Acute urinary retention due to a nonincarcerated retroverted gravid uterus

• DOI: 10.1007/s00192-014-2547-y
• Publication Date: 2014-11-03T13:23:13Z
• Authors: Rachel B. Danis; Ryan K. Brannon; Nigel Pereira
• Keywords: Urinary retention

A 25-year-old primigravid woman at 18 weeks’ gestation presented with acute urinary retention. Pelvic and rectovaginal examination revealed fullness in the posterior cul-de-sac. Bladder catheterization revealed a residual volume of 900 ml clear urine. Transvaginal ultrasonographic imaging is shown in Fig. 1. Uterine incarceration was suspected. No change in uterine polarity was noted after manual reduction under general anesthesia or colonoscopy-assisted rectosigmoid insufflation. As the suspicion for uterine incarceration still existed, a diagnostic laparoscopy was performed, which revealed a sharply retroverted, but freely mobile, uterus. Subsequent magnetic resonance imaging is shown in Fig. 2. Despite normal urodynamic testing, the patient required placement of a no. 5 ring pessary in order to void. Thereafter, her pregnancy remained uneventful, and she vaginally delivered a healthy girl at 39 weeks. She had no urinary complaints at her postpartum visit 5 weeks later.