Intrauterine Device Research Articles

The Migration of an Intrauterine Device in the Bladder of an Asymptomatic Woman: A Case Report

Background: The use of intrauterine devices (IUDs) for contraception has increased in many countries. However, their application has some serious complications such as uterine perforation and injury to adjacent organs. The translocated IUD into the bladder is a very rare occurrence. Case Presentation: Our case was a 41-year-old woman whose IUD was accidentally discovered in her bladder during a routine ultrasound. The IUD has migrated from its normal position in the uterus to the bladder. The IUD was successfully removed by cystoscopy without any complications. Conclusion: The mislocation of an IUD in the bladder, while uncommon, is a possibility that should be considered when the IUD string is not visible during examinations.

The effects of an educational intervention on women's contraceptive preferences in the immediate postpartum period: A cross-sectional study.

To assess postpartum women's contraceptive preferences and the impact of an educational intervention on these preferences, identifying factors motivating method choices. This cross-sectional quantitative study included women within 48 h after delivery in a public Brazilian hospital. Participants were asked about their contraceptive preferences before and after an educational intervention, which aimed to inform women about the importance of early postpartum contraception, available methods, mechanisms of action, effectiveness, proper use, and side effects. A nursing professional explained contraceptives to postpartum women in individual sessions, demonstrating their use on simulators interactively for about 15 min. Statistical analyses were performed using JAMOVI version 2.3.28 and Microsoft Excel 2016. A total of 402 women (226 adolescents and 176 adults) were included. After the intervention, preference for long-acting reversible contraceptives (LARCs) increased significantly from 157 (39.1%) to 279 (68.7%) (P < 0.001). At the initial assessment, contraceptive preferences were injectable hormonal contraceptives (159 [39.6%]), intrauterine devices (IUDs) (109 [27.1%]), and implants (48 [11.9%]). After the educational intervention, IUDs became the most popular method, at 143 (35.6%), followed by implants (133 [33.1%]) and injectables (81 [20.1%]). Among adolescents, there was a significant increase in implant choice (P < 0.001) and a decrease in injectables and pills (P < 0.001; P = 0.006). Adults showed increased preference for implants (P < 0.001) and IUDs (P < 0.001), with a reduction in injectable hormonal contraceptives (P = 0.005) and tubal ligation (P = 0.006). An educational intervention during postpartum period can influence women's contraceptive choices. Timely education was associated with a significant increase in LARC preference.

Prevalence and Determinants of Modern Contraceptive Use among Rohingya Women of Reproductive Age Residing in Refugee Camps in Bangladesh: A Cross-Sectional Survey

Background: Comprehensive studies on the determinants of modern contraceptive use in humanitarian settings are relatively uncommon in Bangladesh. The aim of this study was to examine the prevalence and determinants of modern contraceptive use among Rohingya women living in the refugee camp of Cox's Bazar, Bangladesh. Methods: A cross-sectional survey was conducted among 160 Rohingya refugee women aged 15-49 living in unregistered camps (Camps 7 and 14) in Ukhiya Upazila, Cox's Bazar. In the study, participants were selected using a convenience sampling method, and the sample size was calculated using the single population proportion formula. However, only 160 participants were recruited due to travel restrictions and safety measures implemented throughout Bangladesh during the COVID-19 pandemic. The data were gathered via a structured questionnaire. Results were summarized using both descriptive and inferential statistics and SPSS v.23 software was used for data analysis at 5% level of significance. Results: The prevalence of contraceptive use was found to be 41.9%. The most commonly used contraceptives were Injection Depot-Provera (65.7%) and Oral Contraceptive Pill (OCP) (28.4%) followed by implant (4.5%) and intrauterine device (IUD) (1.5%). Multivariate logistic regression revealed lower odds of modern contraceptive use among women who had more than a 1.5 year interval between the last two pregnancies (OR = 0.19; 95% CI = 0.07– 0.51) and higher odds were found who expressed a lack of desire for future pregnancies (OR = 13.69; 95% CI = 3.43–54.68). Community Health Workers (CHWs) (80.4%) were the main sources of information on modern contraceptives, whereas hospitals (83.6%) were the most accessible places to obtain contraceptives. Conclusion: Community health workers play a vital role in disseminating information, emphasizing the need for their training and involvement in relevant programs. These findings are crucial for shaping future research, policies, and reproductive health services in humanitarian settings.

