Inside out: a rare case of nonpuerperal uterine inversion caused by submucosal leiomyoma

Nonpuerperal uterine inversion (NPUI) is an extremely rare condition characterized by the uterus turning inside out through the endometrial cavity or cervix. Due to its rarity, NPUI presents diagnostic and therapeutic challenges, especially in atypical cases. This report discusses the management of such a case. A 50-year-old woman, P1A0, was referred with a protruding mass from her vagina. With no cervix part identified and no uterus found on abdominal ultrasound, uterine inversion with submucosal leiomyoma was diagnosed. Repositioning was done from the vagina and abdomen using a sondage. Total abdominal hysterectomy was performed. NPUI is a rare condition often caused by uterine fibroids, presenting with vaginal bleeding, pain, and a protruding mass. Diagnosis of uterine inversion relies on clinical signs, ultrasound, or magnetic resonance imaging could help but is not essential. Treatment depends on reproductive goals, but often requires hysterectomy following uterus repositioning. Conservative approaches are rare, and their impact on fertility remains uncertain.