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      Retrieval of a Missing Translocated Intrauterine Contraceptive Device Using Combined Laparoscopic and Cystoscopic Techniques

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          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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          Most cited references18

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          The CARE guidelines: consensus-based clinical case report guideline development.

          A case report is a narrative that describes, for medical, scientific, or educational purposes, a medical problem experienced by one or more patients. Case reports written without guidance from reporting standards are insufficiently rigorous to guide clinical practice or to inform clinical study design.
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            Intrauterine device embedded into the bladder wall with stone formation: laparoscopic removal is a minimally invasive alternative to open surgery

            Spontaneous perforation of the uterus and intravesical intrauterine device (IUD) is very rare. The treatment options for an intravesical IUD are open surgery or cystoscopic removal. Open surgery has been used generally for the removal of IUDs with formation of big stones or partial penetration of the bladder wall. In this case, we removed an IUD (multiload Cu 375®) with calculus that had sunk deeply into the bladder wall via laparoscopic partial cystectomy.
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              Urinary complications of migrated intrauterine contraceptive device.

              The study aimed to present diagnosis and management of urinary complications resulting from migration of intrauterine contraceptive device (IUD). Between May 2002 and January 2007, eight women were treated for urinary complications because of migrated IUD. Persistent lower urinary tract symptoms were the main complaint in five cases, while one patient presented with urinary incontinence and two had suffered from right loin pain. Diagnosis was established after performing noncontrast computed tomography (NCCT) in all cases. Intravenous urogram (IVU) was carried out for evaluation of hydronephrosis in two cases. Cystoscopy was performed before surgical intervention in six cases. The interval between insertion of IUD and onset of symptoms ranged from 1 week up to 2 years. NCCT revealed complete intravesical position of the IUD with calculus formation on top in four cases and partial bladder wall penetration in the fifth. Cystoscopy confirmed the site of the IUD as detected by NCCT. In the last two cases, retroperitoneal migration of IUD had led to fibrosis around the right pelvic ureter. Intravesical IUDs and stones were successfully retrieved using transurethral endoscopy while suprapubic retrieval of the device was followed by repair of vesicouterine fistula in the fifth case and ureteroneocystostomy in the last two cases. Persistent lower urinary tract symptoms in women with IUD should raise the suspicion of intravesical migration. Noncontrast CT permitted excellent depiction of the site of migrated IUD for selection of proper management. Endoscopic retrieval is feasible and safe in cases with intravesical migrated IUD.
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                Author and article information

                Contributors
                Journal
                Case Rep Obstet Gynecol
                Case Rep Obstet Gynecol
                CRIOG
                Case Reports in Obstetrics and Gynecology
                Hindawi
                2090-6684
                2090-6692
                2024
                15 April 2024
                : 2024
                : 2017479
                Affiliations
                1Faculty of Medicine and Health Science, Palestine Polytechnic University, Hebron, State of Palestine
                2Department of Radiology, Al-Ahli Hospital, Hebron, State of Palestine
                3Department of Urology, Al-Ahli Hospital, Hebron, State of Palestine
                Author notes

                Academic Editor: Manvinder Singh

                Author information
                https://orcid.org/0009-0005-4502-4107
                https://orcid.org/0000-0002-2849-3500
                https://orcid.org/0000-0003-2919-4980
                Article
                10.1155/2024/2017479
                11074910
                38716061
                13a164af-d2a3-40ae-940a-e3098f56f7b5
                Copyright © 2024 Shahd T. Natsheh et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 16 August 2023
                : 14 March 2024
                : 27 March 2024
                Categories
                Case Report

                Obstetrics & Gynecology
                Obstetrics & Gynecology

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