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Case Reports
. 2025 Jul 6;17(7):e87377.
doi: 10.7759/cureus.87377. eCollection 2025 Jul.

Minimally Invasive Approach to Intrauterine Device Migration Into the Bladder Using Holmium Laser

Luis Enrique Torres Zapata  1 , Jose Luis Maldonado Calderón  1 , Luis Fernando Aguilar Urrea  1 , Aldo Missael Garcia Bailón  1 , Víctor Manuel Molgado Garza  1
Affiliations
Case Reports

Minimally Invasive Approach to Intrauterine Device Migration Into the Bladder Using Holmium Laser

Luis Enrique Torres Zapata et al. Cureus. .

Abstract

The intrauterine device (IUD) is a widely utilized method of contraception known for its high efficacy, safety profile, and long-term effectiveness. Despite its favorable characteristics, rare but potentially serious complications may occur, such as uterine perforation and device migration into adjacent pelvic or abdominal structures. One of the less frequent but clinically relevant complications is intravesical migration, where the device perforates the uterine wall and erodes into the urinary bladder. This can result in chronic lower urinary tract symptoms, recurrent urinary tract infections, hematuria, pelvic discomfort, and, in some cases, stone formation around the foreign body. We present the case of a 26-year-old female patient who developed recurrent urinary symptoms and intermittent hematuria three years after IUD placement. The device had not been visualized during gynecological follow-up and remained undetected during two full-term pregnancies. A noncontrast abdominal CT scan ultimately revealed a calcified IUD located within the urinary bladder. The patient underwent successful transurethral endoscopic removal using holmium:YAG laser lithotripsy in dusting mode to fragment the calcifications, followed by retrieval of the intact device with foreign body forceps. The procedure was completed without complications, and the patient reported full resolution of symptoms during follow-up. This case underscores the importance of considering IUD migration as a differential diagnosis in women presenting with unexplained urinary symptoms and a remote history of IUD use. It also demonstrates that holmium laser-assisted endoscopic management provides a safe, effective, and minimally invasive approach to remove encrusted or calcified intravesical IUDs, avoiding the need for open or laparoscopic surgery.

Keywords: copper intrauterine device; endoscopic removal; holmium:yag laser; intravesical foreign body; migrated intrauterine device; minimally invasive surgery; recurrent urinary tract infection; urinary bladder.

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Conflict of interest statement

Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Not applicable-single case report with informed consent obtained issued approval Not applicable. This case report did not require IRB or ethics committee approval as it describes a single clinical case. Informed consent was obtained from the patient for publication. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. (A,C) CT noncontrast showing IUD with red arrow, coronal section. (B) Axial section
CT: computed tomography; IUD: intrauterine device
Figure 2
Figure 2. (A) Cystoscopic view of the calcified IUD (pretreatment). (B) Intrauterine device adhered to the bladder dome and holmium laser fragmentation in progress. (C) IUD release after calcification removal using holmium laser lithotripsy. (D) Removed IUD sample. Laser parameters: holmium:YAG, 0.5 J, 15 Hz, dusting mode
IUD: intrauterine device
See this image and copyright information in PMC

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