Postmenopausal uterine inversion treated by subtotal hysterectomy

Simms-Stewart, Donnette; Frederick, Shane; Fletcher, Horace; Char, G; Mitchell, Simon J

doi:10.1080/01443610701844366

Cited by 15 publications

(12 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Only few cases of non-puerperal inversions have been reported in young women and in most cases the aetiology is attributed to malignancy [1,4]. Uterine leiomyoma are known to cause inversion in 78-85% of cases [4,5].…”

Section: Discussionmentioning

confidence: 99%

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

Rathod

Samal

Pallavee

et al. 2014

JCDR

View full text Add to dashboard Cite

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...

show abstract

Section: Discussionmentioning

confidence: 99%

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

Rathod

Samal

Pallavee

et al. 2014

JCDR

View full text Add to dashboard Cite

show abstract

“…However, if the uterus continues to maintain a degree of inversion, hysterectomy is needed [8]. In our case the vaginoscopy-hysteroscopy confirmed the complete uterine inversion and detected the uterine fundal defect after the pedicule was excised, however hysteroscopy failed to identify signs of uterine torsion.…”

Section: Discussionmentioning

confidence: 54%

Uterine inversion in a postmenopausal woman due to a twisted pediculated endometrial polyp with concomitant uterine torsion

Panayotidis

Pressley

2011

Gynecol Surg

View full text Add to dashboard Cite

“…There were various methods in the literature suggested different procedures to reposition the non-puerperal uterine inversion after enucleating the fibroid 7. This could be accomplished by either vaginal or abdominal route followed by hysterectomy.…”

Section: Discussionmentioning

confidence: 99%

“…Many cases of uterine inversion were occurred in multiparous and postmenopausal women. Hysterectomy may be the last consideration in this situation, if the patients want preserving uterus due to worrying about sexual function or loss her femininity 7. Rathod et al2 reported vaginal myomectomy for chronic uterine inversion due to benign fibroid in more hemodynamically stable young patient who desired future pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Non-puerperal Uterine Inversion Presented with Hypovolemic Shock

et al. 2016

View full text Add to dashboard Cite

We report a non-puerperal uterine inversion with nulliparous women caused by huge pedunculated submucosal fibroid. Massive bleeding from protruding mass through vagina brought the heart to stop in 42-year-old nulliparous woman. She became cardiopulmonary resuscitation survivor in emergency room and then underwent laparotomy which ended in successful myomectomy rather than hysterectomy considering her demand for future fertility. Meticulous and adequate fluid therapy and transfusion was also administered to recover from hypovolemic status. Pathologic report confirmed benign submucosal fibroid with degeneration, necrosis and abscess formation. Thus, clinician should be aware of uterine inversion when encountered with huge protruding vaginal mass and consider uterus-preserving management as surgical option when the future fertility is concerned.

show abstract

Postmenopausal uterine inversion treated by subtotal hysterectomy

Cited by 15 publications

References 6 publications

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

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

Uterine inversion in a postmenopausal woman due to a twisted pediculated endometrial polyp with concomitant uterine torsion

Non-puerperal Uterine Inversion Presented with Hypovolemic Shock

Contact Info

Product

Resources

About