Inversion of the Myomatous Uterus.

Uterine inversion due to a leiomyoma on postpartum day 41: A case report

“…Most cases of nonpuerperal uterine inversion are due to uterine leiomyoma (87%), a lesser number are associated with uterine sarcoma (7.4%) and an even lesser number are associated with uterine carcinoma (5.6%) 4 . The forms of uterine leiomyoma prone to inversion complications are not only the submucous type, but also the intramural type 5 . According to the literature regarding the mechanisms of nonpuerperal uterine inversion, the uterine wall is nearly always thin at the point of leiomyoma implantation from pressure atrophy; therefore, the larger the tumor, the more marked the thinness of the uterine wall.…”

“…4 The forms of uterine leiomyoma prone to inversion complications are not only the submucous type, but also the intramural type. 5 According to the literature regarding the mechanisms of nonpuerperal uterine inversion, the uterine wall is nearly always thin at the point of leiomyoma implantation from pressure atrophy; therefore, the larger the tumor, the more marked the thinness of the uterine wall. Contractions of the uterine musculature bring the prolapsed tumor into the uterine cavity.…”

“…The tumor is, thus, gradually forced downwards toward the cervical canal, which dilates, and it may even enter the vagina and be extruded from it. [4][5][6][7] In the present case, three factors seemed to predispose the patient to uterine inversion: (i) the uterine wall is distended and has been thinned during pregnancy; (ii) the tumor is large; and (iii) the presence of postpartum uterine contractions and cervical dilatation.…”

Non‐puerperal uterine inversion. Case report

“…With sarcoma the area of the uterine wall weakened by the growth is believed to prolapse into the cavity and thus be brought under the influence of the active musculature. With submucous polypi the uterine wall at the site of attachment is from the first drawn in by the activity of the remainder of the body of the uterus (Williams 1900;Riterband & Colquhoun 1960;Lascarides & Cohen 1968).…”

“…Non-puerperal or gynaecological inversion is extremely rare and no estimate of its incidence occurs in the literature. It happens chiefly when the uterus acts to expel a submucous fibromyonia with fundal attachment, but cndometrial carcinoma and sarcoma and the mixed mesodermal tumours may have the same effect (Williams 1900;Das 1940;Reich & Nechtow 1946;Jones 1951;Dyroff & Thomas 1955;Nelson & Sites 1956;Riterband & Colquhoun 1960;Sitaratna & Sarma 1962;Ashmore & Attapattu 1975;Pride & Shaffer 1977;Holzer 1979;Sinha & Quadros 1979). Complications develop making surgical treatment particularly difficult.…”