Case Report of a Rare Nonpuerperal Uterine Inversion Managed with Uterosacral Ligament Hysteropexy
Nonpuerperal uterine inversions are rare. Typically occurring in older women, they are most commonly due to transcervical mass expulsion. Diagnosis is often difficult because of vague symptomatology, presentation, and unknown course of the pathology. Surgical correction is often necessary in the pre...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-01-01
|
| Series: | Case Reports in Obstetrics and Gynecology |
| Online Access: | http://dx.doi.org/10.1155/2021/4054924 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849306541113475072 |
|---|---|
| author | Ali Azadi Alexandra Wolfe Greg J. Marchand |
| author_facet | Ali Azadi Alexandra Wolfe Greg J. Marchand |
| author_sort | Ali Azadi |
| collection | DOAJ |
| description | Nonpuerperal uterine inversions are rare. Typically occurring in older women, they are most commonly due to transcervical mass expulsion. Diagnosis is often difficult because of vague symptomatology, presentation, and unknown course of the pathology. Surgical correction is often necessary in the presence of active bleeding or prolapse severity causing urinary retention. This case of nonpuerperal inversion presented to the emergency department with vaginal bleeding and mass protrusion. The examination was consistent with POPQ stage IV prolapse and uterine inversion secondary to cervical expulsion of multiple uterine fibroids. Because of full cervical dilation and concerns of ureteral injury with an extirpative procedure, vaginal myomectomy was performed with concomitant robotic uterosacral ligament hysteropexy. The operative procedure and postoperative course were uncomplicated, and discharge occurred on post-op day 1. She remained asymptomatic at the 6-month follow-up encounter. Though uterine preservation has been performed in cases of uterine inversion to maintain fertility, there are no reported cases of concomitant hysteropexy being completed for correction of POPQ stage IV prolapse simultaneously encountered. Additionally, the novel robotic approach has not been documented. This case illustrates the short-term success of robotic uterosacral hysteropexy as an additional option of care with potentially less morbidity when compared to hysterectomy for advanced stage uterine prolapse with nonpuerperal uterine inversion. |
| format | Article |
| id | doaj-art-2d5d2865bf12465b91e866843e8764a1 |
| institution | Kabale University |
| issn | 2090-6684 2090-6692 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Obstetrics and Gynecology |
| spelling | doaj-art-2d5d2865bf12465b91e866843e8764a12025-08-20T03:55:02ZengWileyCase Reports in Obstetrics and Gynecology2090-66842090-66922021-01-01202110.1155/2021/40549244054924Case Report of a Rare Nonpuerperal Uterine Inversion Managed with Uterosacral Ligament HysteropexyAli Azadi0Alexandra Wolfe1Greg J. Marchand2University of Arizona, College of Medicine, 475 N 5th St, Phoenix, AZ 85004, USAOMS-IV Midwestern University, 19555 N 59th Ave, Glendale, AZ 85308, USAThe Marchand Institute for Minimally Invasive Surgery, 10238 E Hampton Ave, Suite 212, Mesa, AZ 85209, USANonpuerperal uterine inversions are rare. Typically occurring in older women, they are most commonly due to transcervical mass expulsion. Diagnosis is often difficult because of vague symptomatology, presentation, and unknown course of the pathology. Surgical correction is often necessary in the presence of active bleeding or prolapse severity causing urinary retention. This case of nonpuerperal inversion presented to the emergency department with vaginal bleeding and mass protrusion. The examination was consistent with POPQ stage IV prolapse and uterine inversion secondary to cervical expulsion of multiple uterine fibroids. Because of full cervical dilation and concerns of ureteral injury with an extirpative procedure, vaginal myomectomy was performed with concomitant robotic uterosacral ligament hysteropexy. The operative procedure and postoperative course were uncomplicated, and discharge occurred on post-op day 1. She remained asymptomatic at the 6-month follow-up encounter. Though uterine preservation has been performed in cases of uterine inversion to maintain fertility, there are no reported cases of concomitant hysteropexy being completed for correction of POPQ stage IV prolapse simultaneously encountered. Additionally, the novel robotic approach has not been documented. This case illustrates the short-term success of robotic uterosacral hysteropexy as an additional option of care with potentially less morbidity when compared to hysterectomy for advanced stage uterine prolapse with nonpuerperal uterine inversion.http://dx.doi.org/10.1155/2021/4054924 |
| spellingShingle | Ali Azadi Alexandra Wolfe Greg J. Marchand Case Report of a Rare Nonpuerperal Uterine Inversion Managed with Uterosacral Ligament Hysteropexy Case Reports in Obstetrics and Gynecology |
| title | Case Report of a Rare Nonpuerperal Uterine Inversion Managed with Uterosacral Ligament Hysteropexy |
| title_full | Case Report of a Rare Nonpuerperal Uterine Inversion Managed with Uterosacral Ligament Hysteropexy |
| title_fullStr | Case Report of a Rare Nonpuerperal Uterine Inversion Managed with Uterosacral Ligament Hysteropexy |
| title_full_unstemmed | Case Report of a Rare Nonpuerperal Uterine Inversion Managed with Uterosacral Ligament Hysteropexy |
| title_short | Case Report of a Rare Nonpuerperal Uterine Inversion Managed with Uterosacral Ligament Hysteropexy |
| title_sort | case report of a rare nonpuerperal uterine inversion managed with uterosacral ligament hysteropexy |
| url | http://dx.doi.org/10.1155/2021/4054924 |
| work_keys_str_mv | AT aliazadi casereportofararenonpuerperaluterineinversionmanagedwithuterosacralligamenthysteropexy AT alexandrawolfe casereportofararenonpuerperaluterineinversionmanagedwithuterosacralligamenthysteropexy AT gregjmarchand casereportofararenonpuerperaluterineinversionmanagedwithuterosacralligamenthysteropexy |