Urogynecological symptoms of the retroverted gravid uterus in the first half of the pregnancy: A retrospective cohort study of an underestimated, underdiagnosed and underreported issue: Lower urinary tract symptoms in patients with retroverted gravid uterus

Erhan  Akturk; Cagdas Nurettin Emeklioglu; Hale Ozer Caltek; Necirvan Cagdas Caltek; Fatih Sahin; Veli Mihmanli

doi:10.28982/josam.7680

Authors

Erhan Akturk Prof.Dr. Cemil Tascioglu City Hospital, Department of Gynecology and Obstetrics, Istanbul, Turkey https://orcid.org/0000-0003-1436-6049
Cagdas Nurettin Emeklioglu Prof.Dr. Cemil Tascioglu City Hospital
Hale Ozer Caltek Kızıltepe State Hospital, Mardin, Turkey https://orcid.org/0000-0002-1433-6942
Necirvan Cagdas Caltek Kızıltepe State Hospital, Mardin, Turkey https://orcid.org/0000-0002-2823-8630
Fatih Sahin Prof.Dr. Cemil Tascioglu City Hospital, Department of Gynecology and Obstetrics, Istanbul, Turkey https://orcid.org/0000-0002-1621-5896
Veli Mihmanli Prof.Dr. Cemil Tascioglu City Hospital, Department of Gynecology and Obstetrics, Istanbul, Turkey https://orcid.org/0000-0001-8701-8462

DOI:

https://doi.org/10.28982/josam.7680

Keywords:

retroverted uterus, pregnancy, lower back pain, lower urinary tract symptoms

Abstract

Background/Aim: Urogynecological symptoms, including pelvic pain, lower backache, feeling of bearing down, frequency, nocturia, urgency, stress incontinence, and urge incontinence, are common during pregnancy. But little has been reported regarding possible changes in lower urogenital tract anatomy and its effects in pregnancy. Therefore, the subject of this study is whether the incidence of urogynecological symptoms is higher when the uterus is retroverted in pregnancy.

Methods: We enrolled 1432 pregnant women examined before the 20th week of pregnancy between January 2018 and March 2022. Patients were allocated into two groups according to whether the uterus was retroverted (n=226 (15.7%)) or anteverted (n=1206 (84.3%)). These two groups were compared regarding pelvic pain, lower backache, the feeling of bearing down, frequency, nocturia, urgency, stress incontinence, and urge incontinence.

Results: Retroverted gravid uterus was noted in 11.8% (n=41) of nulliparae and 17% (n=185) of multiparae (P=0.021), with an overall prevalence of 15.7%. Of 1432 patients, the overall prevalence for frequency, urgency, nocturia, urge incontinence, stress incontinence, lower backache, pelvic pain, and feeling of bearing down were 31%, 26.7%, 18.2%, 5.4%, 7.5%, 6.9%, 56.4% and 7.5%, respectively. Between both groups, there were differences in frequency, urgency, nocturia and lower back pain. There were two patients with incarcerated gravid uterus with urinary retention.

Conclusion: Patients with a retroverted uterus are more likely to experience the symptoms of lower back pain, frequency, nocturia, and urgency in the first half of pregnancy.

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