Non-puerperal incomplete uterine inversion due to large sub-mucous fundal fibroid found at hysterectomy: a report of two cases

Sharma, Jai Bhagwan; Kumar, Sunesh; Rahman, Syed Monajatur; Roy, Kallol Kumar; Malhotra, Neena

doi:10.1007/s00404-008-0754-9

Cited by 7 publications

(4 citation statements)

References 6 publications

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“…In stage 1, inversion of the uterus is intrauterine (incomplete) and the fundus remains within the cavity; stage 2, complete inversion of the uterine fundus through the fibromuscular cervix; stage 3, total inversion; the fundus protrudes through the vulva; stage 4, the vagina is also involved within total inversion. While stage 1, repositioning of the fundus could be tried for treatment, for stages 2-4, hysterectomy should be an option and should be discussed with the patient if childbearing is not an issue ( 6 , 7 ). Eventually, radiologic evaluation is the key for stage definition and pre-operative decision-making.…”

Section: Discussionmentioning

confidence: 99%

Magnetic Resonance Imaging of Non-Puerperal Complete Uterine Inversion

et al. 2015

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Uterine inversion is shortly described as the indentation and depression of the fundic area extending downwards up to the different levels of the birth canal till vaginal opening. Clinical diagnosis of uterine inversion is difficult due to its non-specific symptoms and physical examination. Ultrasonography is the most practical modality for radiological evaluation, but it is inadequate to determine the exact nature of this condition and making the differential diagnosis. In this case, we present the main MRI findings of non-puerperal complete uterine inversion caused by a giant leiomyoma.

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Section: Discussionmentioning

confidence: 99%

Magnetic Resonance Imaging of Non-Puerperal Complete Uterine Inversion

et al. 2015

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“…Non-puerperal chronic uterine inversions are rare and can be caused by benign (70%) or malignant tumours (20%) 1. Fibroids have been described in some series to cause uterine inversion as they give a continuous drag at the fundus 2. Malignant mixed mesodermal tumours (MMMTs) or carcinosarcomas are even more uncommon since they are of rare occurrence (occur in 5% of all uterine tumours) 3 4.…”

Section: Discussionmentioning

confidence: 99%

Non-puerperal uterine inversion caused by malignant mixed mullerian sarcoma

et al. 2013

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“…Round ligaments were clamped and cut followed by cornual fundal structures. After ligating the uterine arteries, the uterus was cut open with a midline vertical incision to remove the fibroid removed, and hysterectomy was completed as usual [26].…”

Section: Stagementioning

confidence: 99%

Nonpuerperal Uterine Inversion: What the Gynaecologists Need to Know?

Herath

Patabendige²,

Rashid

et al. 2020

Obstetrics and Gynecology International

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Introduction. Nonpuerperal uterine inversion (NPUI) is a rare clinical problem with diagnostic and surgical challenges. The objective of our study was to review the literature on NPUI and describe causative pathologies, diagnosis, and different surgical options available for treatment. Materials and Methods. A comprehensive literature review was carried out on MEDLINE and Google Scholar databases to look for NPUI using the term “non-puerperal uterine inversion,” and further went through the cross-references of the published articles. Data are published case reports from 1911 to September 2018. Of the 153 published cases, 133 reports had adequate details of surgery for analysis. These reports were analyzed, concerning the clinical presentation, methods of diagnosis, and surgical treatment. Results. Mean age of the women was 46.3 years (standard deviation: 18, N = 153). Leiomyoma remained the commonest (56.2%) aetiology. While malignancies contributed to 32.02% of cases, 9.2% were idiopathic. High degree of clinical suspicion and identification of unique features on ultrasonography and magnetic resonance imaging enable prompt diagnosis. In cases of uncertainty, laparoscopy or biopsy of the mass was used to confirm the diagnosis. Hysterectomy or repositioning and repair of the uterus are the only treatment options available. The surgical methods implemented were analyzed in three aspects: route of surgical access, method of repositioning, and final surgical procedure undertaken. The majority (48.8%) had only abdominal access, while 27.1% had both abdominal and vaginal access. Haultain procedure was the most useful procedure for reposition (18.0%) of the uterus. The majority (39.7%) required abdominal hysterectomy with or without debulking of the tumour abdominally, while 15.0% had uterine repair after repositioning. We reviewed the different surgical techniques and described and proposed a treatment algorithm. Conclusions. Fibroids were the commonest cause for NPUI. Malignancies accounted for one-third of cases. A combined abdominal and vaginal approach, followed by hysterectomy or repair after repositioning, seems to be better for nonmalignant cases.

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Non-puerperal incomplete uterine inversion due to large sub-mucous fundal fibroid found at hysterectomy: a report of two cases

Abstract: Two cases of non-puerperal incomplete uterine inversion due to large sub-mucous fundal fibroid are presented. This is rare and the diagnosis is often difficult. In both the cases diagnosis was made only during surgery.

Cited by 7 publications

References 6 publications

Magnetic Resonance Imaging of Non-Puerperal Complete Uterine Inversion

Magnetic Resonance Imaging of Non-Puerperal Complete Uterine Inversion

Non-puerperal uterine inversion caused by malignant mixed mullerian sarcoma

Nonpuerperal Uterine Inversion: What the Gynaecologists Need to Know?

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