Perforated and Embedded Intrauterine Devices

Zakin, David

doi:10.1001/jama.1982.03320400056038

Cited by 7 publications

(6 citation statements)

References 5 publications

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Section: Discussionmentioning

confidence: 99%

“…A primary perforation occurs at the time of insertion, whereas a secondary perforation occurs after a delay, probably due to pressure necrosis and inflammation of the uterine wall. [2,28,29] IUCD migration may follow uterine perforation. It is a rare complication, occurring between 1.2 -1.6 per 1,000 insertions [8] Mechanisms that explain migration of an IUCD include iatrogenic perforation, spontaneous uterine contractions, involuntary bladder contraction, gut peristalsis, and peritoneal fluid movement which together contribute to the migration and implantation of the IUCD in other adjacent organs.…”

Section: Discussionmentioning

confidence: 99%

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

Akhtar

Rasool

Nazir

2021

Cureus

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Introduction Intrauterine contraceptive devices (IUCD) are a commonly used, reversible, contraceptive method. Complications from insertion rarely include migration into the bladder. We report on two cases of intravesical migrated IUCD and present an algorithm for management based on recently published data. Materials and Methods The case records of two patients who underwent surgical procedures for migrated IUCD into the bladder were reviewed. A Pubmed search was performed to identify similar studies. A total of 25 papers met the criteria for inclusion. Results Both cases were managed with laparotomy and partial cystectomy. A review of literature suggests recently reported cases of IUCD migration are rising, with most cases having been reported in the last decade. Bladder calculus developing over the migrated IUCD is the most common presentation. Most cases have been managed using endourological techniques. A small number of cases have required open vesicolithotomy or laparoscopic surgery. Rarely, laparotomy has been required. Discussion IUCD migration into the bladder remains rare, however, recently the number of reported cases has risen. A thorough physical examination and radiological evaluation are warranted. Management is surgical in all cases. Most cases can be managed with endourological techniques. A treatment algorithm has been suggested in this paper based on recent data. Conclusion With the rising use of contraception worldwide, the incidence of IUCD migration is possibly going to increase. Treating doctors need to be aware of the possible complications that may arise from a migrated IUCD, including bladder calculi.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

Akhtar

Rasool

Nazir

2021

Cureus

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“…An uncommon, but severe complication of the IUD is uterus perforation; either partial, in which the device may be embedded in the uterine wall and mostly not diagnosed at time of insertion, or complete, perforating the myometrium and serosa 6. In a reviewed cohort of 16, 159 IUD users, a perforation incidence of 1.6 per 1000 insertions was reported, both partial and complete 3…”

Section: Discussionmentioning

confidence: 99%

“…A severe complication of the intrauterine device (IUD) is uterine perforation, which may occur both complete and partial. Ultimately migration of the device through the uterine wall to adjacent organs may occur, including peritoneum, omentum, ovaries, broad ligament, recto-sigmoid and appendix 5 6. In case of intravesical migration, the foreign body may cause calcium precipitation and may serve as a focus of crystallisation, leading to stone formation 7…”

Section: Introductionmentioning

confidence: 99%

Chronic kidney disease after vesico-vaginal stone formation around a migrated intrauterine device

et al. 2010

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Correspondence to E B Joustra, R.Karsmakers@dz.nl SummaryAlthough the intrauterine device (IUD) seems a reliable and relatively safe method of contraception, it may cause serious complications. A rare complication is uterus perforation. Intravesical migration and secondary calculus formation is exceptionally uncommon. The authors report on a 75-year-old woman in whom a 'forgotten' migrated IUD resulted in vesico-vaginal fistula formation and chronic kidney disease, 39 years after insertion. BACKGROUND

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“…It is an expensive and relatively complex technique and requires skilled personnel. Ultrasonography cannot accurately detect partial perforation (unless the IUD is unequivocally eccentric), complete perforation (unless the IUD is close to the uterus), or deep embedding [11].…”

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confidence: 99%

The value of X-ray with uterine sound in the diagnosis of IUDs with missing tails

Kady¹,

Rifat²,

Hosseiny³

et al. 1986

Adv Contracept

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Missing IUD tails may result from expulsion, retraction of filaments, uterine perforation or pregnancy. Missing IUD tails occur in 5-25% of all IUD insertions, and require a safe and correct diagnostic technique. Plain X-ray with uterine sound in utero is a popular, simple technique which does not require special skills. This study discusses the feasibility and accuracy of this method in 104 women presenting with a history of missed IUD. Twenty women with suspected pregnancy or uterine abnormalities were excluded from the study. The diagnosis was verified by examination of the patient under anesthesia, D & C, laparoscopy or laparotomy. The accuracy rate was 95.23% (80 women). The diagnosis was wrong in 4.76% (4 women) where the X-ray technique wrongly diagnosed intrauterine location of the device, while examination under anesthesia and laparoscopy located these 4 devices in an extrauterine location. Through the use of this technique it was possible to reduce the hospital stay to one day in 95% (80 patients). The technique is feasible, reliable and without complications; it is particularly suitable in hospitals where other diagnostic facilities are not available.

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Perforated and Embedded Intrauterine Devices

Cited by 7 publications

References 5 publications

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

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

Chronic kidney disease after vesico-vaginal stone formation around a migrated intrauterine device

The value of X-ray with uterine sound in the diagnosis of IUDs with missing tails

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