Effect of an Intensive Nurse Home Visiting Program on Postpartum Contraceptive Use and Birth Spacing

OBJECTIVE: To evaluate the effect of an intensive nurse home visiting program on postpartum contraceptive use and birth spacing among individuals with a first pregnancy who were eligible for Medicaid insurance in South Carolina. METHODS: We conducted a nonblinded, randomized controlled trial of the Nurse-Family Partnership (NFP), an established intensive home visiting program that provides prenatal and postpartum home visits through 2 years after childbirth. The trial included patients who were eligible for Medicaid insurance with a first pregnancy at less than 28 weeks of gestation between April 1, 2016, and March 17, 2020, who were followed up through 2 years after childbirth. Participants were randomized 2:1 to NFP compared with standard of care treatment. The primary outcome was a birth interval of less than 21 months between the index pregnancy and a subsequent birth. The secondary outcomes were birth intervals of less than 15 and 24 months, receipt of a contraceptive implant or intrauterine device (IUD) immediately postpartum, any contraceptive use and receipt of a family planning visit (at both 6 weeks and 1 year postpartum), and IUD receipt at 1 year postpartum. We assessed outcomes using linked birth certificate records and Medicaid claims data. RESULTS: A total of 4,932 trial participants (3,295 in the intervention group and 1,637 in the control group) were included in the study analysis. Within 21 months of the study index birth, 11.0% of individuals in the NFP group and 12.2% of the usual care group had a subsequent birth. The NFP did not have a statistically significant effect on birth intervals of less than 21 months (adjusted coefficient −1.1, 95% CI, −2.9 to 0.8). There were no statistically significant differences between the NFP and control groups for any of the study's eight secondary outcomes related to birth spacing and postpartum contraceptive use. CONCLUSION: Home visits with a registered nurse did not affect postpartum contraceptive use or birth spacing. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT03360539.

Study of Knowledge, Attitudes and Practices of Family Planning: Case of Female Staff of the Communal Medical Center (CMC) of Flamboyants, Conakry, Guinea

&amp;lt;i&amp;gt;Introduction:&amp;lt;/i&amp;gt; The aim was to assess the knowledge, attitudes and practices of female staff on family planning at the Flamboyants Communal Medical Center. &amp;lt;i&amp;gt;Methods:&amp;lt;/i&amp;gt; This was a 3-month cross-sectional, prospective, descriptive and analytical study involving women (doctors, midwives, laboratory technicians and nurses) working at the Flamboyants CMC and agreeing to participate in the study. &amp;lt;i&amp;gt;Results:&amp;lt;/i&amp;gt; The contraceptive prevalence was 61.9%. All respondents were aware of FP (100%). The most commonly cited contraceptive methods were: the intrauterine device (IUD) at 85.7%, the Jadelle implant (79.4%) and the contraceptive pill (68.3%). More than 8 out of 10 respondents (81.0%) were in favor of using family planning. Most of the respondents, 74.5%, discussed family planning with their spouses and 70.2% of the spouses were in favor of FP. The most frequently used method was the pill (59.0%). The factors associated with the use of FP were: dialogue with the spouse on contraception (p = 0.018), marriage (p = 0.012) and good attitude of the spouse towards FP (p = 0.000). &amp;lt;i&amp;gt;Conclusion:&amp;lt;/i&amp;gt; Improving this prevalence would require the involvement of spouses and midwives during counseling during antenatal and postpartum follow-up.

