Intrauterine device migration into the bladder leading to stones formation

Abstract

An intrauterine device (IUD) is a popular method of contraception mainly used in developing countries. Perforation is one of the most serious but a rare complication secondary to the insertion of an IUD, while perforation into the intravesical organs such as the bladder is even more rare. A 30-year-old multipara in early 30s, with two previous caesarean sections (CS) and one curettage, was found to have her IUD puncturing the bladder during a cystoscopy procedure to remove her bladder stones. Transvesical migration of an IUD is an uncommon complication with a high rate of calculi formation, which is thought to be caused by the IUD’s lithogenic potential. Imaging approaches such as ultrasound and pelvic X-rays are considered imperative in the accurate diagnosis. Any migrated IUD should be removed regardless of location. Prompt and continual monitoring of women using an IUD is essential and in a case where the IUD has migrated, the removal using the endoscopic approach is a safe and effective method.

Removal of Complete Spontaneous Migration of an Intrauterine Contraceptive Device to the Bladder by Cystoscopy

“…Uterine perforation caused by IUCD migration is a serious complication; however, it occurs very rarely, with an incidence rate of 1.3 to 1.6 per 1,000 IUCD insertions [ 8 ]. Instances of IUCD migration into various locations, including the bladder wall, gut, peritoneum, and retroperitoneal region, have been documented [ 9 , 10 ]. The migration of an IUCD to the bladder, as presented in this case, is a relatively uncommon complication.…”

“…Primary perforation can occur during the insertion process and is often accompanied by intense abdominal pain. Secondary perforation is a delayed occurrence, suspected to be caused by the progressive destruction of the uterine wall due to pressure [ 3 , 10 ]. Uterine perforation can lead to the IUD moving outside the uterine cavity, which is a rare but serious issue.…”

“…The rapid migration observed in our patient, with the IUCD translocating from the uterus to the bladder within a single year, is particularly unusual and merits close attention. Factors such as uterine contractions, inflammatory responses, and potential anatomical variations may contribute to the displacement and subsequent migration of the IUCD [10,12].…”

“…Perforation becomes a significant issue when the IUD is implanted by an untrained practitioner, placed in an improper location, or when the patient has a weakened uterine wall near the insertion site [8,9]. This weakening of the uterine wall often occurs as a result of multiple pregnancies, cesarean sections, or abortions [10]. Perforation of the uterus is more likely to occur during the early stages or immediately after the placement of an IUCD.…”