[Acute abdomen in postoperative gynecological complications and particularly in certain technics practiced for the treatment of uterine retroversion].
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Approximately 11-19% of pregnancies begin in a retroverted uterus. If spontaneous displacement does not occur, fundal impaction may be manifest by 14-16 weeks. We present a report of persistent retroversion discovered at 36 weeks' gestation. A "pelvic mass" was misdiagnosed as posterior sacculation of the uterine wall. We include a review of the literature with regard to incidence, complications, and management of this sometimes confusing condition.
In 20% of the cases, painful symptoms which cannot be dismissed in general practice are experienced by women with uterine retrodeviation. The technique described here is based on anatomical reduction of Douglas' pouch with restoration of tension in the uterosacral ligaments. It is simple and rapid as expected for a minor anatomical defect. The creation of two perpendicular peritoneo-ligamentous planes ensures its solidity. The effectiveness and safety of this technique has been confirmed by a series of more than 70 patients 50% of whom were examined at regular intervals for more than 5 years after surgery.
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A case of chronic urinary retention due to bladder outflow obstruction presenting at 7 months postpartum, following a history of early puerperal voiding difficulties, is outlined. The cause was found to be a markedly retroverted uterus obstructing the urethra. Laparoscopic ventrosuspension was performed, converting preoperative urinary residuals of over 400 ml to zero postoperatively.
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