A LARGE INTRAMURAL FIBROID WITH STAGE 3 UTERO VAGINAL PROLAPSE - A RARE CLINICAL PRESENTATION

Fibroid uterus are the benign tumors of the uterus comprising of smooth muscle fibres. There are 3 main types of fibroid uterus - submucosal, subserosal and intramural. Fibroid with the prolapse usually present as submucosal fibroid prolapsing into the vagina or intramural fibroid becoming submucosal and prolapsing out. A large intramural fibroid usually pulls up the uterus due to its growth and hence uterine prolapse is little rare scenario. In this case a perimenopausal women with mass descending per vaginum and pain abdomen for four years, on examination found to have a large intramural fibroid of size 20*10 cm and uterovaginal prolapse with cervix as leading point with cystocele, enterocoele and rectcoele. After routine pre operative work up, hysterectomy was planned by abdominovaginal route. Supracervical hysterectomy done abdominally followed by removal of cervical stump and anterior and posterior colpoperineoraphy by vaginal route.