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      Management of Intrauterine Device Migrated into the Bladder: A Case Report and Literature Review

      case-report

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          Abstract

          Intrauterine device represents the most reversible method of contraceptive worldwide. Its insertion is a medical procedure not free from complication. We report a rare case of intravesical migration of a copper intrauterine device inserted 18 months earlier in a 28-year-old multiparous woman. The patient presented with irritative lower urinary tract symptoms, and she was managed endoscopically. This case underscores the role of cystoscopy in irritative lower urinary tract symptoms post IUD insertion.

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          Copper-T intrauterine device and levonorgestrel intrauterine system: biological bases of their mechanism of action.

          María Elena Ortiz S, Horacio B Croxatto (2007)
          All intrauterine devices (IUDs) that have been tested experimentally or clinically induce a local inflammatory reaction of the endometrium whose cellular and humoral components are expressed in the tissue and the fluid filling the uterine cavity. Depending on the reproductive strategy of the species considered and the anatomical features and physiologic mechanisms that characterize their reproductive system, the secondary consequences of this foreign body reaction can be very localized within the uterus, as in the rabbit, or widespread throughout the entire genital tract as in women or even systemic as in some farm animals. Levonorgestrel released from an IUD causes some systemic effects, but local effects such as glandular atrophy and stromal decidualization, in addition to the foreign body reaction, are dominant. Copper ions released from an IUD enhance the inflammatory response and reach concentrations in the luminal fluids of the genital tract that are toxic for spermatozoa. In the human, the entire genital tract appears affected due to luminal transmission of the noxa that accumulates in the uterine lumen. This affects the function and viability of gametes, decreasing the rate of fertilization and lowering the chances of survival of any embryo that may be formed, before it reaches the uterus. The bulk of the data indicate that if any embryos are formed in the chronic presence of an IUD, it happens at a much lower rate than in non-IUD users. The common belief that the usual mechanism of action of IUDs in women is destruction of embryos in the uterus is not supported by empirical evidence.
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            CLINICAL MANAGEMENT OF FOREIGN BODIES OF THE GENITOURINARY TRACT

            JEAN DE KERNION, Arndt van Ophoven (2000)
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              Potential user interest in new long-acting contraceptives: Results from a mixed methods study in Burkina Faso and Uganda

              Rebecca L Callahan, Aurélie Brunie, Amelia C L Mackenzie … (2019)
              Method-related concerns represent an important cause of contraceptive non-use and discontinuation. User preferences must be incorporated into the design of new contraceptive technologies to ensure product success and improve family planning outcomes. We assessed preferences among potential users in Burkina Faso and Uganda for six contraceptive methods currently under development or ready for introduction: a new copper intra-uterine device (IUD), a levonorgestrel intra-uterine system, a new single-rod implant, a biodegradable implant, a longer-acting injectable, and a method of non-surgical permanent contraception. Questions were added to nationally-representative PMA2020 household surveys that asked 2,743 and 2,403 women in Burkina Faso and Uganda, respectively, their interest in using each new method. We assessed factors associated with interest through multivariable logistic regression models. We conducted qualitative interviews and focus groups with 398 women, 78 men, and 52 family planning providers and key informants to explore perceived advantages and disadvantages of the methods. Respondents expressed interest in using all new methods, with greatest interest in the longer-acting injectable (77% in Burkina Faso, 61% in Uganda), followed by a new single-rod implant. Least interest was expressed in a new copper IUD (26% Burkina Faso, 15% in Uganda). In both countries, women with less education had higher odds of interest in a longer-acting injectable. Interest in most new methods was associated with desiring a method lasting longer than one year and acceptance of lack of menstrual bleeding as a contraceptive side effect. Perceived advantages and disadvantages were similar between countries, including concerns about menstrual side effects and fear of the biodegradable nature of the biodegradable implant. Potential users, their partners, and providers are interested in new longer-acting methods, however, familiar forms including the injectable and implant may be the most immediately acceptable. A biodegradable implant will require clear counseling messages to allay potential fears.
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                Author and article information

                Contributors
                A. K. Paré:
                ORCID: https://orcid.org/0000-0003-3444-5035
                Journal
                Journal ID (nlm-ta): Case Rep Urol
                Journal ID (iso-abbrev): Case Rep Urol
                Journal ID (publisher-id): CRIU
                Title: Case Reports in Urology
                Publisher: Hindawi
                ISSN (Print): 2090-696X
                ISSN (Electronic): 2090-6978
                Publication date Collection: 2020
                Publication date (Electronic): 31 October 2020
                Volume: 2020
                Electronic Location Identifier: 8850087
                Affiliations
                1Department of Urology, Souro Sanou University Teaching Hospital, Bobo-Dioulasso, Burkina Faso
                2Department of Surgery, Federal Medical Center, PMB 02, Nguru, Yobe State, Nigeria
                Author notes

                Academic Editor: Yankai Xia

                Author information
                https://orcid.org/0000-0003-3444-5035
                https://orcid.org/0000-0001-6965-0325
                Article
                DOI: 10.1155/2020/8850087
                PMC ID: 7648710
                SO-VID: b2bf525b-d683-43a5-992d-6c339498da0a
                Copyright © Copyright © 2020 A. K. Paré et al.
                License:

                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
                Date received : 20 June 2020
                Date revision received : 28 September 2020
                Date accepted : 19 October 2020
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Urology
                Data availability:
                ScienceOpen disciplines: Urology

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