PELVIC FLOOR ANATOMY
In its normal position, the uterus leans slightly over the bladder without touching it and is held in place by ten ligments that attach it to the pelvis and sacrum. These ligaments allow the uterus to move and expand in response to menstruation, pregnancy and whether the bladder and bowels are full.
If any of these ligaments become weak or contracted, the uterus is not held in proper position and can become displaced. Other causes of displacement are previous abdominal surgery or trauma, falls causing injury to the sacrum and coccyx, wearing high heels, running on cement surfaces, chronic constipation, ageing and pull of gravity on the ligaments.
Four Possible Uterine Displacements
Retroverted – the uterus is tilted to the posterior, with the fundus leaning back towards the colon and the cervical opening pointing towards the bladder.
Retroflexed – the uterus is both leaning to the posterior and is bent in the middle, or even folded down on itself with the fundus impinging on the colon.
Retrocessed – the uterus is tilted to the anterior, with the fundus leaning towards the bladder and the cervical opening pointing towards the colon.
Anteflexed – the uterus is folded in on itself, with the fundus resting on top of the bladder. This causes undue pressure on the bladder and frequent urination.
There are four Stages of Prolapse:
The cervix has descended and can easily be felt inside the vagina
The cervix and uterus have descended into mid vagina
The cervix and uterus have descended into mid vagina and are visible within the folds
The uterus and cervix are actually outside the body