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Yu F, Chen M, Cao H, Yang G, Wang W, Wang Y. Intrauterine device (IUD) migration completely into the abdominal cavity and half into the bladder to form a stone: a case report and mini-review. BMC Urol 2024; 24:280. [PMID: 39710656 DOI: 10.1186/s12894-024-01676-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2024] [Accepted: 12/13/2024] [Indexed: 12/24/2024] Open
Abstract
The intrauterine device (IUD) is an important and highly effective means of contraception. Migration of the IUD, post implantation, out of the uterus is an infrequent complication, and its subsequent migration into the urinary bladder with formation of secondary bladder calculi, is even more infrequently reported. The authors report a 51 year old woman who had had her last child delivered via cesarean section 16 years ago. She underwent an IUD insertion in the next few months but was subsequently lost to follow up. Before detection of the ectopic state of the IUD she complained of dysuria and dyspareunia for two weeks. Clinically detected suprapubic discomfort on palpation. After a series of imaging studies and cystoscopy, the presence of an IUD stump with stones attached to it in the patient's bladder were confirmed. Cystoscopy followed by laser lithotripsy of the calculus was performed, as the first step in the treatment. After failure to remove the IUD cystoscopically, further cystotomy was made, however one side end of the cap structure of the IUD could not be located, necessitating abdominal exploration and irrigation till retrieval in totality. The patient made an uneventful recovery.The case report emphasizes the importance of excluding uncommon etiolgies like ectopic IUDs as a cause of immobile adherent bladder calculi in women. Complete removal necessitates good preoperative knowledge of the type of IUD, as structural degradation might lead to separation of its components. An adequate consent for a possible exploration of the abdomen in case of a missing component should also be taken.
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Affiliation(s)
- Fangqiu Yu
- Department of Urology II, First Hospital of Jilin University, Changchun, Jilin, China
| | - Mo Chen
- Department of Urology II, First Hospital of Jilin University, Changchun, Jilin, China
| | - Hongliang Cao
- Department of Urology II, First Hospital of Jilin University, Changchun, Jilin, China
| | - Gang Yang
- Department of Urology II, First Hospital of Jilin University, Changchun, Jilin, China
| | - Weigang Wang
- Department of Urology II, First Hospital of Jilin University, Changchun, Jilin, China.
| | - Yuantao Wang
- Department of Urology II, First Hospital of Jilin University, Changchun, Jilin, China.
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Liu C, Xia Y, Pang Q, Zhao Z, Zhao J. Migration of an intrauterine device to the posterior urethra with stone formation: a case report. Front Med (Lausanne) 2024; 11:1449443. [PMID: 39238594 PMCID: PMC11375611 DOI: 10.3389/fmed.2024.1449443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2024] [Accepted: 08/12/2024] [Indexed: 09/07/2024] Open
Abstract
Migration of an intrauterine device (IUD) to the posterior urethra with stone formation has not been previously reported in the literature. A 42-year-old female patient presented to the gynecology clinic with a complaint of "discovered vaginal mass for 2 years, with growth for 5 days." She was referred to urology on suspicion of IUD migration to the bladder. Physical examination revealed a hard mass palpable on the anterior vaginal wall. Laboratory tests showed normal blood counts, and urinalysis indicated a mild urinary tract infection. Ultrasound and pelvic X-ray indicated IUD migration to the bladder and bladder stones. Cystoscopy revealed that the IUD had migrated to the posterior urethra with stone formation. Holmium laser was used to fragment the stones encasing the IUD's one arm, and the IUD was successfully removed with grasping forceps. The patient had a urinary catheter placed for 10 days and was followed up for 20 days. During the follow-up, there were no lower urinary tract symptoms (LUTS) or vaginal leakage. To our knowledge, we report the first case of an IUD migrating through the vesicovaginal space to the posterior urethra. Endoscopic removal of the IUD is feasible and safe. Urologists and gynecologists should not limit their diagnosis to IUD migration to the bladder but should also consider the possibility of urethral migration.
