title: Non-puerperal uterine inversion due to submucous myoma in a young woman: a case report.
abstract: BACKGROUND
  Inversion of the uterus is an uncommon complication of the puerperium and it is an even rarer complication of the non-puerperal period. A submucous myoma is mostly the cause of the non-puerperal inversion but diagnosis can be difficult. In young women, non-puerperal uterine inversion is likely associated with a malignancy.
  
  
  METHODS
  A 19-year-old nulliparous woman presented with abnormal vaginal bleeding, dysmenorrhoea, and a large mass protruding from her cervix. The mass was interpreted as a prolapsed pedunculated submucosal myoma. After extirpation of the mass by clamping and twisting its pedicle, a laparotomy was required under suspicion of a uterine rupture. The diagnosis was confirmed and the patient's uterus could be preserved. Pathological examination revealed a submucous myoma. The uterine inversion happened when the uterus retracted to expel the submucous myoma with fundal attachment. By extirpating the stalk the fundus was also resected, causing a uterine rupture.
  
  
  CONCLUSIONS
  We report a case of non-puerperal uterine inversion associated with a benign submucous myoma. Non-puerperal uterine inversion is very uncommon in women of reproductive age and is usually caused by a malignant tumour. However, uterine-sparing surgery should be attempted in young women until the final pathology is known.
authors.affiliation: Department of Obstetrics and Gynaecology, Medical Center Leeuwarden, 8901 BR Leeuwarden, the Netherlands. denise.perquin@znb.nl.
authors.forename: Marjolijn
authors.initials: M
authors.lastname: de Vries
authors.forename: Denise Arlette Maria
authors.initials: DA
authors.lastname: Perquin