Uterus Still Retroverted at 14 wks: Pain & Urine Retention
I'm pregnant at 40. First pregnancy. At the end of my 13th week. Diagnosed previously with tipped uterus. History of fibroids, endometriosis and lifelong chronic constipation/IBS. I have experienced urine retention ever since the 10th week. At times acute, once requiring an ER visit for a catheter. I have avoided a permanent foley catheter by sleeping on my side and setting my alarm to wake frequently to urinate. I also do the knee-chest exercise several times a day and in the night when I wake before rising to go to the bathroom. In past weeks I urinated fine during the day. However this last week I'm having difficulty voiding completely during the day. Also last night I had more trouble than usual urinating.
Over a week ago, another doctor in my OB office finally diagnosed and is monitoring the condition, but only after a couple weeks of the other doctors denying the uterus could cause urine retention. I see this doctor again early next week. I am worried that at 14 weeks I should now be seen by a specialist who knows how to perform the manual manipulation to move the uterus into place. How long do I wait before insisting on this? What is the deadline before the uterus becomes too large to move out of the pelvic cavity into the abdomen? I fear after 4 weeks of waiting for the uterus to move to no avail, I am one of those rare few who have a persistent, incarcerated uterus. Secondly, I am desperate for suggestions for top OB/GYN's in NYC who have experience with my condition. I would get a consultation but I don't know who to call. Thank you!
P.S. I really wanted to post this on the Expert Forum as my question is addressed to doctors not fellow patients. But although I am offered the option to post a question on this forum, nowhere on the screen do I see the button to click to post a question on the Doctor's Expert Forum for Pregnancy. Don't know if it's a temporary glitch or what's wrong. If anybody can help me with that I'd appreciate it. There is no "Help" section on this website that offers instructions.
I read your story and was wondering how you doing as it is already a few months down the line. I miscarried at three months about five months ago and th doctors didn't know why. I experienced excuciating pain in my lower abdomen and lower back and am pregnant again with the same pain. My gynae now tells me that i have a retroverted uterus and that the pain should go away once the uterus has pushed out of the pelvis. Did you experience the same thing? Did your pain eventually go away and when? I really hope that you have not lost yours due to this condition and am interested to hear your answers as it might help me. Thanks so much. xxx
I am so sorry, my sympathies for your miscarriage and your continued pain and worries in this pregnancy. I can tell you this from my experience: doctors do not take this condition seriously enough at all. It is so rare for the retroverted uterus to stay retroverted ("incarcerated") into the 2nd trimester or beyond that many doctors have never seen it or have seen in only once in their careers. Therefore I strongly recommend this if the uterus doesn't move by the 12th or 13th week -- seek an older more experienced OB or perinatal specialist who has treated a patient with an incarcerated uterus before. You may need a manual procedure to move the uterus. Here is what happened to me after my post here at 14 weeks: My urine retention became so bad I had to wear a foley catheter for 10 days. Which did not help the uterus move, though it should have. My uterus stayed retroverted well into the 18th week until finally a perinatal specialist performed a manual procedure to move it. It did not "pop out" and move right away but it got the uterus unstuck just enough to start the process. The day I was supposed to undergo anesthesia to move the uterus completely, they found it had moved into the correct position upright. Right now I'm approaching the 30th week, the baby is bigger than average, very healthy. So there's hope! Just do seek treatment from a doctor who takes this seriously. Not to be alarmist but I personally believe there could be many unexplained miscarriages nobody can explain in the 2nd trimester that are caused by an incarcerated uterus, but the doctors aren't diagnosing it properly. The thought I kept having through this frustrating experience was "Okay fine, it's rare, but 'rare' does not mean never!" Good luck and please let me know what happens. P.S. Important, you need do the "knee chest" position for 15 minutes at a time every couple hours. It's also done for breech babies. Unless you have bad adhesions like I did, it should help the uterus to move upright. If this site let's me post a link, here's a link to an image of how to do knee-chest:
My added comment: if you don't want to wait until the 12th or 13th week to seek a specialist who is experienced with this, don't. I was just quoting the time frame that many doctors will tell you you'll have to wait to reach before they might take action. In my case my doctors wanted to keep waiting. I had to provide medical papers stating that miscarriages do occur due to an incarcerated uterus that stayed retroverted past 20 weeks, to get my doctors to start attempting manual manipulations.
