Retroflexion of the uterus - lunge into the posterior fornix. Problems with uterine mobility - what are the dangers? Position of the uterus in the body

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In its normal position, the uterus is located vertically, more or less parallel to the abdominal wall. But there are other locations, in particular, anterior or posterior bending is often found, that is, a slightly different location of the uterus relative to other organs and systems. This position may be a normal anatomical feature or a sign of a pathological process. This article talks about how the backward bending of the uterus (retroflexion) affects pregnancy and why does this condition develop in the first place?

Definition

What does retroflexio (retroflexion) mean? This is the position of the uterus when its body, instead of its normal position, takes a different position. It is bent towards the spine for natural or pathological reasons. Other names for this condition are bending or posterior placement of the uterus.

Causes

Conventionally, all causes can be divided into two large groups: pathological and natural. These reasons have the following features:

Natural causes mean congenital backward bending of the cervix (or bending of the entire organ in this direction). This condition is detected already during the first gynecological examination. If it is congenital, then this is normal and does not require treatment. No symptoms develop in this case. The organ is in this position constantly and this does not in any way prevent pregnancy;
Pathological refers to those cases when the uterus is bent backward as a result of some acquired process. Typically, this is an adhesive process that develops as a result of chronic inflammation in the organs of the reproductive system. Adhesions “tie” the body of the uterus to neighboring organs. In this case, surgical treatment is necessary.

Retroflexion of the uterus can develop quite quickly, therefore, after suffering the inflammatory process, it is recommended to undergo a control ultrasound in 2-3 months.

Kinds

An organ cavity deviated from its normal position can be either mobile or stationary, that is, fixed. Depending on this, the clinical picture and symptoms may be more or less pronounced. It is also sometimes necessary to know this to determine the type of treatment intervention.

Mobile retroflexion

This diagnosis is made in cases where the uterus is mobile, but most of the time it is in a deviated state. This happens when the uterine ligaments and muscles weaken and its tone decreases.

Fixed retroflexion

This is the name given to changes in which the uterus is tightly fixed in the pelvis by adhesions. When its position changes, pain is observed. The most common reason for position changes.

Symptoms and signs

Usually, the condition does not produce characteristic symptoms. However, sometimes a nonspecific clinical picture may develop:

Menstrual irregularities;
Uncharacteristic discharge;
Pain in the lower abdomen during menstruation;
Discomfort during sexual intercourse;
Abdominal pain with a certain type of physical activity.

Due to the absence of characteristic signs of this condition, the main role in diagnosis is given to medical examination. Retroflexio is most often detected by chance during a routine gynecological examination.

Such a deviation can also be noticed on an ultrasound examination, and can also be diagnosed with a greater or lesser degree of accuracy by palpation of the abdominal wall.

Effect on pregnancy

Posterior bending of the uterus and pregnancy are quite compatible. If this condition is congenital, then pregnancy occurs normally, the fetus is also not in danger and can be carried to term normally. The birth process will proceed without deviations. This is due to the fact that as the fetus grows, the naturally mobile uterus enlarges and rises to a more or less normal position.

The situation is more complicated in the presence of adhesions. Firstly, they can cause such a strong bend that problems with conception begin, since sperm will not be mechanically able to penetrate into the uterine cavity through its cervix. In addition, if pregnancy occurs, then as the uterus grows, the adhesions will stretch, causing severe pain. It is also possible for them to rupture during the birth process.

Treatment

How to fix a bend? If the uterus is located posteriorly from birth, then the condition is not considered pathological. It does not bother the patient in any way and does not interfere with conception, pregnancy or normal childbirth. Therefore, treatment for this condition is not required. It is only needed when the uterus is bent backwards due to pathology, that is, when adhesions form. The following methods are used for this:

Laparoscopic intervention to cut adhesions;
Abdominal surgery for the same purposes is performed quite rarely, as it is more traumatic, but sometimes it cannot be avoided (depending on the location of the adhesions);
Laser surgery is theoretically also effective in this case, but in the Russian Federation it is not widely used due to its high cost;
Therapy with broad-spectrum antibiotics is performed when the retroflexed uterus is susceptible to inflammatory processes, for example, when adhesions are inflamed;
Taking medications that promote faster resorption of small adhesions;
Physiotherapy (for example, UHF and microwave) is carried out to accelerate the resorption of adhesions, reduce swelling and inflammation, if any, and normalize blood circulation if it has been disrupted as a result of the uterus being bent from behind.