Menstrual cups to reduce bacterial vaginosis and STIs through reduced harmful sexual and menstrual practices among economically vulnerable women: protocol of a single arm trial in western Kenya

BackgroundIn western Kenya, menstrual hygiene management (MHM) is a pervasive problem. Challenges are compounded for economically constrained women who continue to engage in sex during menses and resort to practices such as vaginal insertion of tissue and cotton to maintain dryness during sex. These practices can be harmful to the vaginal microbiome (VMB) and can lead to high rates of sexually transmitted infections (STIs) and HIV. This study will evaluate whether menstrual cups that can be worn during intercourse may be beneficial to the VMB and help prevent Bacterial vaginosis (BV) and STI acquisition among these economically vulnerable women.MethodsIn this single-arm trial among economically vulnerable women in semi-urban western Kenya, we will evaluate the preliminary efficacy of menstrual cups on non-optimal VMB, BV, and STIs, and investigate safety, acceptability, and implementation needs. Through peer referral we aim to recruit 402 menstruating women aged 15–35 who exchange sex for money or basic needs. Women who are pregnant, have delivered in the past six months, or use an intrauterine device (IUD) will not be eligible. Participants will be seen every six months for 24 months and be asked about their sexual and MHM practices, with samples collected to assess BV and VMB. At baseline, 12-, and 24-month visits, additional samples will be collected to measure HIV and STIs (C. trachomatis, N. gonorrhoeae, and T. vaginalis). HSV-2 status will be assessed at baseline. Intervention provision will consist of one reusable disc-shaped menstrual cup per participant and a group-based training within four weeks of the 12-month visit, followed by monthly telephone surveys for the first three months to assess cup use, adverse events, and provide any assistance. Primary analyses of preliminary efficacy will compare probabilities of optimal VMB, BV, and STIs in the pre-intervention period to the post-intervention period. Primary safety analyses will compare occurrence of menstrual toxic shock syndrome and cervicovaginal laceration.DiscussionIf demonstrated safe and effective, this multipurpose reproductive health intervention will offer a dignified solution for the menstrual hygiene needs of women who engage in sex for livelihood and reduce their occurrence of non-optimal VMB, BV, and STIs.Trial registrationClinicaltrials.gov NCT05666778 (28th December, 2022); Pan African Clinical Trials Registry 202,305,912,778,108 (25th May, 2023).

Retraction: Comparison between the traditional non-guided and a novel ultrasound-guided technique for office fitting of intrauterine contraceptive devices.

M. S. E. Elsedeek, "Comparison Between the Traditional Non-guided and a Novel Ultrasound-guided Technique for Office Fitting of Intrauterine Contraceptive Devices," International Journal of Gynecology & Obstetric 133, no. 3 (2016): 338-341, https://doi.org/10.1016/j.ijgo.2015.11.013. The above article, published online on 23 February 2016 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the journal Editor-in-Chief, Michael Geary; the International Federation of Gynecology and Obstetrics; and John Wiley & Sons Ltd. The retraction has been agreed following an investigation based on concerns raised by a third party. Although the paper does not specify which statistical methods were used, the editors found that numerous results could not be reproduced from the summary data using t-tests or chi-squared tests. The author was invited to comment on the concerns and provide supporting data but did not respond. The editors consider the results and conclusion reported in this article unreliable.

Cross-Sectional Survey to Assess Hospital System Readiness for Hemorrhage During and After Cesarean Delivery in Africa.

