Nonpuerperal vaginal hemorrhage secondary to complete uterine inversion: A case report

Approximately 95% of uterine inversion cases are associated with pregnancy in the early postpartum period. This case describes a rare presentation of uterine inversion in the nonpuerperal period secondary to a submucosal leiomyoma. A 48-year-old G2P2 peri-menopausal female was admitted for 6 weeks of abnormal uterine bleeding and a 17 × 10 cm mass prolapsing into the cervical canal and upper vagina, with a large vascular pedicle inserting into the central superior aspect of the lesion from the fundal region. A computed tomography (CT) scan confirmed the diagnosis of a complete uterine inversion secondary to a large fundal leiomyoma with a submucosal component. Laparoscopic total hysterectomy was performed with no complications, and pathology confirmed the diagnosis of a benign leiomyoma. Though rare, uterine inversion can be caused by a leiomyoma in the nonpuerperal period and should be considered in patients with abnormal uterine bleeding and pelvic masses. Ultrasonography and CT scan were sufficient in providing an accurate diagnosis for which surgical management was indicated in this case.