An Extremely Rare Case of Chronic Non-Puerperal Uterine Inversion Treated by Myomectomy Preceding Vaginal Hysterectomy

Abstract

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 reposit the uterus which made vaginal hysterectomy easier.

Chronic non puerperal uterine inversion secondary to uterine leiomyoma misdiagnosed as advanced cervical cancer: a rare case report

“…4 Non Puerperal uterine inversion is very rare indeed in literature there is no figure about incidence of its occurrence. 1 There are only few case reports of chronic non puerperal uterine inversion. Most reports cite a prolapsed fibroid uterus as cause for inversion corresponding to 78.8-85% of cases.…”

“…1 Uterine inversion is described as part of the uterus indenting towards and eventually prolapsed through the dilated cervix resulting in uterus being turned inside out. It is categorised as puerperal/obstetric and non-puerperal/gynaecological complication.…”

Nonpuerperal inversion of uterus secondary to leiomyoma in menopause: a rare case report

“…10,11 Haultain's procedure uses a vertical incision in the posterior portion of ring with gentle traction on the round ligaments. If a hysterectomy is to be performed, reposition is always done first, because hysterectomy on the inverted uterus is associated with difficulty in identification of the peritoneal pouches, and also associated with a greater risk of injury to the urinary bladder and ureters 2 . In our case also, the same was followed.…”