Mothers in Africa are 50 times more likely to die after cesarean delivery (CD) than in high-income countries, largely due to hemorrhage. It is unclear whether countries across Africa are adequately equipped to prevent and treat postpartum hemorrhage (PPH) during and after CD. This was a cross-sectional survey of anesthesiologists and obstetricians across the African Perioperative Research Group (APORG). The primary objective was to determine readiness of the hospital system to implement the World Health Organization (WHO) recommendations for prevention and treatment of PPH during and after CD. The secondary objectives were to evaluate the availability of blood products, skilled human resources and establish available postoperative care after CD. Survey question format was close-ended or Likert scale, with options "always," "sometimes," or "never." Responses were analyzed from 1 respondent from each of 140 hospitals from 29 low- and middle-income countries across Africa. Most respondents completed every data field on the case report form. Regarding WHO recommendations on prevention of PPH, oxytocin and misoprostol were available in 130/139 (93.5%) and 101/138 (73.2%) hospitals, respectively. There was limited access to heat-stable carbetocin (12/138 [8.7%]) and ergometrine (35/135, [25.9%]). Controlled cord traction for removal of placenta was always performed in 133/135 (98.5%) hospitals. Delayed cord clamping when neonatal resuscitation was not indicated, was not performed universally (86/134 [64.2%]). Regarding the treatment of PPH, crystalloids were always available in 133/139 (95.7%) hospitals, and the preferred initial resuscitation fluid (125/138 [90.6%]). Uterine massage was always performed in 117/139 (84.2%) hospitals. Tranexamic acid was always available in 97/139 (69.8%) hospitals. The availability of intrauterine balloon tamponade devices was limited. Most had immediate access to theater (126/139 [90.6%]). Responses concerning organizational recommendations showed that 113/136 (83.1%) hospitals had written protocols for the treatment of PPH. Protocols for patient referral and simulation training were limited. Most hospitals had access to emergency blood (102/139 [73.4%]). There was limited access to blood component therapy, with platelets available at 32/138 (23.2%), cryoprecipitate at 21/138 (15.2%) and fibrinogen at 11/139 (7.9%) hospitals. In-person specialist cover was reduced after-hours. Important WHO-recommended measures to reduce hemorrhage during and after CD, are not currently available in many hospitals across Africa. It is likely that the lack of a combination of factors leads to failure to rescue mothers in Africa from postoperative complications. These findings should facilitate codesign of quality improvement initiatives to reduce hemorrhage related to CD.

The Thematic Analysis of Barriers to Immediate Post-Partum Long-Acting Reversible Contraception

Background: Globally, many women express the desire to avoid immediate pregnancy for 24 months postdelivery, and only forty percent use contraceptives during this period. There is an enormous demand for postpartum family planning, particularly in developing countries with low- or middle-income grades. Postpartum intrauterine devices such as long-acting reversible contraceptives (LARCs) are among the most effective methods of family planning in the immediate postpartum period, yet their effectiveness is hindered because of a lack of availability and training. Strategies to increase access to LARCs are essential. Hence, the purpose of the current study is to determine the barriers among healthcare providers in providing immediate postpartum family planning services. Methods: A cross-sectional study was conducted in the Department of Obstetrics and Gynaecology at SIMS, a tertiary care teaching hospital, from January to March 2024. Approximately 293 healthcare providers who fulfilled the inclusion criteria were provided an online questionnaire in the form of a Google Forms link, which included a structured questionnaire focusing on various aspects, including demographics, knowledge, practices, and barriers in their practice. The data collected were analysed through SPSS version 26, which employs chi-square tests and Pearson’s correlation to determine any significant associations among them. Based on the key statistical outcomes and the significant correlations observed related to the data, a thematic analysis through SWOT (strengths, weaknesses, opportunities, threats) was conducted. The study adhered to the method outlined by Braun and Clarke (2006) and compiled with the COREQ (consolidated criteria for reporting qualitative research) checklist to uphold methodological integrity. Results: Among the participants, 92.4% provided family planning counselling after childbirth, predominantly during the antenatal period (75.1%), and the provision of immediate postnatal family planning was reported in 76.1% of the participants, with PPIUDs identified as the most utilized method by 52.6%. Various barriers were identified, including insufficient training on Implanon (33.4%) and the PPIUCD (12.6%), the unavailability of implants (59.0%), and a lack of interest among patients (46.1%). Statistically significant associations were observed between the practice setting and knowledge of postpartum family planning (p = 0.002), as well as deficiencies in training for the PPIUCD (p &lt; 0.001). The study highlights the place of practice and the practitioners’ experience as significant strengths in offering immediate postpartum contraception and referring patients for family planning. However, qualification was identified as a limiting factor for practicing immediate postpartum family planning. Conclusions: This study revealed significant difficulty in delivering prompt postpartum long-acting reversible contraceptives (LARCs), underscoring the necessity of improved education and training for professionals. Focusing on these challenges is important in enhancing postpartum family planning acceptance and decreasing unfulfilled requirements in resource-limited settings.

