Non-puerperal uterine inversion due to submucosal fibroid in a nulliparous woman: A case report

Abstract

Introduction: Non-puerperal uterine inversion (NPUI) is an extremely rare condition. Our case is the second reported case in a patient who had never been sexually active. Most reported cases are in multiparous women, with this being the ninth reported case in a nulliparous woman in the past 10 years: 2006-2017. Case Report: A 45-year-old, nulliparous woman who had never been sexually active presented with significant anemia due to menorrhagia for the past five months. A diagnosis of chronic uterine inversion secondary to a fibroid was made on CT scan. She was managed with a total abdominal hysterectomy with anterior longitudinal incision to release a tight ring around the fibroid and fundus, followed by excision of the myoma. Histopathology revealed a degenerated uterine fibroid. Conclusion: Non-puerperal uterine inversion is a rare condition that can pose diagnostic and management dilemmas. A high index of suspicion with help from radiological tools is required to make the diagnosis and plan management accordingly. Surgery to correct chronic inversion of the uterus is challenging.