What are the consequences of lack of treatment in this case? In addition to the possible difficulties during pregnancy described above, over time this condition will begin to cause painful symptoms. In addition, inflammatory processes may begin in the adhesions and organs of the reproductive system. This position of the uterus, if there are fibroids or other neoplasms in it, can lead to compression of neighboring organs, which may result in uncharacteristic symptoms, for example, problems with defecation.

Doctors call the main function of the uterus to bear a child, but due to certain pathological diseases, this task of the organ can be nullified. Retroflexion of the uterus involves the incorrect position of the latter in the system of internal organs of the small pelvis, when the fundus is placed upward and strictly posteriorly. But is it possible to become a mother if such an anomaly is diagnosed and how is it treated?

In contact with

Retroflexion of the uterus is, as we see, an anatomically incorrect position of the organ and its bending backwards, closer to the spine. It may occur without pronounced symptoms, or be accompanied by attacks of pain and vaginal discharge, but doctors do not recommend leaving it unattended.

Types of retroflexion

In practice there is a distinction movable and fixed shape pathological bend. If installed fixed form- the uterus will be completely or partially motionless, the course of the pathology will be accompanied by severe pain. The most common causes are abnormalities and tumors, endometritis and endometriosis.

In a relationship movable form pathological bending - it can occur as a result of improper and unbalanced nutrition, trauma after childbirth, heavy physical exertion and prolonged bed rest.

Displacement and bending of the uterus may be a consequence of such reasons:

Stretching of the ligaments in the cavity of the reproductive organ and their pathological elongation - weak connective tissue, multiple pregnancies, and so on.
A sharp decrease in a woman’s body weight and a decrease in the layer of fat around the uterus can also cause an abnormal curvature of the cavity.
Volumetric neoplasms in the cavity of the pelvic organs - this can be the development of myoma nodes, cysts, and so on. All of them can put pressure on the organ cavity and provoke abnormal bending and displacement.
The abdominal muscles are pathologically weak, which is why there is a decrease in the intra-abdominal process and anatomical mobility and displacement.
Inflammatory processes that provoke adhesions, connecting the uterus to the intestinal loop and its displacement posteriorly.
The course of chronic forms of endometritis and endometriosis, oophoritis.

Temporary displacement as such is not felt - such a change in position is most likely during an examination on a gynecological chair, during an ultrasound. Unpleasant symptoms will be shown precisely by adhesions, which provoke mixing and bending, inflammation, leading to pathological changes in the structure.

These symptoms will be:

Pain when shifting body position and turning.
Mucous vaginal discharge.
Failure of the menstrual cycle.
Menstrual discharge a woman may have or abundant or very scanty.
Pain during thrusting.

Therefore, we can summarize that there are no characteristic and obvious symptoms indicating the course of retroflexion.

Diagnostic methods

Diagnosis of pathological bending involves examining the patient on a gynecological chair and bimanual examination. So, with a two-handed examination, a gynecologist can determine position of the uterus — movable or stationary. In the first case, it can be returned to its place, in the second, you will have to resort to surgical intervention. If there is a suspicion of a tumor, the doctor refers the patient to hardware diagnostics using ultrasound or CT.

The doctor decides on the treatment of retroflexion after examining the patient and studying her complaints, receiving diagnostic results using ultrasound or CT. It is enough to understand that this pathological bend is not an independent pathology, but a consequence of other negative changes and diseases in the body. That's why it's so it is important to identify the root cause and eliminate it.

After eliminating the cause, they consider the question of whether it is possible to return the displaced organ to its place and correct its anatomical bend. In the case of a fixed form of retroflexion, it can be returned to its place manually; in the case of a mobile form, it can be returned by surgical intervention. In addition, positive results are obtained from a course of specially selected exercise therapy and gynecological massage, plus the use of special pessaries.

If anatomical displacement provokes inflammation, adhesions, a course of fibrinolytic and anti-inflammatory drugs, vitamins and physiotherapeutic procedures, such as electrophoresis and mud therapy, acupuncture courses and paraffin baths are used.

It is also worth taking a course of hormonal medications, which will normalize the hormonal levels in the body. If the cause of the abnormal curvature is a tumor, it is removed and corrected during surgical intervention of the position of the reproductive organ.

If we consider the question of the possibility of conception with pathological bending, retroflexion - is it possible. It is important to remember that it is more difficult for sperm to enter the cavity of the reproductive organ - there may not be enough of them to penetrate the membrane of the egg. Therefore, after ejaculation into the uterine cavity - a woman It is recommended to take the “Birch” pose and stay like this for 10-15 minutes. In this position, sperm will penetrate into the uterine cavity in a larger volume, increasing the chances of conception.

