Which of the following is the most common cause of perforation of uterus in non-pregnant state?

In the non pregnant state,perforation of the uterus occurs usually during dilatation and curettage Dilatation and curettage procedure is a primary tool for diagnostic evaluation and treatment of abnormal uterine bleeding. Perforation of the uterus is common during a state of pregnancy or malignancy ( Soft Uterus) The atrophic uterus of post menopausal woman may also be perforated easily during D&C IUCD inseion also cause perforation, especially if done in a hurry. In case of a perforation: If the uterus is empty and not malignant, simple observation will suffice. However in complicated cases hysterectomy is done. Often abdominal viscera prolapse through the perforation and hence a laparotomy is done to repair the defect and bowel .