Definition and research guide
This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.
Content available: 4 complete abstracts (739 words), 10 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.
Definition
A hole or break through the wall of the uterus, usually made by the placement of an instrument or intrauterine devices.
Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.
Also known as: Perforations, Uterine; Perforation, Uterine; Uterine Perforations.
Where it fits in the MeSH classification
- Broader topics
- Uterine Rupture
Related concepts
- Uterus
- Intrauterine Devices
Research landscape
PubMed indexes 1,013 records tagged with the MeSH heading “Uterine Perforation” (counts retrieved 2026-11-04). 73 of them (7.2%) were published from 2020 onward, and the busiest period so far is through 1999 with 589 records.
Reviews account for 87 records (8.6%) and meta-analyses for 2. Randomized controlled trials number 16 (1.6%) as a share of all records on the topic. Randomized trials make up only a small share of this literature, so much of what is known comes from laboratory, observational or descriptive work.
Show the data
| Period | Records |
|---|---|
| through 1999 | 589 |
| 2000-2009 | 161 |
| 2010-2019 | 190 |
| 2020 onward | 73 |
Publication-type chart data
| Type | Records | Share |
|---|---|---|
| Reviews | 87 | 8.6% |
| Meta-analyses | 2 | 0.2% |
| Randomized controlled trials | 16 | 1.6% |
Method: PubMed query "Uterine Perforation"[MeSH Terms] with publication-type and date filters, retrieved 2026-11-04.
Reading the evidence in kidney, urology and women's health
Kidney, urinary and reproductive health research uses lab markers (such as creatinine), imaging, symptom scores and registry data on pregnancy and birth. Findings about pregnancy are especially sensitive to who was studied and when in pregnancy exposure occurred. Nothing on this page is advice about treatment, fertility or pregnancy; speak to a qualified clinician. Check the population, the outcome measured and whether the study accounted for other health differences between groups.
Evidence from open-access studies
These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.
Spontaneous uterine perforation due to pyometra presenting as acute abdomen [1]
Abstract reading summary — source excerpts
- Opening excerpt
- Spontaneous perforation of the uterus is rare, its incidence being about 0.
- Closing excerpt
- Although spontaneously perforated pyometra is rare, a perforated pyometra should therefore also be considered when elderly women present with acute abdominal pain.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (132 words)
Spontaneous perforation of the uterus is rare, its incidence being about 0.01%-0.05%. We report a rare case of diffuse peritonitis caused by spontaneously perforated pyometra. A 63-year-old woman with severe abdominal pain was admitted to our hospital. Laparotomy was performed because of the suspicion of gastrointestinal perforation with generalized peritonitis. At laparotomy, about 900 mL of pus was found in the peritoneal cavity. There were no abnormal findings in the alimentary tract, liver, or gallbladder. A total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. Pathological investigation of the surgical specimen revealed endometritis and myometritis of the uterus; but there was no evidence of malignancy, and the cervical canal was patent. Although spontaneously perforated pyometra is rare, a perforated pyometra should therefore also be considered when elderly women present with acute abdominal pain.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 17485806 · DOI · PMC1581470
Intrauterine devices migrated into the bladder: two case reports and literature review [2]
Abstract reading summary — source excerpts
- Opening excerpt
- BackgroundIntrauterine devices (IUD) are widely used all over the world.
