Uterine displacement

Introduction Uterine shift refers to the phenomenon that the uterus is excessively leaning forward or backward. The normal position of the uterus is the anterior tilt position, that is, the uterus is facing the pubis, and the cervix and the uterus form an obtuse angle of 120°-150°. About 80% of women have a anterior tilt of the uterus, 20% have a posterior tilt, and only 5% have symptoms. Posterior flexion of the uterus is the most common displacement, followed by forward anteversion. Most people are asymptomatic, and there are a few people who have a back and back and have a backache, an anal bulge, dysmenorrhea, excessive leucorrhea, and severe infertility. Gynecological examination can confirm the diagnosis. Asymptomatic patients do not need treatment, and the daily knee and chest position can be naturally reset. Symptoms may be placed in the pessary to maintain the anterior tilt of the uterus after manual reduction. If other conditions are combined, the cause should be treated. Excessive flexion of the uterus is mostly congenital lesions. The uterus is small and the cervix is slender. The angle between the uterus and the cervix is less than 90°, which can occasionally cause dysmenorrhea or infertility. Treatment with cervical dilator can be used to dilate the cervical canal and female hormone artificial cycle therapy.

Cause

The normal uterine position relies on the support of the pelvic floor muscles and their fascia and the ligaments attached to the uterus (especially the main ligament). Under normal circumstances, the position of the uterus may change slightly when the position changes, the force is applied, and the bladder and rectum are filled. When the tissue supporting the uterus is damaged and relaxed, or because the pelvic cavity is tilted, sitting, standing, standing, and staying in bed for too long can change the position of the uterus. Pelvic inflammation, pelvic abscess, adhesions from old ectopic pregnancy, or endometriosis can pull or fix the uterus backwards. There are two common types of uterine shift:

Posterior uterus

Most common. If the entire uterus moves toward the concave and concave, and the relationship between the uterus and the cervix does not change, it is called the uterus posterior movement; the uterus can also be significantly flexed. The posterior position of the uterus can be divided into three degrees due to the degree of posterior tilt: the uterus at the end of the uterus tends to be one degree, the sacral tendon is second, and the uterus rectum is third. The uterus is mildly posterior and active, and is asymptomatic. The posterior position is obvious, often accompanied by ovarian ptosis, may have back and shoulders, anal swelling or sexual intercourse pain. Post-tilt and posterior flexion of the uterus may cause menstrual abnormalities, dysmenorrhea, excessive leucorrhea due to hypertrophy of the uterine wall, or due to the outward appearance of the cervix, which hinders sperm from entering the uterine cavity and causes infertility.

Uterine excessive anterior position

Mostly congenital lesions. The uterus is small and the cervix is slender. The angle between the uterus and the cervix is less than 90°, and the external cervix is facing the anterior wall of the vagina. Generally does not affect health, but can cause dysmenorrhea or infertility. Treatment with cervical dilatation can expand the neck tube and/or sex hormone artificial cycle therapy.

an examination

Related inspection

Uterine position gynecological ultrasound examination

The diagnosis mainly relies on double or triple diagnosis to find out the location, size, activity and ovarian presence or absence of prolapse. The asymptomatic and active posterior uterus does not require treatment. Taking a knee-thoracic position on a longer-term basis for a longer period of time may naturally reset the mobile posterior uterus.

Differential diagnosis

Symptoms can be manually repositioned in a double or triple examination, and then placed in a suitable pessary to maintain the anterior flexion position of the uterus.

Severe uterus posterior position and obvious symptoms, after the reduction of the method or the improvement of symptoms after the reduction of the pessary; or in addition to the uterus, can not find other causes of infertility, may consider surgery.

If secondary to inflammation, tumors, endometriosis, etc., the cause should be treated first.

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