Dr Associate Professor

Background: Most women do not desire pregnancy immediately after delivery and are highly motivated to accept family planning methods. The post partum intrauterine device is one of the family planning methods that can address this need. According to prior reports intrauterine device use has been very low from the contraceptive method mix. Objective: To assess barriers to postpartum intra uterine device uptake among mothers who delivered at two public hospitals in Addis Ababa, Ethiopia. Method: It is an institution based cross-sectional study. Simple random sampling method was used to select study participants. Descriptive statistics and regression analysis were used to determine the presence and strength of association between uptake of post partum intrauterine device and independent variables. Result: In this study the uptake of postpartum intrauterine contraceptive device was 11% (95%CI=8.0, 14). The stated barriers for the none uptake of post partum intrauterine device were fear and concern (61.6%), religions value for family planning (16.9%), husband and relative opinion (7%), culture norm (5%) and health provider related factor (5% (17/367)). Parity and mode of delivery were significantly associated post partum intrauterine device uptake. The odds of intrauterine contraceptive device utilization for mothers with previous number of deliveries of ?3 and 1-2 were 35 (AOR=34.8, 95%CI=7.33, 165.4) and 4 (AOR=4.2, 95%CI=1.47, 12.07) times higher than those with no previous delivery. In addition, assisted vaginal delivery had 11 (AOR=11.06, 95%CI=3.26, 37.5) times increased odds of intrauterine contraceptive device uptake than SVD. Conclusion and recommendations: The uptake of post partum intrauterine device was low (11%). The main barriers identified for the low uptake were fear and concern to myth and misconceptions, religions value for family planning, husband and relative opinion, culture norm and health provider related factors. To identify and address reasons for gaps in knowledge and to clear public misconceptions and fears further large scale studies are recommended. Key-words: PPIUD, Contraception, post partum, Ethiopia.

058. A Rare Case: Anterior Wall Rectum Perforation Due to Intrauterine Device Migration

Background: Intrauterine devices (IUDs) are widely used for contraception due to their long-acting, safe, and effective nature in preventing pregnancy. However, common side effects and complications, such as vaginal bleeding, expulsion, displacement, translocation, and perforation necessitate attention, with translocation and perforation being rare but potentially severe, warranting prompt removal according to WHO recommendations. This study aims to document and analyze a rare case of rectal perforation resulting from the migration of an IUD. Case: A report was made from 31-year-old pregnant woman with a history of two cesarean sections presented with 10-day abdominal pain and an IUD inserted 42 days post-surgery, which MRI revealed had translocated into the left anterolateral rectal wall, prompting retroscopy for extraction. Uterine perforation and IUD migration into adjacent organs can result in various complications, including uterine, bladder, and intestinal perforation, with initial symptoms potentially being asymptomatic, emphasizing the need for routine check-ups. Retrieval of migrated IUDs can be achieved through methods such as endoscopy, laparoscopy, or laparotomy, as illustrated in a case involving a patient with abdominal pain and imaging evidence of IUD translocation to the rectum's anterior wall, managed through less invasive rectoscopy. Conclusion: Translocated IUDs may exhibit varying symptoms or none at all, necessitating removal regardless of type or location, with management guided by radiological and endoscopic findings alongside understanding abdominal organ anatomy

Counseling Women About Sexual Health Effects of Contraceptives.

