Uterine Incarceration Caused by Adenomyosis: A Case Report With Review of Relevant Literature

Although uterine incarceration is typically associated with pregnancy, this report presents a rare case of uterine incarceration in a non-pregnant woman, highlighting adenomyosis as an uncommonly and underrecognized etiology, distinct from the typical pregnancy-related causes. A 49-year-old non-pregnant woman presented with acute urinary retention and lower abdominal pain. Imaging revealed a retroverted, incarcerated uterus. The key distinguishing feature was the pathological finding: the incarceration was not solely due to adhesions or congenital factors but was primarily caused by significant uterine enlargement and fixation resulting from diffuse adenomyosis. Pelvic adhesions were also present and may have contributed. A hysterectomy was performed, which confirmed the diagnosis and served as the curative intervention. This case demonstrates that adenomyosis can be a contributing cause of uterine incarceration, a finding seldom reported. It expands the differential diagnosis for urinary obstruction in non-pregnant women. For patients not seeking fertility preservation, hysterectomy is a definitive curative treatment.