Non-puerperal uterine inversion is an extremely rare gynecological condition associated with significant diagnostic challenges. A high index of suspicion is essential when evaluating patients with atypical gynecological presentations to ensure timely diagnosis. Although multiple etiologies have been reported, it is most commonly associated with a prolapsed endometrial polyp, submucosal fibroid, or, less frequently, a malignant mass. Imaging modalities, including transabdominal and transvaginal ultrasound, magnetic resonance imaging (MRI), and computed tomography (CT), play a crucial role in confirming the diagnosis and identifying the underlying cause. Consideration of the patient’s fertility is important, as uterine preservation may not be feasible in all cases. We, here, report the case of a 40-year-old nulliparous woman with a known diagnosis of fibroid uterus for the past three years, who presented with acute severe lower abdominal pain, urinary retention, and sudden prolapse of a large fibroid polyp measuring approximately 20 × 14 cm. Uterine inversion was suspected based on clinical examination and confirmed by radiological findings. Vaginal myomectomy was performed, and the uterine inversion was reduced manually under direct visualization. The patient had a smooth post-operative recovery.
Shahwar et al. (Wed,) studied this question.