Disorders of normal anatomic position of genitals are markedly diverse. They can be congenital or develop at any time in the woman's life. Clinical presentations of female genital position anomaly differ in nature and degree. To date, there is no unified understanding of their origin, pathogenesis and treatment, and most important - of their rehabilitation and prevention of the disease itself or of its relapse.
At the same time, all these conditions are associated with a considerable deterioration in the quality of patient's life. This feature was described graphically by J. Braun who said that they do not kill but rather steal the life.
23.1. NORMAL TOPOGRAPHY OF PELVIC ORGANS
To understand the malposition of pelvic organs it is important to define the normal position of the uterus as the central genital organ since changes in the topography of other genital and adjacent organs cannot occur in isolation from the uterus.
The major issues of the anatomy, physiology and topography of the genitals were considered in previous chapters. However, it should be remembered that the body of the uterus is normally located in the center of pelvic cavity, its fundus is not higher than the area of brim, and the vaginal portion of uterus is located at the level of the narrowest dimension of the pelvic cavity. The fundus normally faces upward and anteriorly, and the vaginal portion - downward and posteriorly. In front the body of the uterus is adjoined by the bladder, and behind - by the rectum.
The position of uterus in the pelvis is usually described with two terms:
• version of uterus describes the topography of the uterus in the lesser pelvis: the angle formed by the axis of uterine body, and the axis of pelvic inlet;