I have had a horrific ordeal and am so thankful ( and sad at the same time) that I am not the only one going thru this. I am 15 weeks pregnant, and some weeks back I noticed that despite quite a bit of liquid intake ( I drink as much water as I can) I was going less and less and it took some actual effort to go, especially at nite time. When I mentioned to doctor, he said he was well aware this could be due to my (very) tilted uterus and that as baby got bigger the situation would correct itself. well meanwhile its getting harder to go, I noticed when i would walk after being asleep for a few minutes it made it easier to go. I mentioned again it was getting more difficult to go to which he shrugged and said there was nothing to do other than knee to chest positions to help get the uterus in place. well throughout the afternoon and evening very little urine and then early in the morning I was racked with pain and could NOT go even a drop, I was bawling and my husband was begging me to go to ER I tell you this was the most terrible pain I have ever experienced (and I have given birth with no drugs a few times) I went to ER and they gave me a catheter and I sobbed in relief. the nurse was so shocked by amount she went and got other nurses to show them, over 1, 300 cc of urine!! I started to get a bit of shock from losing to much liquid too fast, after treating me for that they sent me home with a foley catheter I wear all the time. I saw Dr. next day and he tried right there to MANUALLY fix my uterus. he says in his 20 years of experience he has never seen this, and this one is the worst he's ever heard of. My uterus is completely flipped. It hurt so very much to have him try to flip it manually, he let me have pain medicine and tried the next day, it still won't flip so I may have to do surgery. he is worried because baby does not have the blood flow it needs and I am miserable with this catheter.. ( how on earth are you supposed to take a shower?) All I know is this: if you have suspicions that your uterus is tilted or causing urine retention, DONT WAIT and if your doc is not listening GET A 2ND OPINION and start doing the excercises sooner, and avoid the awful ordeal i continue to go through. I know it will all be worth it when I get to hold that beautiful warm little bundle of innocence... until then God Bless and take care!!!
I am 13 weeks and one day pregnant and have been experiencing urine retention initially just once per week which I eventually managed to pass myself although the time it took to pass increased with each episode. Then just this week it happened 3 nights in a row. With a need to go to a&e to be catherterised after 2 to 2.5 hours of being unable to pee after waking up last night to the point of absolute agony. I have previously been diagnosed with a severely retro flexed uterus and tonight decided to try some pelvic tilts and this knee to chest position I kept reading about online.... I went from being barely able to release a drop of pee at 0030 to a comfortable pee at 0105.... Going to keep this going and feed it back at my hospital appointment tomorrow....
I have struggled with this with all my pregnancies, and I'm on my sixth! I did miscarry my first, and even had this problem then. This does seem to baffle every practitioner. It also seems to get worse with every pregnancy as I have to self cath more. I didn't know you could physically manipulate the uterus. I'd also never heard of this knee chest position, but I've done it in hopes it would help. I also try lying on my back with head down and hips up to try and slide things up as it feels I'm sitting on a grapefruit. Downward dog also helped a little. It seems like in some of my previous pregnancies it would take to nearly half way to get better because I was so concerned about drinking water for my ultrasound. Last pregnancy it got better at 13.5 weeks. I'm 10 weeks now and have had to press on my bladder to go for about the last four. If I bear down while going it seems to help, but I don't want to cause other problems by bearing down so much. I'm just praying and hoping it goes away soon because we're supposed to go on a trip at 13 weeks. This is so hard emotionally.
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