Non-Puerperal Uterine Inversion Secondary to Prolapsed Tumours about Two Cases

Abstract

Background: Non-puerperal uterine inversion (NPUI) is a rare gynecological affection whose scarcity makes its diagnosis challenging. Uterine inversion may be -acute- most seen in obstetrics as a complication of the third stage of labor or- chronic- due to uterine benign or malign tumors. Case report: We proffer two cases of non-puerperal uterine inversion presenting to our emergency department complaining of a protruded mass through the vagina outside the introitus. The first one outlays the second reported case - to our knowledge- in a patient without sexual experience of a uterine inversion due to a leiomyosarcoma, presenting in an acute state, leading to hemorrhagic shock. The second case occurs after recurring uterine inversions due to a known submucosal myoma. Both diagnoses relied on physical examination where not being able to palpate the uterus was the cornerstone of clinical suspicion. Using ultrasound as imaging investigation was pivotal to confirming the diagnosis and an etiology, uterine tumors. For different reasons, both patients underwent transvaginal hysterectomy. Conclusion: NPUI is a complicated clinical condition where the diagnosis is often exacting. If accurately and timely managed, it has an excellent prognosis. It’s very important to define the tumor’s histopathological profile before choosing one of the underlining known surgical and non-surgical procedures. However, taking into consideration fertility and the patient’s desire should be mandatory before deciding on any course of action.