Non-puerperal Uterine Inversion Research Articles

Management of nonpuerperal uterine inversion using a combined laparoscopic and vaginal approach

Although described as a postpartum complication, uterine inversion may also occur in nonpregnant women. We report a case of nonpuerperal uterine inversion, because of a large exteriorized submucous myoma in a 40-year-old woman, which was surgically managed by hysterectomy using a combined laparoscopic and vaginal approach.

Uterine inversion with massive uterovaginal prolapse and multiple bladder stones

A non-puerperal uterine inversion in advanced uterovaginal prolapse is a rare occurrence. Even more unusual is the presence of bladder calculi in these two conditions, which has not been documented before. We report a case of acute urinary retention secondary to severe uterovaginal prolapse associated with uterine inversion and multiple bladder calculi.

Ultrasound diagnosis and comprehensive surgical treatment of complete non-puerperal uterine inversion

Ultrasonographic diagnosis of very rare case of complete non-puerperal uterine inversion secondary to a large sub-mucous fibroid. A 50-year-old woman was admitted with heavy vaginal bleeding. Detailed vaginal and abdominal ultrasound, using color Doppler flow, raised the suspicion of complete uterine inversion. The distal ends of the fallopian tubes and part of the ovaries were demonstrated adherent to the uterine fundus. Laparoscopy showed there was no uterus inside the abdomen because of complete uterine inversion. Only a dimple with a constriction ring was found at the site of the uterus. A sub-mucous 6 cm fibroid was attached to the fundus, and vaginal myomectomy was performed to reduce uterine size in order to restore the uterus to its abdominal position. However, the uterus was impacted and only cutting longitudinally the anterior and posterior fornices helped to restore the uterus and facilitate an abdominal hysterectomy. Histological examination of the uterus and fibroid following hysterectomy confirmed their benign nature. Ultrasonographic diagnosis of complete uterine inversion is feasible. However, high index of suspicion is necessary.

Non puerperal Uterine inversion due to Submucous Fibroid: A Case Report

An unusual case of non-puerperal uterine inversion is presented. The patient, a 37 year old multipara who had been earlier diagnosed with uterine fibroids, subsequently developed a protrusion from the vagina having declined surgery. The mass had become necrotic and infected at the time of presentation. Uterine inversion was diagnosed clinically and further confirmed at surgery where a vaginal hysterectomy was carried out. Uterine inversion is a rare condition not encountered by most gynaecologists. Diagnosis and treatment could thus be challenging. The literature on non-puerperal uterine inversion regarding the evaluation and management is reviewed.

Non-Puerperal Uterine Inversion Following a Prolapsed Leiomyoma in a CameroonianWoman

Non-puerperal uterine inversion is a rare condition that occurs as a complication of intrauterine tumors, especially giant submucosal leiomyomas. This condition can cause severe pain and hemorrhage. Management can consist of manual repositioning through the cervical ring, or surgical corrective measures. We report here a case of uterine inversion following the prolapse of a submucosal leiomyoma, managed by laparotomy. We also discuss alternative therapeutic approaches.

Pelvic organ prolapse and uterine inversion: A case report and literature review

Non-puerperal uterine inversion is a rare clinical problem with only 150 cases reported. It usually results from a tumor implanted on fundus of the uterus. Uterine inversion associated with pelvic organ prolapse (POP) is extremely rare with only 1 case reported. A 74-year-old multiparous menopausal women was admitted to our hospital with the following condition: purulent vaginal discharge, voiding diffi culty, lower abdominal discomfort, vaginal bleeding, protruding vaginal mass and POP. She was diagnosed as a POP with uterine inversion. After a posterior hysterotomy, vaginal hysterectomy, bilateral salpingoophorectomy and colpocleisis was performed and the pathological examination revealed a pyometra. We report a rare case of uterine inversion associated with POP and pyometra with a brief review of literature.

Non-puerperal uterine inversion due to a fundally located submucous myoma - A case report

Non-puerperal uterine inversion due to a fundally located submucous myoma - A case report

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.

