Uterine perforation

Uterine perforation is a medical complication that can occur during surgical procedures such as dilation and curettage, hysteroscopy, or intrauterine device (IUD) insertion. It involves the unintentional puncturing of the uterus, which can lead to serious complications if not promptly diagnosed and treated.

Causes

Uterine perforation is most commonly caused by medical procedures involving the uterus. The risk of perforation is higher in procedures such as dilation and curettage, hysteroscopy, and IUD insertion. Other factors that can increase the risk of uterine perforation include a retroverted uterus, recent pregnancy, and the presence of uterine fibroids or uterine adhesions.

Symptoms

Symptoms of uterine perforation can vary depending on the severity of the perforation and whether any other organs are affected. They may include severe abdominal pain, heavy vaginal bleeding, fever, and signs of peritonitis or sepsis in severe cases. However, some cases of uterine perforation may be asymptomatic and only discovered during a subsequent medical examination.

Diagnosis

Diagnosis of uterine perforation typically involves a combination of physical examination, medical history, and imaging tests. Ultrasound is often the first-line imaging test, but computed tomography (CT) scan or magnetic resonance imaging (MRI) may also be used. In some cases, a laparoscopy may be performed to directly visualize the uterus and surrounding organs.

Treatment

Treatment of uterine perforation depends on the severity of the perforation and whether any other organs are affected. Small perforations may heal on their own with conservative management, while larger perforations or those involving other organs may require surgical repair. In severe cases, a hysterectomy may be necessary.

Prevention

Prevention of uterine perforation involves careful technique during surgical procedures involving the uterus, as well as awareness of risk factors such as a retroverted uterus, recent pregnancy, and the presence of uterine fibroids or adhesions.

See also

• Dilation and curettage
• Hysteroscopy
• Intrauterine device
• Retroverted uterus
• Uterine fibroids
• Uterine adhesions