Novel correction technique of chronic puerperal inversion of the uterus

Abstract

fibroid, which carries less operative risk than an intramural fibroid. Ehigiegba et al. (2001) have also emphasised the importance of case selection in performing myomectomy in pregnancy in their review of 25 cases in which myomectomy was performed at caesarean section.Most uterine fibroids complicating pregnancy can be managed conservatively, however myomectomy may be indicated in cases of intractable pain not responding to analgesia and where the fibroid is solitary or subserous and removal will not breach the endometrial cavity. Such cases have to be carefully selected and the risks of the procedure discussed in detail, documented and consent obtained.

Non-puerperal Uterine Inversion: A Tertiary Category Hospital Case

“…The technique of huntington consists of clamping the round ligaments with Allis's pliers at the point of insertion with the uterus and exert a gentle traction force upright until correction of the inversion. Hauntain's own consists in doing a longitudinal incision till the ringed cervical stricture to reduce the constriction and facilitate by an upright traction the reversion of the uterus [10][11].…”

“…The technique of Twe, consists in the realization of an anterior hysterotomy after dissection of the cervical bladder, the inferior segment and then the restitution of the uterus. That of Kustner, consist in the realization of an incision of the cervix and the posterior part of the uterine corpus [10]. By the way, these techniques requiring first of all the re-integration of the uterus in the abdominal cavity may increase the risk of post-operative abdominal infection in the case of uterine inversion seen late.…”

Non-Puerperal Uterine Inversion in a Young Woman: A Case Report, Brief Surgical Review, and Clinical Insights

“…Two abdominal approaches for reduction of the inverted uterus have been documented: the Haultain and Huntington techniques [7]. In Huntington's technique, the cup or dimple of the inversion is identified, Allis forceps are introduced into the cup and placed on the round ligaments, and gentle upward traction is exerted on the clamps containing the ligaments.…”

“…In Haultain's technique, the technique utilized in this case, a longitudinal incision is made in the posterior uterine wall and through the cervical constriction ring. This releases the constrictive pressure and facilitates anatomical restoration of the uterus with continued upward pressure until it reverts to normal positioning [7,8].…”

“…The uterus is then reverted, and the hysterotomy is closed in several layers in cases of uterine preservation; otherwise, hysterectomy is performed. The Kustner's technique involves replacing the uterine fundus after opening the posterior cul-de-sac and incising the cervix and posterior wall, providing the clearance for correcting the inversion [7]. The defect in the posterior uterine wall and cervix is then closed in layers, followed by closure of the colpotomy [8].…”