Chronic Non-puerperal Uterine Inversion Research Articles

Modified vaginal hysterectomy for chronic non-puerperal complete uterine inversion: video presentation.

Chronic non-puerperal complete uterine inversion is a relatively rare condition. Abdominal Haultain's operation is the usual management. We present such a case with fundal fibroids managed by modified vaginal hysterectomy. Preoperative computerized tomography enhanced intravenous urogram depicted normal ureters and bladder. Diluted vasopressin (10 U in 100 ml normal saline) was infiltrated at the base of the myoma and a myomectomy was performed. The fundal raw area was pierced to reach the formed space between the anterior and posterior uterine serosa. The bilateral round ligaments were clamped, cut, and ligated. Diluted vasopressin was injected into the fundal anterior uterine wall and about 1 cm was excised. Then, the bilateral utero-ovarian ligaments were clamped, cut, and ligated. In the same way another 1 cm of anterior uterine wall was excised and the bilateral uterine vessels were clamped, cut, and ligated. The rest of the uterine wall area was infiltrated with diluted vasopressin circumferentially. An incision at the vesico-cervical junction was made and the bladder pushed up. The posterior fornix area was incised and the Pouch of Douglas (POD) opened. Vesico-uterine pouch opened under finger guidance placed through POD. The rest of the anterior uterine wall was excised. Exposed bilateral cardinal-uterosacral ligament complexes (CULCs) were clamped, cut, and ligated. The remaining vaginal attachments ligated hemostatically and the vault was closed. For vault prolapse prevention, vault closure suture ends were tied with ipsilateral CULC suture end, brought outside the vagina at vault angle. A follow-up visit up to 1 year found no complications. This novel reverse vaginal hysterectomy combining the principles of both abdominal and vaginal hysterectomy can successfully manage chronic non-puerperal complete uterine inversion.

Non-Puerperal Uterine Inversion Managed Robotically

Video Objective To demonstrate a method for surgical correction of chronic non-puerperal uterine inversion. Setting Patient with chronic non-puerperal uterine inversion of unknown duration, symptomatic for 3 months. She was referred to Urogynecology at a tertiary referral center for presumed pelvic organ prolapse. Interventions Surgical video demonstration of robotic assisted total laparoscopic hysterectomy and bilateral salpingo-oophorectomy in the setting of complete uterine inversion. Conclusion We found that the chronic nature of this patient's uterine inversion precluded reduction with traditional methods. We demonstrate additional surgical techniques that may be used to ensure safe dissection of pelvic anatomy.

Chronic Uterine Inversion Secondary to Uterine Sarcoma: A Case Report

Chronic non-puerperal uterine inversion is a rare condition that usually presents with vaginal bleeding and vaginal mass. Frequently, it is caused by benign and malignant tumors. A mass in the vagina, particularly if it is a malignant tumor, can be confused with a uterine malignancy without inversion. Clinical diagnosis of chronic uterine inversion is difficult and may be diagnosed during surgery. In this report, we present a case of chronic uterine inversion diagnosed as a uterine sarcoma by punch biopsy.

Chronic Postmenopausal Uterine Inversion: A Case Report

Introduction: Chronic non-puerperal uterine inversion is rare and emerges particularly in an over-aged group of women of reproductive age, usually associated with uterine pathology. Its diagnosis is based on high index of suspicion. Case presentation: A 70-year-old para-2 Ethiopian woman came to our hospital with a complaint of mass protruding per vaginum of month duration for it become painful and irreducible over the last five days. Subsequently vaginal hysterectomy done via combined abdomino-vaginal approach. The certainty of diagnosis of inverted uterus reached intraoperative when a dimple with a diameter of 3 cm in the midpelvis containing bilateral round ligaments, infundibulopelvic ligaments and bladder were seen intraoperative after laparotomy. Gross examination of cut section of the removed uterus showed a fundally located fundal myoma which was confirmed on histopathologic examination which revealed degenerating uterine fibroid and a dense chronic inflammation with necrosis of the endometrium. Conclusion: Non-puerperal chronic inversion of the uterus is rare and thus its diagnosis should be based on high index of suspicion. Though, mentioned in literatures of case reports to occur commonly in over-aged group of women of reproductive age, its diagnosis should be considered at any age in postmenopausal period. Super infection of the inverted part should be suspected and treated with appropriate broad spectrum antibiotics before the surgery. Usually it is a first encounter for a gynecologist and an attempt in restoration and abdominal hysterectomy may be difficult mandating vaginal approach.

English

Chronic non-puerperal uterine inversion is an extremely rare clinical situation. We report a 56 year-old woman with chronic nonpuerperal uterine inversion due to a fundal leiomyoma. She was treated with myomectomy followed by vaginal hysterectomy without reinverting the uterus. We emphasize use of pre-operative pelvic ultrasonography for excluding possible bowel loops in the inverted uterus and use of intravenous pyelography for confirming normal ureteric course. We also emphasize that performing myomectomy first helped to partially

Chronic non-puerperal uterine inversion: Case series

Inversion of the uterus is a rare clinical problem. Non-puerperal inversion usually results from a tumor arising from the fundus of the uterus. We report two cases of chronic non-puerperal uterine inversion in a 38-year-old and a 54-year-old postmenopausal woman. They both presented with vaginal bleeding, a mass protruding from the vagina and lower abdominal pain. Diagnosis was made based on these clinical features. At first, vaginal myomectomy was performed and after that, a Kustner procedure and vaginal hysterectomy was performed in both cases. Early diagnosis and appropriate surgical treatment of the inverted uterus are important to prevent further complications.

Chronic nonpuerperal uterine inversion and necrosis: a case report

IntroductionInversion of the non-pregnant uterus is rare.Case presentationA 56-year-old African American woman presented to our emergency center with complaints of a mass protruding from her vagina. She subsequently underwent vaginal myomectomy, abdominal hysterectomy and bilateral salpingo-oophorectomy. Pathologic examination revealed a necrotic fibroid and endometrium. At the time of laparotomy an inverted uterus was diagnosed when a 3 cm dimple containing bilateral round ligaments, infundibulopelvic ligaments and bladder was observed.ConclusionChronic nonpuerperal inversion of the uterus is rare. Infection should be suspected and appropriate broad spectrum antibiotics begun while planning surgery. An attempt at vaginal restoration and removal is difficult. Abdominal hysterectomy may be necessary taking care to locate the distal urinary collecting system.

Idiopathic chronic uterine inversion in a nulligravida

A 25-year-old nulligravida presented at this Gynaecology clinic with post coital and intermenstrual bleeding with brownish vaginal discharge dating 8 months. She attained menarche at 18 years of age and since then had normal menstruation until onset of complaints. She had moderate pallor with normal cardiopulmonary status and her abdomen was normal. There was a reddish firm polypoid friable and tender mass measuring 6x4 cm in the vagina which appeared continuous with the cervix but the uterus was not bimanually ballotable. An impression of cervical polyp with anaemia was made to exclude a chronically inverted uterus. She was transfused and had examination under anaesthesia (EUA) and the findings were consistent with idiopathic chronic non-puerperal uterine inversion. The uterus was repositioned using the Haultain’s operation as described below. Her post-operative recovery was satisfactory and she resumed normal menstruation 4 weeks later. (excerpt)

Computed Tomography of Chronic Nonpuerperal Uterine Inversion

Uterine inversion is an unusual entity; chronic nonpuerperal inversion is rare. In this report we present a case of chronic nonpuerperal uterine inversion that was initially diagnosed as invasive endometrial carcinoma. The CT findings in this case are presented.