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Nonpuerperal Uterine Inversion: What the Gynaecologists Need to Know?

R P Herath1, M Patabendige2, M Rashid3

  • 1Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka.

Obstetrics and Gynecology International
|June 23, 2020
PubMed
Summary
This summary is machine-generated.

Nonpuerperal uterine inversion (NPUI) is rare, often caused by fibroids or malignancies. Surgical treatment involves hysterectomy or repositioning, with a combined approach favored for non-malignant cases.

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Area of Science:

  • Gynecology
  • Surgical Pathology

Background:

  • Nonpuerperal uterine inversion (NPUI) presents significant diagnostic and surgical challenges due to its rarity.
  • Understanding causative pathologies and treatment options is crucial for effective management.

Purpose of the Study:

  • To conduct a comprehensive literature review on NPUI.
  • To analyze causative pathologies, diagnostic methods, and surgical treatments for NPUI.

Main Methods:

  • A systematic literature search was performed on MEDLINE and Google Scholar for NPUI cases published between 1911 and September 2018.
  • Analysis included 133 case reports detailing clinical presentation, diagnosis, and surgical interventions.
  • Surgical methods were evaluated based on access route, repositioning technique, and final procedure.

Main Results:

  • The most common etiologies for NPUI were leiomyoma (56.2%) and malignancies (32.02%).
  • Diagnosis relies on clinical suspicion, ultrasonography, MRI, and sometimes laparoscopy or biopsy.
  • Abdominal hysterectomy was the most frequent treatment (39.7%), while uterine repair after repositioning was performed in 15.0% of cases.

Conclusions:

  • Uterine fibroids are the leading cause of NPUI, with malignancies accounting for a substantial portion.
  • A combined abdominal and vaginal surgical approach followed by hysterectomy or repair is recommended for non-malignant NPUI.