Uterine displacement often causes women to experience back pain, anal pain, increased vaginal discharge, dysmenorrhea and other problems. Some of them may also affect women's fertility and may cause infertility, so scientific treatment should also be paid attention to. 1. Symptoms Excessive antevertion or retroversion of the uterus. The normal position of the uterus is anteverted, that is, the fundus of the uterus is toward the pubic bone, and an obtuse angle of 120° to 150° is formed between the cervix and the uterine body. About 80% of women have an anteverted uterus, 20% have a retroverted uterus, and less than 5% have symptoms. Retroversion and flexion of the uterus is the most common displacement, followed by antevertion and antevertion. Most people have no symptoms, but a few with retroflexion may experience back pain, anal distension, dysmenorrhea, excessive vaginal discharge, and in severe cases, infertility. Gynecological examination can confirm the diagnosis. Asymptomatic people do not need treatment and can naturally return to normal position by lying on their knees and chest every day. For those with symptoms, manual reduction can be performed and a pessary can be inserted to maintain the anteversion of the uterus. If combined with other diseases, treatment should be directed at the cause. Excessive anteflexion of the uterus is mostly a congenital disease, with a small uterine body and a slender cervix. The angle between the uterine body and the cervix is less than 90°, which can occasionally cause dysmenorrhea or infertility. Treatment can be done by dilating the cervical canal with a cervical dilator and artificial cyclical therapy with female hormones. 2. Treatment methods are mainly divided into two categories: surgery and medication. They vary from person to person based on comprehensive considerations such as the patient's age, severity of the disease, and whether or not they want to have children. 1. Drug treatment: Suitable for patients with mild condition and small ovarian chocolate cyst. The course of treatment is generally 6-9 months. If used as an adjuvant treatment before or after surgery, the course of treatment can be shortened to 3-6 months. 2. Surgical treatment: It was first used to treat endometriosis and is still one of the main methods. The treatment is mainly suitable for those with more serious illness or severe pain who are not responsive to drug treatment; (A) Conservative surgery: Only the endometriotic lesions are removed, and the ovaries and uterus are preserved. It is suitable for young people who want to preserve their reproductive function, especially those who have not responded to drug treatment. About 50%-60% of them can become pregnant after the operation. Laparotomy is suitable for patients with extensive adhesions, huge lesions, especially those with huge ovarian chocolate cysts. (ii) Semi-radical surgery: The uterus is removed while the ectopic lesions are removed, and at least part of the ovaries is retained. It is suitable for women who have given birth, are over 35 years old, have persistent pain or have uterine lesions. Semi-radical surgery can cure dysmenorrhea, and the chance of recurrence of dysmenorrhea after surgery is very small. (III) Radical surgery: Removal of bilateral adnexa and uterus can cure endometriosis and is suitable for menopausal women. In recent years, vaginal resection has been widely used to treat endometriosis. Through the vagina, the ectopic lesions and the entire uterus are removed, sparing patients the pain of open abdominal surgery. |
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