As doctors note, the combination of pregnancy and retroflexion is a common phenomenon, and what is most interesting in the practice of gynecologists is that there are cases when, after childbirth, the organ assumed a normal, anatomically correct position of the body.

The bone structure of the spinal column and small pelvis does not allow the organ itself to stretch, and the movable ligaments themselves allow it to change its position to the correct one.

The only problems can arise from tight compression and fusion between the reproductive organ and the intestinal loops - in the early stages of gestation, it can provoke severe attacks of pain in the lower abdomen and lower back, even leading to pathological termination of pregnancy.

Video: everything about the disease - retroflection.

The main function of the uterus is to bear the fetus. By the end of pregnancy, the child weighs up to 5 kg and, together with the placenta, amniotic fluid, and membranes, occupies a large volume of the abdominal cavity. Therefore, the uterus is anatomically located in such a way that it can increase in size many times over.

The uterine fundus (the rounded part facing upward) is normally directed towards the anterior abdominal wall, since its skin is elastic and can withstand significant stretching. Gynecologists call this arrangement of the organ anteflexio, which means “bending forward.” An angle is formed between the cervix and its bottom, the tip directed towards the spine.

Retroflexion of the uterus is an abnormal position of the organ, in which the fundus is directed strictly upward or posteriorly. The angle between the cervix and its body is completely smoothed out or opens towards the spine. Can such a condition be classified as a pathology and why is it dangerous?

Causes

To understand what the uterus means in retroflexion, knowledge of the normal location of the organ in the pelvis will help. It is located behind the symphysis pubis and the bladder when viewed from the front or between the rectum and bladder when viewed from the side and occupies a central position. The uterus is held in the pelvis by elastic ligaments. They consist of connective tissue and are attached at one end to the organ, and at the other to the bone walls. Additionally, the uterus is fixed by increased pressure inside the abdominal cavity, which is created by the abdominal muscles and fatty tissue. Accordingly, organ displacement occurs when:

sprains of ligaments, their elongation - can be a congenital feature or occur during life due to weakness of connective tissue, multiple pregnancies;
a sharp decrease in body weight - leads to a decrease in the fat layer around the uterus and an increase in its mobility;
space-occupying formations in the pelvic cavity – a large myomatous node in some cases deviates the body of the uterus posteriorly;
weakness of the abdominal muscles - occurs as a result of a sedentary lifestyle, cesarean sections and other surgical interventions, severe infectious and somatic diseases. Leads to a decrease in intra-abdominal pressure, the disappearance of the compressive effect on internal organs;
inflammatory diseases of the pelvic organs - the pathological process spreads from the organ to the surrounding tissues, causing changes in them. As a result, the uterus may be fused with intestinal loops and displaced posteriorly. Acute and chronic endometritis, endometriosis, oophoritis, salpingo-oophoritis, abdominal surgery, and peritonitis lead to similar consequences.

The first four reasons lead to a temporary change in the position of the uterus, since its backward bending is associated with loss of fixation. The adhesive process leads to a permanent form of retroflexio (retroflexion) and can only be corrected surgically.

Signs of uterine retroflexion

A woman does not feel a temporary change in the position of the uterus, since the organs normally move relative to each other. If the ligamentous or supporting apparatus (abs, fat layer) is weak, it changes its angle of inclination during physical activity, sharp turns, or overcrowding of the bladder or rectum. Similar changes are detected during gynecological examination or ultrasound.

Adhesions formed as a result of inflammation of the uterus and appendages can compress the intestines and disrupt the digestion process. In this case, a woman experiences abdominal pain without clear localization, increased gas formation, constipation or pasty stools. Unpleasant sensations may appear with a sudden change in body position, turns, or physical exercise. In addition, the woman is concerned about the symptoms of the underlying inflammatory disease, which led to the formation of adhesions:

mucous discharge from the genital tract;
cycle disruption;
heavy or scanty menstrual bleeding;
pain during sexual intercourse.

There are no symptoms specific to uterine retroflexion, so it can only be determined during a gynecological examination or ultrasound.

Effect on pregnancy

The question of how to get pregnant with uterine retroflexion arises if no other abnormalities can be detected in a woman, but conception does not occur within a year of attempts or more. Normally, after ejaculation, sperm accumulate in the posterior vaginal fornix - it is located behind the cervix and is a deep pocket. The cervical canal opens into this depression, which facilitates the penetration of male reproductive cells into the uterus and conception.

