Extrauterine Migration of a Displaced IUD Leading to Bladder Wall Perforation: A Case Report

Abstract

Background: Uterine perforation and Intrauterine contraceptive device (IUD) migration into adjacent organs is a serious complication of IUD insertion with an incidence of 0.1% to 0.9%. Only 2% of all migrated IUD cases have included the bladder. Case Presentation: In this report we discuss the presentation and management of a 54-year-old female diagnosed with extrauterine IUD migration into the bladder with consequent stone formation. She underwent an IUD insertion 28 years ago after her third pregnancy. She presented to our clinic complaining of lower urinary tract symptoms for 2 years. An initial urinary tract ultrasound showed an intravesical echogenic structure with posterior acoustic shadowing that was initially thought to represent a stone. The patient underwent an elective open cystolithotomy under general anesthesia where the IUD was located and then removed. The patient tolerated the procedure well and had an uneventful recovery period. Conclusion: IUD migration is a rare yet serious complication of IUD placement and should be ruled out in females with chronic urinary symptoms. WHO recommends removal of any displaced IUD regardless of location and severity of symptoms.