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Affiliation(s)
- Chuanfeng Liu
- Department of Urology, Linyi Maternity and Child Health Care Hospital, Linyi, Shandong, China
| | - Yongqiang Xia
- Department of Urology, Linyi Maternity and Child Health Care Hospital, Linyi, Shandong, China
| | - Qingtan Pang
- Department of Urology, Linyi Maternity and Child Health Care Hospital, Linyi, Shandong, China
| | - Zichao Zhao
- Department of Urology, Linyi Maternity and Child Health Care Hospital, Linyi, Shandong, China
| | - Jianfang Zhao
- Department of Gynecology, Linyi Maternity and Child Health Care Hospital, Linyi, Shandong, China
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Varlas VN, Meianu AI, Rădoi AI, Balescu I, Bacalbasa N, Varlas RG. Intrauterine Contraceptive Device Migrated in the Urinary Tract: Case Report and Extensive Literature Review. J Clin Med 2024; 13:4233. [PMID: 39064273 PMCID: PMC11278257 DOI: 10.3390/jcm13144233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 07/13/2024] [Accepted: 07/15/2024] [Indexed: 07/28/2024] Open
Abstract
The migration or translocation of an intrauterine device (IUD) in the urinary tract is a rare event. Here, we present the case of a 55-year-old woman who accidentally discovered the ectopic presence of an IUD following a radiological examination for pelvic pain caused by a lumbar discopathy. Over the years, the patient had several IUDs inserted without being able to specify which one had migrated. The removal of the IUD was performed laparoscopically with the minimum resection of the bladder wall and the subsequent cystorrhaphy. The evolution of the patient was favorable. To better analyze these events, we conducted an all-time extensive electronic search of the PubMed database and identified 94 eligible articles, with a total of 115 cases. The literature analysis on the IUD migrations shows either the simultaneous existence of the second IUD or of a maximum number of up to two IUD insertions during the life of patients. Thus, in the presented case, we identified five IUD insertions over time, which explained the chronic inflammatory process by forming an important mass of adherents that included the urinary bladder, uterus, omentum, sigmoid colon, and abdominal wall. Therapeutic management must be adapted to each case depending on the intra/extravesical location of the migrated IUD evaluated by imaging.
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Affiliation(s)
- Valentin Nicolae Varlas
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Department of Obstetrics and Gynecology, Filantropia Clinical Hospital, 011132 Bucharest, Romania; (A.I.M.); (A.I.R.)
| | - Andreea Ioana Meianu
- Department of Obstetrics and Gynecology, Filantropia Clinical Hospital, 011132 Bucharest, Romania; (A.I.M.); (A.I.R.)
| | - Andra Ioana Rădoi
- Department of Obstetrics and Gynecology, Filantropia Clinical Hospital, 011132 Bucharest, Romania; (A.I.M.); (A.I.R.)
| | - Irina Balescu
- Doctoral School, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania;
| | - Nicolae Bacalbasa
- Department of Surgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Visceral Surgery, Center of Excellence in Translational Medicine “Fundeni” Clinical Institute, 022328 Bucharest, Romania
| | - Roxana Georgiana Varlas
- Doctoral School, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania;
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Natsheh ST, Manasra MR, Hammouri AG, Fakhorui NK, Abugharbieh YM, Alazzeh AMI. Retrieval of a Missing Translocated Intrauterine Contraceptive Device Using Combined Laparoscopic and Cystoscopic Techniques. Case Rep Obstet Gynecol 2024; 2024:2017479. [PMID: 38716061 PMCID: PMC11074910 DOI: 10.1155/2024/2017479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 03/14/2024] [Accepted: 03/27/2024] [Indexed: 05/12/2024] Open
Abstract
Background Intrauterine contraceptive devices (IUCDs) are considered to be an effective way of preventing unwanted pregnancies. However, one significant complication associated with IUCDs is uterine perforation especially at the time of insertion and could reach the peritoneal cavity and the viscus of the adjacent organs. Intravesical migration is extremely rare. Case Presentation. We report a 41-year-old woman who was diagnosed with IUCD intravesical migration after she presented to our hospital complaining of persistent lower urinary tract symptoms. Laparoscopic removal was done after the failure of cystoscopic extraction. Conclusion The IUCD must be monitored continuously by the gynaecologist, and suspicions of intravesical migration must be considered in those presenting with persistent, unexplained lower urinary tract symptoms.