Retroflexion leads to displacement of the cervix, as a result of which the cervical canal opens either vertically downwards or towards the anterior wall of the vagina. Sperm penetrate the woman’s genital tract in smaller quantities and may not be enough to melt the dense shell of the egg and conceive. The problem of infertility is especially pronounced in couples in which the man experiences a slight decrease in the number of germ cells in the ejaculate or activity.

In such cases, the position of a woman on her stomach with an elevated pelvis after sexual intercourse for 15-20 minutes can facilitate conception. Thus, sperm accumulates in large volumes at the external opening of the cervical canal and the chances of penetration of a sufficient number of sperm increase. In addition, it is necessary to treat concomitant inflammatory diseases - they prevent the implantation of the embryo into the uterus and its further development.

Uterine retroflexion and pregnancy are a common combination. If conception is successful, then fetal growth will gradually be corrected by retroflexion. The bone structures of the spine and pelvis prevent the organ from stretching, so movable ligaments allow it to change its position. Problems can arise if there is a tight fusion between the uterus and intestinal loops: pregnancy in the early stages causes pain in the abdomen or is interrupted.

Treatment

Whether treatment for uterine retroflexion is necessary is determined by a gynecologist after collecting an anamnesis, studying complaints, examination and research. Typically, such a deviation is an accidental discovery during an appointment; in such cases, the doctor tries to return the organ to its normal position with his hands. With a slight deviation, a mobile ligamentous apparatus, and the absence of adhesions, the manipulation is successful, but there is a high probability that the uterus will return to the retroflex position. The woman is given recommendations on increasing physical activity and nutritious nutrition so that intra-abdominal pressure and fatty tissue retain the organ.

If there are adhesions in the pelvis that firmly fix the uterus in retroflexion, manual straightening is impossible and causes severe pain. In such cases, therapy is aimed at eliminating the inflammatory process in the pelvis and resorption of connective tissue bridges. Previously, a woman is examined for sexually transmitted infections: chlamydia, trichomoniasis, gonorrhea, mycoplasmosis, ureaplasmosis, as they can cause pathology. If a pathogen is detected, the gynecologist prescribes:

a course of antibacterial drugs (Azithromycin, Ofloxacin, Metronidazole);
topical probiotics - suppositories with lactobacilli to normalize vaginal microflora and increase the strength of the immune response (Acylact);
local antiseptics - douching with a solution of chlorhexidine, sitz baths with chamomile, a weak solution of potassium permanganate.

If the cause of adhesions is endometriosis, then the woman is shown:

hormone replacement therapy with estrogen and progesterone preparations (Zhanin, Yarina, Duphaston) and their antagonists (Danazol);
non-steroidal anti-inflammatory drugs (Indomethacin, Nimesulide).

The adhesive process is stopped by prescribing enzyme preparations intravenously and by electrophoresis (Lidase, Hyaluronidase, Ronidase). They are most effective in the initial stages of inflammation; in advanced cases, adhesions are cut surgically. Such interventions are carried out if there are indications: chronic pelvic pain, infertility or miscarriage.

Retroflexion of the uterus is not an independent disease, but a consequence of other pathological processes in the body. Restoring the normal position of the organ is ineffective if the influence of provoking factors remains: muscle weakness, exhaustion, inflammatory diseases of the pelvic organs. It is important to detect the root cause and eliminate it, since retroflexio is fraught not only with reproductive dysfunction, but also with further loss (prolapse) of the genital organs.

Retroflexion of the uterus: causes, signs, consequences and possible treatment - all about diseases of the genital area, their diagnosis, operations, problems of infertility and pregnancy on the website

The female body can rightfully be called another wonder of the world. This is the source of human life, its carrier, but is there a higher value on Earth? That’s why it’s so important for women to take care of their health, and above all, their reproductive system. If it fails, there will be neither a full conception of a child, nor a smooth pregnancy, nor a successful delivery. In order for the gene pool of our planet to improve, we need gynecology - the oldest branch of medicine that studies and treats diseases characteristic exclusively of the female body.

The word "gynecology" is derived from two Greek words: "γυναίκα", which means "woman" and "λόγος", which translates as "study"

Unfortunately, not everyone regularly and promptly visits the “women’s doctor”, even if some problems arise. Some don't have time, others are simply shy. The result is serious disturbances in the functioning of the reproductive system, which negatively affect the reproductive function of the female body. The more you know about what is happening to your body, the calmer you will be about the processes occurring inside you. Thanks to the articles that you will find on the site, you will be able to:

recognize various diseases related to gynecology based on some symptoms and signs and seek help from doctors in a timely manner;
understand the terminology that gynecologists use and not be afraid of these words that seem scary at first glance;
know how to properly prepare for certain tests so that the results are more reliable;
be able to read your test results.

