Tipped Uterus


What is tipped uterus?

Uterus is a reproductive female organ, which holds the fetus during pregnancy. It is a pear shaped organ and the tip of the uterus is situated in forward direction towards pelvis. In some female, anatomical position variation has been seen and the uterus tip is tilted in a backward direction of the pelvis.  Anatomically this is termed as tipped uterus.

tipped uterus picture

Symptoms

The changing of the uterus tip’s position cannot create any problem to conceive, but may some indications is particularly felt during pregnancy:


  • Back pain, but it also quite normal in normal positioning of the uterus
  • Tran-abdominal ultrasound may not get the image of fetus during first trimester, but trans-vaginal ultrasound can able to produce proper image.
  • During the second and third trimester, when uterus size is enlarged, then voiding of bladder may become difficult due to tilted tips of the uterus provides pressure against bladder.
  • The chances of urinary tract infection increases.

Tilted tips with endometriosis causes health issues and provides following symptoms

  • Pain  during sexual intercourse
  • The upward posture of female during sexual activity creates discomfort
  • Painful menstruation.

Causes

The following conditions can cause tipped uterus.

  • Natural deviation: With maturation of female reproductive system, some time naturally the uterus becomes tilted and stays behind.
  • Injury due to adhesion: Injury due to adhesion such as surgical intervention causes separation of anatomic surfaces which are joined together and causes pull backwards the uterus.
  • Endometriosis: the outer membranous lining of the uterus is called endometrium. The over growth of endometrial cellular structure in outer direction leads to shifting of the uterus in retroflexed state.
  • Fibroids: this is a formation of non-malignant nodules can cause tilted the uterus in the backward direction.
  • Conceive: conceive and child delivery also may result in the shifting positing of the uterus, as the uterus is hold by ligaments which are overstretched during pregnancy. This often causes tipped of uterus in the backwards direction. Normally after delivery of the child, uterus moves to forward position.

Diagnosis

A tipped uterus can be diagnosed by physical examination of pelvic. It is also possible during Pap test, some female diagnosed with tipped uterus.

Pain during sexual intercourse is an initial indicator to detect tipped uterus. After explaining this to gynecologist, often a range of diagnostic procedure is required identifying the cause which include fibrosis and endometriosis.

Treatment

The treatment does not require if it is occur during pregnancy, as after child delivery normally uterus gets back in its own position. The decision is taken by the doctor after diagnosing the underlying cause.

Hormonal therapy

Hormonal therapy is prescribed in case of endometriosis

Pelvic exercise: During physical examination, if doctor repositions the uterus then some pelvic exercise may help to hold the uterus in its normal position, though the chances of uterus tipping is possible after continuing the physical exercise. Before conducting pelvic exercise it is important to discuss with doctors. In case of fibroids or endometriosis, pelvic movement is become restricted.

Pessary

This is a small uterine device made by plastic or silicon inserted may be permanently or temporarily to detained the uterus in forward direction. This insertion cannot lessen the pain during sexual intercourse and it can also increase the discomfort for partner. Other than this, this foreign body insertion increased the probability of uterine infection and swelling.

Surgical intervention

For repositioning the uterus over the bladder, laproscopic surgery is conducted. This surgery is not comprises complicated procedure and usually provide successful result. Rarely hysterectomy (complete removal of uterus) is preferred.

Cather insertion

If tipped uterus causes micturition problem and urinary bladder cannot void fully, then catheter insertion for excretion of accumulated fluid is conducted, other than this some suggestions are also provided for urination which include during micturition bend towards backwards, which helps to move the uterus from bladder and helps in voiding.

Reference

  1. Can A Tipped Uterus Prevent Pregnancy?, How Can A Tipped Uterus Affect My Pregnancy? at http://americanpregnancy.org/womens-health/tipped-uterus/
  2. http://www.mayoclinic.org/diseases-conditions/female-infertility/multimedia/tipped-uterus/img-20008147
  3. http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Retroverted_uterus
  4. WHAT ARE THE SYMPTOMS OF A TILTED UTERUS? at http://www.whattoexpect.com/pregnancy/tilted-uterus

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