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Affiliation(s)
- Shahd T. Natsheh
- Faculty of Medicine and Health Science, Palestine Polytechnic University, Hebron, State of Palestine
| | - Mahmoud R. Manasra
- Faculty of Medicine and Health Science, Palestine Polytechnic University, Hebron, State of Palestine
| | - Ahmad G. Hammouri
- Department of Radiology, Al-Ahli Hospital, Hebron, State of Palestine
| | - Nour K. Fakhorui
- Department of Urology, Al-Ahli Hospital, Hebron, State of Palestine
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Arshad Z, Saleem A, Zarak MS, Ahadi A, Umar Q, Afshan R. From Contraception to Calculus: An Unusual Case of Intrauterine Contraceptive Device (IUCD) Migration to the Bladder, Recovering Nine Years Post-insertion. Cureus 2024; 16:e57582. [PMID: 38707065 PMCID: PMC11069622 DOI: 10.7759/cureus.57582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 04/03/2024] [Indexed: 05/07/2024] Open
Abstract
Uterine perforations caused by intrauterine contraceptive devices (IUCDs) have been rarely documented in medical literature. However, the migration of these devices into the bladder (intravesical migration), resulting in calculus formation, is an exceptionally uncommon occurrence. When intravesical migration happens, the IUCD may be found lodged in the bladder. In this particular case, the presence of the IUCD was detected within the bladder in the form of calculus, notably without adhering or embedding in the bladder walls. Despite being inserted nine years prior, the patient underwent seven normal deliveries without complications and remained asymptomatic concerning urinary issues until the last two years before presentation. The calculus was successfully removed from the urinary bladder via a laparotomy performed by gynecologists. This case underscores the essential role of radiological investigations and regular follow-ups in patients who report conception after IUCD insertion, as they aid in confirming the potential migration of the device and facilitate timely intervention for removal.
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Affiliation(s)
- Zara Arshad
- Research, Global Remote Research Scholars Program, Chicago, USA
- Internal Medicine, Shifa International Hospital Islamabad, Islamabad, PAK
| | - Anum Saleem
- Internal Medicine, Bolan University of Medical and Health Sciences, Quetta, PAK
| | - Muhammad Samsoor Zarak
- Internal Medicine, Bolan Medical College Quetta, Quetta, PAK
- Internal Medicine, Northwest Medical Center, Tucson, USA
| | - Awranoos Ahadi
- Internal Medicine, Bolan University of Medical and Health Sciences, Quetta, PAK
| | | | - Rubia Afshan
- Obstetrics and Gynaecology, Shaikh Khalifa Bin Zayed Al Nahyan Medical & Dental College, Quetta, PAK
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Wu P, Yang Y, Hou Z, Liu X, He R, Zeng Y. A Laminated Bladder Stone Secondary to an Ectopic Intrauterine Device. Urology 2023; 182:e244-e245. [PMID: 37598891 DOI: 10.1016/j.urology.2023.06.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 05/16/2023] [Accepted: 06/12/2023] [Indexed: 08/22/2023]
Affiliation(s)
- Pingeng Wu
- Department of Urology, Dandong Central Hospital, Dandong, Liaoning, China; Department of Urology, the Cancer Hospital of Dalian University of Technology & Liaoning Cancer Hospital, Shenyang, Liaoning, China
| | - Yun Yang
- Department of Obstetrics and Gynecology, Dandong Central Hospital, Dandong, Liaoning, China
| | - Zheng Hou
- Department of Urology, Dandong Central Hospital, Dandong, Liaoning, China
| | - Xi Liu
- Department of Urology, the Cancer Hospital of Dalian University of Technology & Liaoning Cancer Hospital, Shenyang, Liaoning, China
| | - Rongjun He
- Department of Urology, Dandong Central Hospital, Dandong, Liaoning, China
| | - Yu Zeng
- Department of Urology, the Cancer Hospital of Dalian University of Technology & Liaoning Cancer Hospital, Shenyang, Liaoning, China.
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Yu HT, Chen Y, Xie YP, Gan TB, Gou X. Ectopic intrauterine device in the bladder causing cystolithiasis: A case report. World J Clin Cases 2022; 10:3194-3199. [PMID: 35611133 PMCID: PMC9082705 DOI: 10.12998/wjcc.v10.i10.3194] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 11/22/2021] [Accepted: 02/23/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND An intrauterine device (IUD) is a commonly used contraceptive among women in China. It is widely used because it is safe, effective, simple, economic, and reversible. Among the possible complications, an ectopic IUD in the bladder is rare. It occurs insidiously, has a long course, is associated with a high risk for injury, and is difficult to treat.
CASE SUMMARY A 44-year-old woman was admitted for repeated episodes of urinary frequency, urgency, and dysuria over three months. Laboratory tests revealed significantly elevated urine leukocytes and bacteria. Urine culture suggested colonization with Enterococcus faecalis. Abdominal computed tomography images suggested an abnormally positioned IUD that was protruding into the bladder. Cystoscopy revealed a metallic foreign body with multiple stones on its surface in the left posterior bladder wall. The foreign body measured approximately 1 cm. Hysteroscopy revealed the arm of a V-type metal IUD embedded in the middle and upper sections of the anterior wall of the cervical canal. The majority of the IUD was located in the uterine cavity. Cystoscopy was performed, and a holmium laser was utilized to break the stones attached to the portion of the IUD in the bladder. The IUD was then removed through hysteroscopy.
