Secondary Vesical Calculus Resulting from Migration of an Intrauterine Contraceptive Device

Abstract

Intrauterine contraceptive device (IUCD) is the commonest form of contraception used in view of less systemic side effects. However, there are a multitude of local complications caused by it. Of all the local complications described, migration of the device into adjacent organs is the most morbid of all complications. A patient presenting with history of loss or disappearance of the intrauterine contraceptive device accompanied by urinary symptoms should raise the doubt of a migrated device with the formation of a secondary calculus. This prompts further radiological investigations and merits surgical intervention either endourologically or by open surgery depending upon the merits of the case. A case report elucidating this fact is presented.

Intravesical Migration of an Intrauterine Contraceptive Device with Secondary Calculus Formation

“…Once the IUCD migrates to the urinary bladder, the patient will experience urinary symptoms like frequency, dysuria, hematuria, retention of urine, and fever due to infection 5). Calculus formation occurs in long-standing cases 5).…”

“…Hence, the importance of a good and proper history cannot be overemphasized. Simple investigations like plain radiography and ultrasound of the pelvis are enough to arrive at a diagnosis 5). A CT scan can precisely locate the migrating IUCD in the pelvic/abdominal cavity and help in planning the appropriate management 4)…”

“…Laboratory investigations usually reveal leukocytosis in infected cases, and the urine examination will reveal either pus cells or microscopic or gross hematuria 5). Surgery is the mainstay of treatment for migrated IUCDs with calculus formation 5).…”

“…A preliminary cystoscopic examination is mandatory to chart the course of further intervention 57). For mobile stones, the endoscopic methods will suffice 5).…”

“…For mobile stones, the endoscopic methods will suffice 5). However, if the stone is large and fixed, then open suprapubic cystolithotomy is indicated for safe and complete removal 5)…”