Uterine Suspension - Frequently Asked Questions

Q: What exactly does a uterine suspension do?

A: A uterine suspension procedure is used to reposition a tipped uterus from its backward facing position to a forward facing position. Approximately 80% of women have a uterus in a forward position (anteverted). However, in approximately 20% of women the uterus may be tipped backwards.

Not all women with a tipped uterus experience symptoms as a result of this condition. A tipped uterus is just a normal variant much like different eye colors. But for some women who experience problems from a tipped uterus, like painful intercourse or painful periods, a uterine suspension can provide relief. Click here to read about the UPLIFT procedure.

Q: What types of conditions are uterine suspension procedures used to treat?

A: Uterine suspension may be used to treat deep dyspareunia (pain during intercourse) or dysmenorrhea (pain during menstruation). It may also be used in women who sense bladder pressure and have frequent urination or those who sense pressure in the rectum.

Scarring from adhesions as a result of endometriosis, surgery or fibroids can also cause the uterus to shift to a tilted or retroflexed state. A uterine suspension, such as the UPLIFT procedure, may be used in conjunction with treatments for endometriosis to prevent the formation of adhesions after surgery.

Q: Why is the UPLIFT procedure better than other uterine suspension procedures?

A: The UPLIFT procedure is a newer and improved method of performing a uterine suspension. It is quicker to do (average procedure time of 12 minutes) and has been proven clinically to result in fewer postoperative complications than other uterine suspension procedures.

Secondly, the UPLIFT procedure is reversible. The sutures can simply be snipped, and the uterus will return to its previous position.

Q: Can a uterine suspension procedure such as UPLIFT reduce the pain experienced during intercourse or menstruation?

A: Typically "yes". Several articles published in peer-reviewed medical journals that followed women long-term after uterine suspension have documented that pain has been significantly reduced or eliminated.

These studies include:

• Carter JE, Carter-Thomason Uterine Suspension and Positioning by Ligament Investment, Fixation and Truncation J Reprod Med 1999 May; 44:417-422.
• Casa A, et al. Laparoscopic Uterine Suspension for Relief of Chronic Pelvic Pain: J Am Assoc Gynecol Laparoscop 1995 Aug; 2(4, Supplemement):S8.
• Gordon SF, Laparoscopic Uterine Suspension J Reprod Med 1992 Jul;37(7):615-616.
• Kohl LW, et al. Preliminary Experience in Pelvoscopic Uterine Suspension Using Webster-Baldy and Franke's Method: Acta Obstet Gynecol Scand 1996 Jul;75(6):575–578.
• Kulakov, et al. An Alternative Approach to the Surgical Correction on Malpositions of the Uterus: Akush Ginekol (Mosk) 1997:6:36-39.
• Ostrzenski A, Laparoscopic Retroperitoneal Hysteropexy J Reprod Med 1998 April;43(4):361-36.
• Perry CP., et al. Laparoscopic Uterine Suspension for Pain Relief - A Multicenter Study. J Reprod Med, 2005 August;50(8):567-570.

Q: Someone told me a pessary could be used to relieve the pain from my tipped uterus instead having a uterine suspension. Is this true?

A: " Yes and no." Because insertion of a pessary can lead to vaginal infections and restrains one from regular intercourse, it is generally considered a temporary solution for pelvic pain resulting from a tipped uterus. Also, a pessary typically makes intercourse painful for the male partner.

So "yes", a pessary may relieve your pain but "no" because it can cause other undesirable side affects as well.

Q: Will a uterine suspension procedure like the UPLIFT prevent pregnancy?

A: We know of no clinical findings that suggest that a uterine suspension can make pregnancy more difficult. In fact, women have become pregnant after having had a uterine suspension procedure.¹

Q: People tell me my pain is psychological and that a uterine suspension procedure like the UPLIFT will not help me. Is this true?

A: Although it was once believed that dyspareunia was caused by physical or psychological trauma or abuse earlier in life, this is not the case today. Physicians have come to understand that there are many physical reasons for dyspareunia. This is not to say that dyspareunia does not result from past or current sexual abuse, but it is not the reason in the majority of cases.

If you are, or have been sexually abused, speak candidly with your physician so he or she can help you. Your physician will protect your confidentiality and use the information to help you to the best of his or her abilities.

However, if sexual abuse is not involved and your physician still insists it is all in your head, then it might be a good idea to seek a second opinion. You may visit Doctors4women.com to help you find a doctor in your area who specializes in the treatment of pelvic pain.

Q: I have severe pain during menstruation as well as a tipped uterus. I asked my doctor about having a uterine suspension, and he/she told me to try anti-inflammatory medications first. Is this the usual procedure?

A: Yes, physicians usually do not recommend an invasive medical procedure without first trying simpler, less invasive solutions. Any surgical procedure has risks an possible complications. Your physician is practicing good medicine. A uterine suspension should be considered only if less invasive alternatives fail.