Nonpuerperal Uterine Inversion Associated with Endometrial Polyp

Introduction: Current literature fails to describe an accurate incidence of nonpuerperal uterine inversion as a consequence of its rarity. However, uterine inversion may cause ischemia with subsequent necrosis and infection requiring immediate resolution with little or no prior experience. Case: A 68-year-old multiparous white woman, without prior gynecological surveillance, went to the emergency room complaining of vaginal bleeding. She had had vaginal spotting for the past 3 years. Examination revealed an approximately 10-cm mass filling the vagina. She was admitted for further study and surgery programming. A few hours later she developed abdominal pain, fever, and the mass protruded from the vulva. It was decided that she should immediately undergo surgery. The mass was removed by twisting through the vaginal route. At laparotomy, a doughnut appearance of an inverted uterus with tubes and ovaries abnormally positioned within the crater was observed. Exerting pressure from below and bilateral traction on the round ligaments failed to restore the uterus to normal position. An incision through the full thickness of the posterior uterine wall at the constriction site ring level was performed with combined traction from below, which was successful. Total hysterectomy with bilateral adnexectomy followed without difficulties. Pathological diagnosis was endometrial polyp. Conclusions: Nonpuerperal uterine inversion is a rare condition and the diagnosis is often made during surgery. Ultrasonography and magnetic resonance imaging have been shown useful as diagnostic tools. The authors review the surgical techniques described in the literature. (J GYNECOL SURG 26:215)

Non-puerperal uterine inversion secondary to uterine sarcoma and ascites demonstrated on CT and MRI

Uterine inversion is an uncommon condition usually found in association with childbirth. Non-puerperal uterine inversion is rare and clinical diagnosis is difficult. The condition is usually diagnosed during surgery. Prompt recognition of the radiological features of uterine inversion at an early stage permits optimal management including appropriate modification of subsequent surgical approach. We present a case of non-puerperal inversion secondary to uterine sarcoma in the context of ascites (a factor postulated to have played a contributary role). Uniquely, the diagnosis of uterine inversion was suggested on both computed tomography and magnetic resonance imaging. The key radiological findings are described along with a review of the relevant literature.

Non-puerperal uterine inversion due to submucous myoma in a young woman: a case report

IntroductionInversion of the uterus is an uncommon complication of the puerperium and it is an even rarer complication of the non-puerperal period. A submucous myoma is mostly the cause of the non-puerperal inversion but diagnosis can be difficult. In young women, non-puerperal uterine inversion is likely associated with a malignancy.Case presentationA 19-year-old nulliparous woman presented with abnormal vaginal bleeding, dysmenorrhoea, and a large mass protruding from her cervix. The mass was interpreted as a prolapsed pedunculated submucosal myoma. After extirpation of the mass by clamping and twisting its pedicle, a laparotomy was required under suspicion of a uterine rupture. The diagnosis was confirmed and the patient's uterus could be preserved. Pathological examination revealed a submucous myoma. The uterine inversion happened when the uterus retracted to expel the submucous myoma with fundal attachment. By extirpating the stalk the fundus was also resected, causing a uterine rupture.ConclusionWe report a case of non-puerperal uterine inversion associated with a benign submucous myoma. Non-puerperal uterine inversion is very uncommon in women of reproductive age and is usually caused by a malignant tumour. However, uterine-sparing surgery should be attempted in young women until the final pathology is known.

CT angiography of postpartum uterine inversion: Intra-uterine thread and streak sign

Inversion of the uterus is an uncommon event that usually occurs as a postpartum complication [Krenning RA. Nonpuerperal uterine inversion. Review of literature. Clin Exp Obstet Gynecol 1982;9:12–5; Dali SM, Rajbhandari S, Shrestha S. Puerperal inversion of the uterus in Nepal: case reports and review of literature. J Obstet Gynaecol Res 1997;23:319–25], and is often subject to diagnostic delay. These delays are partly due to a stable clinical condition, except for a minor vaginal discharge and bleeding. However, this condition can be devastating and result in shock or even death [Rachagan SP, Sivanesaratnam V, Kok KP, Raman S. Acute puerperal inversion of the uterus—an obstetric emergency. Aust N Z J Obstet Gynaecol 1988;28:29–32]. We describe radiographic findings of postpartum uterine inversion in a 26-year-old woman. Multiplanar reformatted CT demonstrated typical deformation of the uterus and CT angiograms revealed a characteristic arterial vasculature, which allowed us to make a diagnosis. We describe this unique CT angiographic marker as “the intra-uterine thread and streak sign”.

Nonpuerperal Uterine Inversion in an Afghan Woman

Nonpuerperal uterine inversion is a rare but serious condition which is often associated with polypoid benign or malignant tumors of the uterus. Timely diagnosis and intervention may prevent long-term sequelae. This report presents an unusual case of nonpuerperal uterine inversion which was diagnosed 14 months after an uneventful vaginal delivery, the longest period of time reported in world literature. The patient was successfully treated for uterine inversion and was discharged home in good condition. Nonpuerperal uterine inversion can be successfully treated in a low-resource environment, but may require utilization of elements from several standard techniques before reversion is accomplished.

