Migrated Intravesical Intrauterine Contraceptive Devices: A Case Series and a Suggested Algorithm for Management

Akhtar, Omar; Rasool, Sabahat; Nazir, Syed Sajjad

doi:10.7759/cureus.12987

Cited by 6 publications

(15 citation statements)

References 25 publications

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“…Literature review shows methods like cytoscopic removal, laser lithotripsy and even laparotomy have been used to remove migrant IUCD. However, open cystolithotomy is the most commonly used procedure [13]. Similarly, open cystolithotomy through a suprapubic approach was preferred in our case due to the significantly larger stone.…”

Section: Discussionmentioning

confidence: 87%

Giant vesical calculus associated with migrant IUCD: a case report

Shoaib¹,

Yousaf²,

Shah

et al. 2021

Afr J Urol

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Background Intrauterine copper devices are a popular type of contraceptives, being in use for a long time. Migration of IUCD into the bladder is one of the many side effects of this contraceptive measure. Though a rare phenomenon, IUCD acting as a foreign body can cause stone formation in the bladder. Case presentation We present a 42-year-old female patient who presented with increased urinary frequency, dysuria, and suprapubic pain. Examination showed mild tenderness in the suprapubic region. On X-ray pelvis, she was found to have a giant stone covering IUCD in the bladder. She ultimately underwent cystolithotomy, and her IUCD with stone was removed. Consequently, she was discharged on the 4th postoperative day with a satisfactory condition. Conclusion Vesical calculus can form following migration of IUCD in the bladder. This article highlights the importance of careful insertion and follow-up investigation of IUCD. Radiological modalities like X-rays pelvis provide excellent visualization of the IUCD and can be used to confirm the accurate location of the contraceptive device.

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Section: Discussionmentioning

confidence: 87%

Giant vesical calculus associated with migrant IUCD: a case report

Shoaib¹,

Yousaf²,

Shah

et al. 2021

Afr J Urol

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“…The common IUD types currently in use are the copper-releasing IUD (TCu-380A) and the Levonorgestrel-releasing IUD (LNG-IUD). 1 , 2 The use of IUD is associated with a 0.2–3.6/1000 overall complication rate. 3 , 13 Uterine wall perforation is the least common and the most feared complication of IUD insertion.…”

Section: Discussionmentioning

confidence: 99%

“…The most involved sites are the peritoneal cavity, pouch of Douglas, and colon. 2 , 7 , 12 , 15 , 16 …”

Section: Discussionmentioning

confidence: 99%

“…A detailed contraceptive history should not be overlooked, as it was the most important diagnostic tip in our patient. 1 , 2 , 12 …”

Section: Discussionmentioning

confidence: 99%

“…10 At times, IUDs can be impacted in the bladder wall, necessitating an open partial cystectomy. 2 , 5 There are few reports on a modified cystoscopic extraction of embedded IUDs where the bladder mucosa is incised with a J-hook monopolar electrocautery to facilitate removal. However, unless the extraction is performed by experienced hands, the risk of urine leak and uterovesical fistula can be significant.…”

Section: Discussionmentioning

confidence: 99%

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Gross Hematuria Caused by Intravesical Migration of a Forgotten Intrauterine Device: A Case Report and Literature Review

Salih¹,

Tefera²,

Gebrehiwot³

et al. 2022

RRU

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Intrauterine device (IUD) is the second most widely used method of contraception worldwide. Up to 14% women prefer IUD for its attractive advantages such as cost effectiveness, high efficiency, and low complication rate. Despite these advantages, however, some complications may occur. One of these complications is uterine perforation and migration of the device to involve adjacent viscera such as peritoneum, bowel, vessels, and rarely bladder. IUD migration into the urinary bladder is uncommon, and only 70 cases are reported in the literature. Recurrent urinary tract infection and bladder calculi are the commonest presentations, and, rarely, women can present with gross hematuria. A high index of suspicion is needed in the evaluation of women who report pregnancy after IUD insertion as it might be the first clue to suspect migration. A forgotten and long-standing IUD increases the risk of uterine perforation and migration. A routine abdominal radiography, cystoscopy, and transvaginal ultrasonography are diagnostic. A computed tomography can also be employed in selected cases to delineate anatomic relations. Urologists should consider a vesical foreign body such as migrated IUD in women with recurrent lower urinary infections. Gross hematuria in a young woman should alert the urologist, and the evaluation should address a detailed contraceptive history. Every migrated IUD should be removed via endoscopy, laparoscopy, or open surgery. Proper follow-up and education of women before and after IUD insertion is also recommended to pick up on complications in time. Here, we report the successful open surgical treatment of a woman who had a forgotten IUD for 15 years and ultimately presented with gross hematuria due to trans-vesical migration. As to our literature search, there was no similar case reported from a urology center from Ethiopia.

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

Saputra,

Rahman,

Widyasari

2024

Case Reports in Obstetrics and Gynecology

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Intrauterine contraceptive devices (IUCD) are widely used as a reversible method of contraception. Although uterine perforation caused by an IUCD is rare, in some cases, the device may migrate to the pelvic/abdominal cavity or nearby structures. When the IUCD migrate to the bladder, it can lead to various symptoms. These include pain or discomfort in the lower abdomen, difficulties or pain during urination, frequent urinary tract infections, and the development of bladder stones. This article presents a case report of a 24-year-old woman with an intrauterine contraceptive device (IUCD) that had migrated completely into the bladder. She had an IUCD inserted by a midwife four years earlier and became pregnant a year later, unaware of the IUCD’s presence. She later presented with lower abdominal pain, hematuria, and dysuria three months before being admitted to our hospital. Imaging confirmed the intravesical location of the IUCD. She underwent successful cystoscopy treatment to remove the migrated IUCD. Prompt diagnosis and appropriate management are crucial in preventing complications and improving patient outcomes. Clinicians should be aware of this potential complication and consider it when patients present with symptoms or complications after IUCD insertion. Regular monitoring and timely intervention can help detect and address IUCD migration effectively.

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Migrated Intravesical Intrauterine Contraceptive Devices: A Case Series and a Suggested Algorithm for Management

Cited by 6 publications

References 25 publications

Giant vesical calculus associated with migrant IUCD: a case report

Giant vesical calculus associated with migrant IUCD: a case report

Gross Hematuria Caused by Intravesical Migration of a Forgotten Intrauterine Device: A Case Report and Literature Review

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

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