted uterus become pregnant, the uterus takes its normal position during pregnancy with the progression of pregnancy and the enlargement of the uterus, and the baby is delivered by vaginal delivery or cesarean section without any problems. A retroverted uterus before pregnancy does not prevent normal delivery. After birth, the uterus shrinks and at the end of the puerperium, it regains its former shape and remains retroverted.
Very rarely, in 3-14 cases per thousand, while the uterus is growing, it cannot turn forward, take its normal position, and get stuck in the pelvic cavity. This condition, called uterine incarceration, can threaten the mother and baby's life.
Although not essential in the presence of an incarcerated uterus, the 12th-20th week of pregnancy. The following symptoms may occur between weeks:
frequent urination
A feeling that the bladder is not empty
Remaining urine in the bladder after urinating
severe constipation
lower abdominal pain
vaginal bleeding
Very rarely, there are no findings and no complaints occur until the onset of labour at term.
The fetal loss rate can reach up to 33% in untreated cases. The treatment is to ensure that the uterus returns to its normal position with various methods.
Many women with a retroverted uterus are worried about this situation, but the retroverted uterus does not cause infertility in any way. There was no difference in terms of pregnancy between these women and women with the uterus facing forward. If there is a problem in conceiving a woman with a retroverted uterus, the reason for this is another pathology, it should be investigated.
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