CHRONIC INVERSION OF THE UTERUS
Definition: Inversion is a condition where the uterus becomes turned inside out the fundus prolapsing through the cervix.
- Incomplete obstetric inversion unnoticed or left uncared following failure to reduce for a variable period of 4 weeks or more.
- Submucous myomatous polyp arising from the fundus → traction effect.
- Sarcomatous changes of fundal fibroma → infiltration of malignancy into the myometrium
- softening of the wall. - Senile inversion following high amputation of the cervix. It is probably due to cervical atony and incompetence.
TYPES: Two types are described in chronic inversion.
INCOMPLETE — The fundus protrudes through the cervix and lying inside the vagina.
COMPLETE — Whole of the uterus including the cervix are inverted. The vagina may also be involved in the process.
- Sensation of something coming down per vaginum.
- Irregular vaginal bleeding.
- Offensive vaginal discharge.
The protruding mass has got the following features:
(ii) No opening in the leading part
(iii) Shaggy look
(iv) Tumor may be present at the bottom.
(a) The cervical rim is felt high up in incomplete variety but not felt in complete one.
(b) Cup-shaped depression at the fundus is felt or the uterus is not felt in position.
RECTAL EXAMINATION: Recto abdominal examination is more informative to note the fundal depression or displacement of the uterus.
SOUND TEST: Demonstration of shortness or absence of uterine cavity using a uterine sound is reasonably confirmative.
EUA: At times, it is needed to confirm the diagnosis.
The diagnostic difficulty is much when inversion is secondary to a fibroid polyp or sarcoma and the inversion is incomplete, filling the vagina. A portion is to be removed from the tumor mass for histological examination to differentiate between a simple fibroid or sarcoma.
DIFFERENTIAL DIAGNOSIS: -
- Fibroid polyp,
- Uterine prolapse,
- Prolapsed hypertrophied ulcerated cervix,
- Fungating cervical malignancy.
In fibroid polyp — The uterus is in normal position and the uterine sound can be passed into the uterine cavity. In difficulty, examination under anesthesia may be required.
HOMOEOPATHIC MANAGEMENT OF UTERINE TROUBLES: -
Thlaspi bursa: - One of the top homeopathic medicine for Uterine troubles with heavy menstruation. It is given in cases where the periods are prolonged, frequent, and very discomforting.
Calcarea carb: - Another excellent remedy for heavy, frequent periods, sometimes accompanied by vertigo. The troubles usually increase during a tiring and straining day.
Calcarea flour: - Cal carb is one of the best Homoeopathic medicine for uterine troubles. It restores the elasticity of smooth muscles in the uterus.
Belladonna: - If the pain causes a cramping sensation in the whole Abdominal region.
Sepia: - Reduces the bearing down sensation and protects against recurrent vaginal and urinary tract infections.