Chronic uterine inversion

Occasionally uterus undergoes incomplete inversion which is often over looked.
May be due to:
 Pedunculated tumor.

Senile inversion because of atonicity of cervix.

Clinical features:
Vaginal discharge
Irregular bleeding
Low backache
Chronic pelvic pain etc.

On examination:
Infected hemorrhagic mass in the vagina.

Differential diagnosis:
Sloughing polyp
Retained portion of placenta.

Management:
1) Clear up the infection by antiseptic packing of the vagina.
2) If prolapsed fundus is clean then replacement can be tried with special repositor- aveling's repositor.
Surgical procedures:
Vaginal – Spinelli procedure Abdominal – Huntinton's procedure, Haultain's procedure and Ocejo procedure.
In multiparous – Vaginal or abdominal hysterectomy