And the most important thing that this project will teach all women is not to be afraid to visit gynecologists on a timely and regular basis. This will allow you to forget about your problems and always be cheerful and beautiful. After all, 90% of a woman’s youth depends on the health of the reproductive system. The MedNews.info website is ready to help provide the most useful information on this topic.

Retroflexion of the uterus (bending) is an abnormal position of the uterus, or rather the presence of a pathological bend and tilt of the uterus. With retroflexion, the following situation is observed - the tilt and bend of the uterus are directed posteriorly, towards the spine, the angle is open back. Whereas normally the opposite is typical - the angle formed by the cervix and the body of the uterus is directed anteriorly, and the body of the uterus is tilted forward.

inflammatory diseases;
endometriosis;
tumors;
adhesions;
a congenital structural feature - unlike previous reasons, it is mobile and painless.

Bend of the uterus - symptoms

The symptoms of this pathology depend directly on the cause of the bend. Mobile reflection is completely asymptomatic and has no special diagnostic value.

Symptoms of a fixed bend are more varied. First of all, these are complaints caused by the underlying disease, which led to pathology (pain in the lower abdomen, discharge from the genitals, etc.). There is also a violation of urination and constipation occurs due to constant pressure on the rectum.

Often, over time, retroflexion leads to a rather terrible consequence - prolapse of the genital organs due to impaired functioning of the ligamentous apparatus.

Pregnancy and uterine flexion

Mobile retroflexion and pregnancy are quite well-coexisting concepts. In addition, during pregnancy the uterus grows and gradually moves from a bend to the correct position. Therefore, during childbirth there are no features compared to the initially normal position of the uterus.

In the case of immobility of the uterus, for pregnancy to occur, it is better to have sexual intercourse in the woman’s position on the stomach or in the knee-elbow position. This position provides the best way to access the cervix. It also improves the passage of sperm through the fixed uterus and fallopian tubes. But even if pregnancy occurs, there is a risk of complications and...

Treatment of retroflexion

Causes

sprains of ligaments, their elongation - can be a congenital feature or occur during life due to weakness of connective tissue, multiple pregnancies;
a sharp decrease in body weight - leads to a decrease in the fat layer around the uterus and an increase in its mobility;
space-occupying formations in the pelvic cavity - large in size, in some cases the body of the uterus deviates posteriorly;
weakness of the abdominal muscles - occurs as a result of a sedentary lifestyle, cesarean sections and other surgical interventions, severe infectious and somatic diseases. Leads to a decrease in intra-abdominal pressure, the disappearance of the compressive effect on internal organs;
inflammatory diseases of the pelvic organs - the pathological process spreads from the organ to the surrounding tissues, causing changes in them. As a result, the uterus may be fused with intestinal loops and displaced posteriorly. Acute and chronic surgeries on the abdominal cavity and peritonitis lead to similar consequences.

The first four reasons lead to a temporary change in the position of the uterus, since its backward bending is associated with loss of fixation. leads to a permanent form of retroflexio (retroflexion) and can only be corrected surgically.

Signs of uterine retroflexion

mucous discharge from the genital tract;
cycle disruption;
heavy or scanty menstrual bleeding;
pain during sexual intercourse.

There are no symptoms specific to uterine retroflexion, so it can only be determined during a gynecological examination or ultrasound.

Effect on pregnancy

Treatment

If there are adhesions in the pelvis that firmly fix the uterus in retroflexion, manual straightening is impossible and causes severe pain. In such cases, therapy is aimed at eliminating the inflammatory process in the pelvis and resorption of connective tissue bridges. The woman is first examined for sexually transmitted infections: gonorrhea, ureaplasmosis, as they can cause pathology. If a pathogen is detected, the gynecologist prescribes:

a course of antibacterial drugs (Azithromycin, Ofloxacin, Metronidazole);
topical probiotics - suppositories with lactobacilli to normalize vaginal microflora and increase the strength of the immune response (Acylact);
local antiseptics - douching with a solution of chlorhexidine, sitz baths with chamomile, a weak solution of potassium permanganate.

If the cause of adhesions is endometriosis, then the woman is shown:

hormone replacement therapy with estrogen and progesterone preparations (Zhanin, Yarina, Duphaston) and their antagonists (Danazol);
non-steroidal anti-inflammatory drugs (Indomethacin, Nimesulide).