Non-puerperal uterine inversion: A case report

Fofie, CO; Baffoe, Peter

doi:10.4314/gmj.v44i2.68889

Cited by 29 publications

(39 citation statements)

References 6 publications

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“…Abdominal approaches include Huntington's and Haultain whereas vaginal approaches include Kustner and Spinelle. Kustner procedure includes entering the pouch of Douglas vaginally and splitting the posterior aspect of the uterus and cervix and finally re-inverting the uterus where as in Spinelli's method incision is given in anterior aspect of cervix and uterus is reinverted [7]. Where fertility is wished, the uterine incision is repaired through abdominal approach otherwise routine vaginal hysterectomy can be proceeded.…”

Section: Discussionmentioning

confidence: 99%

Non Puerperal Uterine Inversion in A Young Female- A Case Report

Rathod

Samal

Pallavee

et al. 2014

JCDR

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A 28-year-old P 1 L 1 woman presented to our outpatient department with the complaints of mass descending per vaginum and foul smelling vaginal discharge for the past six months. She had an institutional normal vaginal delivery two and a half years back which was uneventful. She had history of irregular and excessive menstrual flow with intermittent abdominal pain for the last one year and was treated in local hospital medically.General examination revealed pallor and haemoglobin estimation was reported as 7.4gm/dl. There was no other systemic abnormality. Gynaecological examination revealed a mass protruding through the vaginal introitus which was globular and the broadest leading part measured 25x10x6cm [Table/ Fig-1]. The surface of the mass appeared hemorrhagic, edematous and had a shaggy look. No opening could be seen in the leading part of mass. Cervical os could not be identified. There was no active bleeding at that time. On palpation the mass felt firm and bled on touch. Vagina was completely inverted out, cervix could not be felt and the mass was found to be irreducible. Uterine sound could not be passed.Uterus could not be felt and a vacuum was felt anteriorly in the per rectal examination. obstetrics and Gynaecology SectionTransabdominal ultrasound could not identify uterus in its normal position in pelvis. A provisional diagnosis of chronic uterine inversion with submucosal fundal myoma was made and the patient was prepared for surgery. Continuous bladder drainage with Foleys catheter and broad spectrum intravenous antibiotics was started. Blood transfusion was done to improve her anaemic status preoperatively. Local dressing using the antiseptic solution of povidone iodine and hygroscopic action of magnesium sulphate was done daily. Intravenous pyelography was done preoperatively to trace the course of ureter. As the patient was young and desirous of future pregnancy, a combined abdomino-vaginal approach using Kustner's method was undertaken to reposition the uterus into the pelvic cavity. Vaginal myomectomy [Table/ Fig-2] was done by giving a longitudinal incision on the most dependent part of mass with posterior extension followed by enucleation of the fibroid. Redundant wall was excised and the uterus was reposed into the pelvic cavity [Table/ Fig-3]. Abdominal part of the operation entailed accessing the abdominal cavity through a transverse incision which revealed normal appearing bilateral ovaries, visible distal parts of fallopian tube and an absent uterine corpus along with the medial ends of fallopian tube. Through the abdominal approach, the uterine Non Puerperal Uterine Inversion in A Young Female-A Case Report aBstRaCt We report a case of 28-year-old, primipara who presented with complaints of mass descending per vaginum along with excessive bleeding and foul smelling vaginal discharge for the past six months. Clinical examination revealed an inverted uterus, cervix and vagina with a large submucosal fundal fibroid. A diagnosis of non-puerperal uterine inversion was made. Surgical manag...

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Section: Discussionmentioning

confidence: 99%

Non Puerperal Uterine Inversion in A Young Female- A Case Report

Rathod

Samal

Pallavee

et al. 2014

JCDR

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show abstract

“…Spinelli and Kustner are trans-vaginal repositioning techniques and the Huntington's, Haultain's and Dobbin's procedures are trans-abdominal techniques. 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 .…”

Section: Discussionmentioning

confidence: 99%

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

Kalarani

Amudha

Rubini

et al. 2016

Int J Reprod Contracept Obstet Gynecol

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“…Kustner procedure includes entering the pouch of Douglas vaginally and splitting the posterior aspect of the uterus and cervix and finally re-inverting the uterus where as in Spinelli's method incision is given in anterior aspect of cervix and uterus is reinverted. 11 Abdominal approaches include Huntington's and Haultain.…”

Section: Discussionmentioning

confidence: 99%