Nafiseh Saghafi , Leila Pourali , Elham Hamidi ,
Volume 78, Issue 3 (6-2020)
Abstract
Background: Nonpuerperal uterine inversion is a rare medical condition that many gynecologists might not be encountered even with one case during their entire medical practice. It refers to the expulsion of uterine corpus from the dilated cervix resulting in uterus being turned inside out. There are two kinds of uterine inversion, puerperal and non-puerperal, which the second condition is less common. Acute uterine inversion usually presented by crampy abdominal or pelvic pain, vaginal bleeding, anemia, and even symptoms of severe sepsis. We describe a case of uterine inversion in a postmenopausal woman.
Case Presentation: A 66 years old grand multiparous woman (6 normal vaginal delivery) who was menopause since 15 years ago, was referred to the emergency unit of an academic hospital of Mashhad University of Medical Sciences at October 2016 due to postmenopausal uterine bleeding, cramp-like abdominal pain and mass protrusion from the vagina. The vital sign was stable at the first visit but a big non-necrotizing red vaginal mass was protruded from vaginal opening that connected to other soft intravaginal mass. Abdominal ultrasonography revealed the dilated vaginal cuff and some air-fluid levels in the uterine cavity. The patient referred to the operative room and vaginal myomectomy was done with diagnosis of pedunculated submocusal leiomyoma. Then, total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed after the correction of uterine inversion by abdominoperineal approach.
Conclusion: Acute uterine inversion is a potentially dangerous condition (due to vaginal bleeding, severe abdominal or pelvic pain, and the possibility of uterine necrosis and even systemic infection). This condition should be considered as an important differential diagnosis as a vaginal mass in the post-menopausal period.
Babak Hooshmand-Moghadam , Abbas Ali Gaeini,
Volume 82, Issue 12 (3-2025)
Abstract
Background: As survival rates among breast cancer patients improve, cardiovascular disease (CVD) has emerged as a leading cause of long-term morbidity and mortality in postmenopausal survivors. This epidemiological transition from oncologic risk to cardiometabolic vulnerability reveals a critical yet underexplored dimension of survivorship care. Structured exercise training represents a promising intervention, and this narrative review-grounded in a systematic literature search investigates the effects of aerobic, resistance, and combined training modalities on cardiovascular health in postmenopausal women with breast cancer. The review synthesizes evidence across physiological mechanisms, clinical outcomes, and implementation challenges to provide a comprehensive perspective on exercise oncology in this underserved population.
Methods: A systematic search of reputable international databases including PubMed, Scopus, Web of Science, Embase, and Google Scholar as well as Persian databases SID and Magiran was conducted to identify relevant human studies, clinical trials, and randomized controlled trials published between January 2000 and April 2025. Screening, selection, and synthesis of the studies were performed in Iran between October 2024 and January 2025.
Results: Accumulating evidence supports that structured exercise especially combined aerobic and resistance training exerts substantial cardioprotective effects through multiple mechanisms, including reductions in systemic inflammation, improvements in body composition, regulation of blood pressure, enhancement of cardiorespiratory fitness, and improved left ventricular function. Combined interventions consistently outperformed single-modality programs, underscoring the importance of integrative approaches in oncologic rehabilitation. Despite this promise, persistent barriers such as limited access to trained personnel, lack of individualized protocols, and weak institutional support impede translation into routine practice. Notably, few existing reviews have bridged mechanistic, clinical, and operational domains in this population, highlighting a significant gap in the literature.
Conclusion: Exercise training is not merely an adjunct to care it is a clinically potent, physiologically grounded, and policy-relevant strategy for mitigating cardiovascular risk in postmenopausal breast cancer survivors. Given the increasing burden of CVD in this group, integrating personalized, evidence-based exercise into oncologic care pathways is both urgent and essential for advancing survivorship standards and informing future clinical guidelines.