- Closing excerpt
- For patients with IUD combined with lower urinary tract symptoms, it is necessary to be aware of whether IUD perforation affects the bladder.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (220 words)
BackgroundIntrauterine devices (IUD) are widely used all over the world. One of the most serious complications is uterine perforation, and it is very rare for the IUD to penetrate the bladder after perforation. Here we report two cases of IUD migration into the bladder, and review the literature to analyze the possible causes and solutions of such complications.Case presentationCase NO. 1 is a 37-year-old female who presented lower urinary tract symptoms for a year. Cystoscopy showed that a strip of metal penetrated into the bladder, and the surface was covered with stones. The patient underwent cystotomy and foreign body removal under general anesthesia. Case NO. 2 is a 46-year-old woman who previously inserted an IUD in 1998, but she had an unexpected pregnancy in 1999. Her doctor believed that "the IUD had spontaneously expulsed" and a new IUD was inserted after her pregnancy was terminated. Her CT scan showed an IUD on the left side of the bladder and another IUD in the uterus. Her foreign body was removed by cystotomy.ConclusionPatients with IUD should be suggested to check the device regularly, and those who with a missed IUD have to rule out the possibility of IUD migration. For patients with IUD combined with lower urinary tract symptoms, it is necessary to be aware of whether IUD perforation affects the bladder.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 34399735 · DOI · PMC8365895
Uterine perforation following a fractional curettage successfully treated with the modified polysaccharide 4DryField® PH: a case report [3]
Abstract reading summary — source excerpts
- Opening excerpt
- BackgroundUterine perforation is the most common complication of curettage and may result in bleeding.
- Closing excerpt
- ConclusionsThe efficient hemostasis combined with the adhesion prevention effect of 4DryField®, allowed a fast control of the uterine wall bleeding, saved operation time, avoided the risks of other procedures for bleeding control and contributed to the normal healing of the uterine wall without any adhesion formation.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (265 words)
BackgroundUterine perforation is the most common complication of curettage and may result in bleeding. Therefore, urgent control of bleeding from the uterine wall perforation is necessary to avoid an emergency hysterectomy or blood transfusion, to prevent peritoneal adhesion formation, possible chronic pelvic pain, and infertility. In the present case, an active bleeding secondary to a perforation of the uterus during curettage, for diagnosis of endometrial carcinoma, was instantaneously and successfully treated with only the application of a novel modified polysaccharide powder. This is, to the best of our knowledge, the first time that the agent 4DryField® has been used for this purpose.Case presentationA 71-year-old German woman with serometra and endometrial hyperplasia suffered a perforation of the anterior wall of the uterus during the hysteroscopic resection of submucosal polyps and a fractional curettage. Subsequently, an immediate laparoscopy showed an active bleeding from the wound, which was promptly stopped with only the application of the hemostatic and anti-adhesion polysaccharide powder, 4DryField®. There were no postoperative complications. Nine weeks later, a laparoscopic hysterectomy with bilateral salpingoophorectomy for endometrial carcinoma (histology: stage IA, pT1a, cN0, L0 V0 M0/G2) was performed. The former injured area looked slightly prominent, was completely healed, and showed a shiny serosa. All her pelvic organs were free of adhesions, and there was one 0.5-mm calcified granuloma in the Douglas pouch.ConclusionsThe efficient hemostasis combined with the adhesion prevention effect of 4DryField®, allowed a fast control of the uterine wall bleeding, saved operation time, avoided the risks of other procedures for bleeding control and contributed to the normal healing of the uterine wall without any adhesion formation.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 27599567 · DOI · PMC5011909
Hysteroscopy combined with laparoscopy in the diagnosis and treatment of omentum majus incarceration secondary to uterine perforation: A case report and literature review [4]
Abstract reading summary — source excerpts
- Opening excerpt
- Cervical dilatation, uterine evacuation, and curettage (D&E&C) are common gynecological procedures for abortion, yet they carry risks of complications such as uterine perforation and intra-abdominal organ incarceration.
- Closing excerpt
- In conclusion, hysteroscopic and laparoscopic combination treatment can be a preferred approach to avoid serious adverse outcomes for uterus perforation patients who developed omentum majus incarceration.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (122 words)
Cervical dilatation, uterine evacuation, and curettage (D&E&C) are common gynecological procedures for abortion, yet they carry risks of complications such as uterine perforation and intra-abdominal organ incarceration. Here, we report a rare case of a breastfeeding patient who had an embedded abdominal greater omentum in the anterior wall of the uterus and into the uterine cavity during D&E&C. We used combined hysteroscopic and laparoscopic treatment for this case and successfully removed the embedded greater omentum. Our experience underscores the importance of vigilant intraoperative monitoring and prompt management to prevent serious complications like infection and bowel injury. In conclusion, hysteroscopic and laparoscopic combination treatment can be a preferred approach to avoid serious adverse outcomes for uterus perforation patients who developed omentum majus incarceration.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 39814042 · DOI · PMC11735067
Key reviews and meta-analyses
The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.
