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Thursday, 9 August 2012

Unusual symptom of a tilted womb

I had a patient consult me with the problem of faecal incontinence. She was unable to control her bowel movements and whenever she had the urge to go to the toilet she would leak faeces before she could reach the toilet. Faecal incontinence can occur in those who have had previous normal deliveries and have had tears of the anal sphincter as a result of the delivery. Sometimes a difficult assisted delivery can cause this. However this patient had two previous deliveries by caesarean section some 10 years ago. The only significant finding was a tilted or retroverted but slightly prolapsed womb on pelvic ultrasound scan. Now a retroverted uterus is common and is present in about 20% of women. It is known to cause infertility, dyspareunia or painful intercourse and backache, however it has not been known to cause faecal incontinence. The patient was counselled and was advised that an operation to correct the retroverted uterus may not help her symptoms. However, the patient decided to go ahead with the operation. I have followed the patient up for 6 months after the operation and to my surprise she is free of this debilitating and socially embarrasing condition of faecal incontinence.

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