Complications associated with intravesical migration of an intrauterine device

Abstract

The intrauterine device (IUD) is the most common method of reversible contraception in women. However, IUD can perforate the uterus and also migrate into pelvic or abdominal organs. A 43-year-old woman with a 5-year history of IUD placement and without specific symptoms, decided to remove her IUD and undergo tubal ligation. Radiological assessment, including a pelvic X-ray and ultrasonography, revealed no copper IUD within the uterus. Retrieval attempts with cystoscopy were unsuccessful. The IUD was found embedded in the fundal part of the bladder wall and was subsequently removed through a laparotomy incision. Although there are cases in the literature that were successfully managed with cystoscopy, in chronic cases, the formation of granulation tissue may preclude retrieval of an IUD using this intervention.

Keywords: Bladder; Contraception; Intrauterine devices; Migration.

Fig. 1.

Migrated intrauterine device and stone seen on abdominal plain X-ray. In abdominal plain X-ray, intrauterine device (IUD) looks upside down (in reverse position) in uterine cavity, it’s also left leaning instead of longitudinal position along the middle line of the uterus .A few stones has been formed on the right branch of the IUD which shows passage of the time.

Fig. 2.

Removal of the intrauterine device (IUD) during cystostomy. During laparotomy, left branch of the IUD was seen as a bulging point in the left side of fundus of bladder, so through a transverse incision on the bladder and despite the severe adhesion, the IUD was removed and the incision site was repaired.