Uterine Prolapse and Its Impact on Frequent Urination

Frequent urination issues?

The doctor asked you the following question: Is a retroverted uterus congenital? I have visited several gynecologists and none of them mentioned that I have a retroverted uterus.
After giving birth on April 10, 2015, I have had a constant urge to urinate for 24 hours straight, and this has not improved in almost five months.
I have consulted many gynecologists, and one of them said that the retroverted uterus is pressing on the bladder, causing the constant urge to urinate.
They also mentioned that a retroverted uterus is congenital.
I would like to ask the doctor if a retroverted uterus is indeed congenital? Can a retroverted uterus cause frequent urination? If it is congenital, why was it not detected in my previous visits to gynecologists? If it is congenital, why did the frequent urination only start after childbirth?
Response from: Taipei Hospital / Doctor's reply from Obstetrics and Gynecology / Dr.
Tsao Kuo-Tao, 2015/09/02
Hello, a retroverted uterus is a congenital condition, but it does not necessarily cause frequent urination unless the uterus is significantly enlarged and pressing on the bladder.
If you are still experiencing frequent urination, I recommend consulting a urologist to check for other potential issues.
Wishing you good health.
Follow-up: I have already been examined by a urologist, and everything was normal.
The urologist prescribed medication for overactive bladder for two weeks, but it was ineffective, so I returned to the gynecologist.
The gynecologist prescribed the same medication for overactive bladder, but after a month of no improvement, they said that I no longer need to return for follow-up regarding the retroverted uterus.
So, am I being dismissed from treatment? (I have been seeing a major hospital.) During the first ultrasound examination, the gynecologist did not mention a retroverted uterus; it was only after the third examination that it was noted.
I have seen different gynecologists before and during my pregnancy, and none of them mentioned any issues with a retroverted uterus… so I don’t know what to do… the frequent urination is troubling me… which specialist should I see?

Shi, 20~29 year old female. Ask Date: 2015/09/02

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, it seems that neither of the two specialists you consulted was able to resolve your issue.
Have you considered visiting a medical center to see a urologist? Wishing you good health.

Reply Date: 2015/09/02

More Info

Uterine prolapse is a condition where the uterus descends into the vaginal canal due to weakened pelvic support structures. This can occur due to various factors, including childbirth, aging, and genetic predisposition. In your case, it seems that you have been experiencing persistent urinary urgency since giving birth, and a healthcare provider has suggested that a uterine prolapse may be contributing to your symptoms.

To address your questions:
1. Is uterine prolapse congenital?
Uterine prolapse can be influenced by genetic factors, but it is not strictly congenital. Many women may have a predisposition to pelvic floor weakness, which can manifest as prolapse later in life, particularly after childbirth. It is possible that you may have had a predisposition that became more pronounced after your delivery.

2. Can uterine prolapse cause frequent urination?
Yes, uterine prolapse can lead to frequent urination. When the uterus descends, it can exert pressure on the bladder, leading to increased urinary urgency and frequency. If the prolapse is significant, it can obstruct the normal function of the bladder, causing symptoms such as the ones you are experiencing.

3. Why was the prolapse not identified earlier?
It is not uncommon for conditions like uterine prolapse to go unnoticed during routine examinations, especially if the prolapse is mild. The symptoms may not have been apparent until after childbirth when the pelvic floor structures are more likely to be compromised. Additionally, different healthcare providers may have varying levels of experience in diagnosing such conditions, which could explain why it was identified later in your care.

4. What should you do next?
Since you have already consulted with urologists and gynecologists without satisfactory resolution of your symptoms, it may be beneficial to seek a specialist in pelvic floor disorders. A urogynecologist, who specializes in both urology and gynecology, may provide a comprehensive evaluation of your condition. They can assess the degree of prolapse and its impact on your urinary symptoms and recommend appropriate treatment options.

5. Treatment Options:
Treatment for uterine prolapse can vary based on the severity of the condition and your symptoms. Options may include pelvic floor exercises (like Kegel exercises), lifestyle modifications, pessary devices to support the uterus, or surgical interventions if the prolapse is significant and causing distressing symptoms.
6. Managing Urinary Symptoms:
In addition to addressing the prolapse, managing urinary symptoms may involve behavioral therapies, bladder training, and medications that can help reduce urgency. It is essential to communicate openly with your healthcare provider about your symptoms and how they affect your quality of life.

In conclusion, uterine prolapse can indeed contribute to urinary symptoms like frequent urination. It is essential to pursue a thorough evaluation with a specialist who can provide targeted treatment options. Your concerns are valid, and seeking the right care can significantly improve your quality of life.

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