CONCLUSION Ectopic IUDs in the bladder can be diagnosed with thorough imaging and safely removed through cystoscopy or hysteroscopy.
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Affiliation(s)
- Hai-Tao Yu
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - Yong Chen
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - Yong-Peng Xie
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - Ting-Bin Gan
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - Xin Gou
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
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Liu G, Li F, Ao M, Huang G. Intrauterine devices migrated into the bladder: two case reports and literature review. BMC WOMENS HEALTH 2021; 21:301. [PMID: 34399735 PMCID: PMC8365895 DOI: 10.1186/s12905-021-01443-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 08/02/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Intrauterine devices (IUD) are widely used all over the world. One of the most serious complications is uterine perforation, and it is very rare for the IUD to penetrate the bladder after perforation. Here we report two cases of IUD migration into the bladder, and review the literature to analyze the possible causes and solutions of such complications. CASE PRESENTATION Case NO. 1 is a 37-year-old female who presented lower urinary tract symptoms for a year. Cystoscopy showed that a strip of metal penetrated into the bladder, and the surface was covered with stones. The patient underwent cystotomy and foreign body removal under general anesthesia. Case NO. 2 is a 46-year-old woman who previously inserted an IUD in 1998, but she had an unexpected pregnancy in 1999. Her doctor believed that "the IUD had spontaneously expulsed" and a new IUD was inserted after her pregnancy was terminated. Her CT scan showed an IUD on the left side of the bladder and another IUD in the uterus. Her foreign body was removed by cystotomy. CONCLUSION Patients with IUD should be suggested to check the device regularly, and those who with a missed IUD have to rule out the possibility of IUD migration. For patients with IUD combined with lower urinary tract symptoms, it is necessary to be aware of whether IUD perforation affects the bladder.
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Affiliation(s)
- Guangtao Liu
- Department of Urology, People's Hospital of Leshan, 238 BaitaStreet, Leshan, 614000, Sichuan Province, People's Republic of China.
| | - Feifei Li
- Department of Oncology, People's Hospital of Leshan, Leshan, 614000, Sichuan Province, People's Republic of China
| | - Min Ao
- Department of Urology, People's Hospital of Leshan, 238 BaitaStreet, Leshan, 614000, Sichuan Province, People's Republic of China
| | - Guimin Huang
- Department of Urology, People's Hospital of Leshan, 238 BaitaStreet, Leshan, 614000, Sichuan Province, People's Republic of China
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Qu R, Yang L, Dai Y. Cystoscopy to remove an intrauterine contraceptive device embedded in the urinary bladder wall: a case report and literature review. J Int Med Res 2021; 49:3000605211015032. [PMID: 34000871 PMCID: PMC8135220 DOI: 10.1177/03000605211015032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Migration and embedding of an intrauterine contraceptive device (IUCD) in the urinary bladder wall is rare. We present such a case of a 30-year-old woman with complaints of persistent lower urinary tract symptoms and a history of IUCD placement 8 years earlier. The IUCD was successfully removed with cystoscopy alone. The patient recovered well and had her second baby after the surgery without complaints of new urinary symptoms.
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Affiliation(s)
- Rui Qu
- Division of Urology, Department of Minimally Invasive Surgery, West China No. 4 Hospital, Sichuan University, Chengdu, 610041 PR China
| | - Luo Yang
- Division of Urology, Department of Minimally Invasive Surgery, West China No. 4 Hospital, Sichuan University, Chengdu, 610041 PR China
| | - Yi Dai
- Division of Urology, Department of Minimally Invasive Surgery, West China No. 4 Hospital, Sichuan University, Chengdu, 610041 PR China
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Dappa E, Ramos R, Cunha TM, Ramos N, Silva E. Intrauterine device migration into the bladder with stone formation after radiochemotherapy for cervical cancer: a case report. J OBSTET GYNAECOL 2020; 40:1166-1168. [PMID: 32270726 DOI: 10.1080/01443615.2019.1693524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Evelyn Dappa
- Department of Diagnostic and Interventional Radiology, Johannes Gutenberg-University Medical Centre, Mainz, Germany
| | - Rodrigo Ramos
- Departamento de Urologia, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal
| | - Teresa Margarida Cunha
- Departamento de Radiologia, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal
| | - Nuno Ramos
- Departamento de Urologia, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal
| | - Eduardo Silva
- Departamento de Urologia, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal
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