Gynäkologie und Geburtshilfe
Offener Zugang

Abstrakt

Chronic Postmenopausal Uterine Inversion: A Case Report

Dejene Asefa and Nadia Yimar

Introduction: Chronic non-puerperal uterine inversion is rare and emerges particularly in an over-aged group of women of reproductive age, usually associated with uterine pathology. Its diagnosis is based on high index of suspicion.

Case presentation: A 70-year-old para-2 Ethiopian woman came to our hospital with a complaint of mass protruding per vaginum of month duration for it become painful and irreducible over the last five days. Subsequently vaginal hysterectomy done via combined abdomino-vaginal approach. The certainty of diagnosis of inverted uterus reached intraoperative when a dimple with a diameter of 3 cm in the midpelvis containing bilateral round ligaments, infundibulopelvic ligaments and bladder were seen intraoperative after laparotomy. Gross examination of cut section of the removed uterus showed a fundally located fundal myoma which was confirmed on histopathologic examination which revealed degenerating uterine fibroid and a dense chronic inflammation with necrosis of the endometrium.

Conclusion: Non-puerperal chronic inversion of the uterus is rare and thus its diagnosis should be based on high index of suspicion. Though, mentioned in literatures of case reports to occur commonly in over-aged group of women of reproductive age, its diagnosis should be considered at any age in postmenopausal period. Super infection of the inverted part should be suspected and treated with appropriate broad spectrum antibiotics before the surgery. Usually it is a first encounter for a gynecologist and an attempt in restoration and abdominal hysterectomy may be difficult mandating vaginal approach.