Nonpuerperal Uterine Inversion Caused by Fibroid Polyp Associated with Squamous-Cell Carcinoma of the Cervix

Abstract Nonpuerperal uterine inversion is an extremely rare event. Of the small number of cases reported in the literature, most have been associated with benign uterine tumors and only a few with uterine sarcoma or carcinoma. To the best of our knowledge, no case associated with cervical carcinoma has been reported. In this paper, we report a rare case of nonpuerperal uterine inversion caused by an aborting fibroid and associated with squamous-cell carcinoma of the cervix in a 70-year-old postmenopausal woman. The patient was successfully treated surgically by excision of the fibroid vaginally, followed by a repositioning of the uterine inversion abdominally (the Haultain method) and total abdominal hysterectomy and bilateral salpingo-oopherectomy. Postoperative radiotherapy for cervical carcinoma was given after histopathologic confirmation. The association of malignancy with a nonpuerperal uterine inversion must be kept in mind and confirmed by histopathology. (J GYNECOL SURG 25:37)

Nonpuerperal Uterine Inversion Associated With an Immature Teratoma of the Uterus in an Adolescent

Nonpuerperal Uterine Inversion Associated With an Immature Teratoma of the Uterus in an Adolescent

Non-puerperal incomplete uterine inversion due to large sub-mucous fundal fibroid found at hysterectomy: a report of two cases

Two cases of non-puerperal incomplete uterine inversion due to large sub-mucous fundal fibroid are presented. This is rare and the diagnosis is often difficult. In both the cases diagnosis was made only during surgery.

Nonpuerperal Uterine Inversion Associated With an Immature Teratoma of the Uterus in an Adolescent

We report a case of nonpuerperal uterine inversion associated with an immature teratoma of the uterus. An adolescent nullipara with prolonged vaginal bleeding, severe abdominal pain, symptomatic anemia, and a presumed diagnosis of retained products of conception was found to have a large mass in the vagina. Uterine inversion was diagnosed and corrected using the Haultain procedure. The inversion catalyst was found to be an immature teratoma of the uterus. Reproductive age women with the rare finding of nonpuerperal uterine inversion are likely to have a malignancy. However, uterine-sparing surgery to correct the inversion should be attempted in young women until final pathology is known.

Non-puerperal complete uterine inversion caused by malignant mixed mullerian tumour of the uterus

Non-puerperal uterine inversion is an extremely rare entity, which many gynaecologists would never come across in their lifetime. Diagnosis can be difficult. Our patient was a 91-year-old lady who presented with profuse vaginal bleeding. Hysteroscopy was unsuccessful as the cervix was completely replaced by a friable growth. A total abdominal hysterectomy and bilateral salpingo-oophorectomy was planned as a palliative measure to stop bleeding. Uterine inversion was suspected for the first time at laparotomy and confirmed after dissecting the hysterectomy specimen, which revealed both tubes and ovaries lying inside the inverted uterus. Histology showed a malignant mixed mullerian tumour of the uterus.

Submucous Myoma Induces Uterine Inversion

Inversion of the uterus is indeed a rarity for a gynecologist. The puerperal variety is associated with pregnancy, including term pregnancy and abortion. The nonpuerperal condition may be tumor-induced or idiopathic. We present a nonpuerperal uterine inversion and discuss a reasonable plan for its management. A 42-year-old, unmarried woman without sexual experience and any systemic diseases noted a mass outside of the vaginal introitus combined with massive vaginal bleeding and abdominal pain of sudden onset after taking laxative agents for colonoscopic preparation. Then she had voiding difficulty with distended bladder. A suprapubic urinary catheter was inserted and 800 mL urine was drained out. The patient received emergency tumor resection and subtotal hysterectomy. The diagnosis of uterine inversion was confirmed during operation. The postoperative course was uneventful and she was discharged without complication. Nonpuerperal inversion of the uterus is rarely encountered by gynecologists. Diagnosis of uterine inversion is often not easy and imaging studies might be helpful. Surgical treatment is the method of choice in nonpuerperal uterine inversion.

Posterior hemidissection for nonpuerperal uterine inversion

A novel surgical technique using posterior hemidissection was introduced to treat a case of uterine inversion that was caused by a submucous fibroid and could not be managed by standard procedures. A 46-year-old woman gravida 6 para 4 2 living children presented with a mass that had been protruding from her vagina for three days. She was diagnosed as having nonpuerperal uterine inversion and underwent emergency abdominoperineal surgery. The uterus uterine ligaments fallopian tubes and ovaries could not be seen on exploration and there was a 2-cm hole in the Douglas pouch. The mass on the inverted fundus was resected but the uterus could not be reinserted into the pelvis by pulling the round ligaments (Huntington procedure). (excerpt)