- Research article Facility-based treatment for medical complications resulting from unsafe pregnancy termination in the developing world, 2012: a review of evidence from 26 countries [5]
- Research article Complete and partial uterine perforation and embedding following insertion of intrauterine devices. I. Classification, complications, mechanism, incidence, and missing string [6]
- Research article Laparoscopic removal of an intra-abdominal intrauterine device: case and systematic review [7]
- Research article Complete and partial uterine perforation and embedding following insertion of intrauterine devices. II. Diagnostic methods, prevention, and management [8]
- Research article Spontaneous perforation of pyometra presenting as generalized peritonitis in a patient with cervical cancer [9]
- Research article The safety of intrauterine devices in breastfeeding women: a systematic review [10]
References
- Geranpayeh L, Fadaei-Araghi M, Shakiba B. Spontaneous uterine perforation due to pyometra presenting as acute abdomen. . 2006. PMID 17485806 · DOI · PMC1581470
- Liu G, Li F, Ao M, Huang G. Intrauterine devices migrated into the bladder: two case reports and literature review. . 2021. PMID 34399735 · DOI · PMC8365895
- Ziegler N, Korell M, Herrmann A, de Wilde MS, Torres-de la Roche LA, Larbig A, et al.. Uterine perforation following a fractional curettage successfully treated with the modified polysaccharide 4DryField® PH: a case report. . 2016. PMID 27599567 · DOI · PMC5011909
- Li X, Hu J, Li J, Tao Z, Qu Q, Li F. Hysteroscopy combined with laparoscopy in the diagnosis and treatment of omentum majus incarceration secondary to uterine perforation: A case report and literature review. . 2025. PMID 39814042 · DOI · PMC11735067
- Singh S, Maddow-Zimet I. Facility-based treatment for medical complications resulting from unsafe pregnancy termination in the developing world, 2012: a review of evidence from 26 countries. BJOG. 2016. PMID 26287503 · DOI · PMC4767687
- Zakin D, Stern WZ, Rosenblatt R. Complete and partial uterine perforation and embedding following insertion of intrauterine devices. I. Classification, complications, mechanism, incidence, and missing string. Obstet Gynecol Surv. 1981. PMID 7029368 · DOI
- Gill RS, Mok D, Hudson M, Shi X, Birch DW, Karmali S. Laparoscopic removal of an intra-abdominal intrauterine device: case and systematic review. Contraception. 2012. PMID 22067801 · DOI
- Zakin D, Stern WZ, Rosenblatt R. Complete and partial uterine perforation and embedding following insertion of intrauterine devices. II. Diagnostic methods, prevention, and management. Obstet Gynecol Surv. 1981. PMID 6455610 · DOI
- Imachi M, Tanaka S, Ishikawa S, Matsuo K. Spontaneous perforation of pyometra presenting as generalized peritonitis in a patient with cervical cancer. Gynecol Oncol. 1993. PMID 8406207 · DOI
- Berry-Bibee EN, Tepper NK, Jatlaoui TC, Whiteman MK, Jamieson DJ, Curtis KM. The safety of intrauterine devices in breastfeeding women: a systematic review. Contraception. 2016. PMID 27421765 · DOI · PMC11283814
About this article
- Sources
- NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
- Verification
- Every reference was resolved against PubMed on 2026-11-04; title, year and DOI matched.
- Review state
- automated source verified; no human expert review has been recorded yet.
- Version
- 1, last updated 2026-11-04.
See how EvidenceLib is built. Spotted an error? Email support@evidencehelix.com.
Evidence strength
EvidenceHelix's computed view of the study designs behind this topic: how common meta-analyses, randomized trials and reviews are, how recent the literature is, and a plain-language reading. It describes the design mix of the literature. It is not a quality appraisal of any study, and it is not medical advice.