Background: Choosing a contraceptive method is a pivotal decision for patients, whereas health care professionals (HCPs) face challenges in providing suitable recommendations. Adverse sexual effects often lead to dissatisfaction and discontinuation of contraceptives, underscoring the importance of thorough counseling and shared decision making between HCPs and patients. Objective: This article aims to investigate the relationship between contraceptive methods and female sexual function through a comprehensive review of available literature, emphasizing the importance of considering sexual health in contraceptive prescription and management. Methods: A systematic analysis of existing literature, incorporating studies utilizing validated sexual health questionnaires, was conducted to elucidate the intricate interplay between contraceptives and female sexual function. Results: The review encompasses various contraceptive methods, including combined hormonal contraceptives, progestin-only pills, depot medroxyprogesterone acetate, subdermal contraceptive implants, hormonal intrauterine devices, permanent sterilization, and barrier methods. Insights gleaned from the analysis shed light on the impact of these methods on female sexual health. Conclusion: Comprehensive understanding of the effects of contraceptives on female sexual function is crucial for both HCPs and patients. By integrating sexual health considerations into contraceptive surveillance, compliance can be improved, contraceptive efficacy optimized, and the risk of unwanted pregnancies minimized. This review underscores the significance of tailored counseling and shared decision making in contraceptive management, particularly for cisgender women.

11740 Presentation and Management of Bladder Perforation Related to Intrauterine Device: A Case Report and Review of the Literature

11740 Presentation and Management of Bladder Perforation Related to Intrauterine Device: A Case Report and Review of the Literature

Effectiveness of virtual reality in reducing Pain During Intrauterine Device Insertion: A Systematic Review and Meta-analysis

Effectiveness of virtual reality in reducing Pain During Intrauterine Device Insertion: A Systematic Review and Meta-analysis

The impact of prior levonorgestrel intrauterine device use at the time of embryo transfer.

To investigate whether infertile women with a history of levonorgestrel intrauterine device (LNG IUD) use have impaired pre-transfer endometrial thickness and pregnancy rates after embryo transfer. Retrospective cohort study at a single academic medical center of infertile women ages 18-44 with a history of LNG IUD use undergoing their first embryo transfer cycle between January 2019 and January 2021 compared to controls with a history of no prior birth control use (NONE) or only prior oral contraceptive use (OCP). The primary outcome is endometrial thickness prior to embryo transfer. Secondary outcomes include embryo transfer results. We analyzed data from a total of 616 patients (197 NONE, 357 OCP, 62 LNG IUD). Women with a history of LNG IUD use had thinner endometrial stripes than women with a history of no prior birth control use (LNG IUD 8.93mm, NONE 10.32mm [aRR 0.88, 95% CI 0.80-0.97]), but not when compared to women with a history of OCP use (OCP 9.61mm [aRR 0.92, 95% CI 0.84-1.01]). Women with a history of LNG IUD use had slightly higher implantation rates than those with no birth control use history (LNG IUD 43.37%, NONE 24.17% [RR 1.79, 95% CI 1.21-2.45]), though not when compared to prior OCP users (OCP 38.72% [RR 1.12, 95% CI 0.86-1.47]). The remainder of the embryo transfer outcomes were similar between the three groups. Prior LNG IUD users have reduced endometrial thickness at the time of embryo transfer but do not have worse pregnancy outcomes.

Efficacy and Safety of EMLA Cream in Reducing Pain During Intrauterine Device Insertion: Systematic Review and Meta-Analysis of Randomized Controlled Trials

Efficacy and Safety of EMLA Cream in Reducing Pain During Intrauterine Device Insertion: Systematic Review and Meta-Analysis of Randomized Controlled Trials

Frequency of androgenic cutaneous adverse events associated with levonorgestrel intrauterine devices: an analysis of the Food and Drug Administration Adverse Events Reporting System database

Frequency of androgenic cutaneous adverse events associated with levonorgestrel intrauterine devices: an analysis of the Food and Drug Administration Adverse Events Reporting System database

Effectiveness of Intrauterine Contraceptive Device in Immediate Post-Partum Period

Objective: To determine the effectiveness of intra-Uterine Contraceptive Device (IUCD) in immediate postpartum period for prevention of pregnancy. Study Design: Quasi-experimental study Place And Duration Of Study: Department of Obstetrics and Gynecology, POF Hospital Wah Cantt. Pakistan, from Jan to Jun 2021. Methodology: A total of 100 women, aged 20-40 years, and parity 1-4 undergoing delivery either through normal vaginal (Group-A) or Cesarean section (Group-B) who accepted Long-Acting Reversible Contraceptives (LARC) in postpartum period were included. IUCDs were placed within 48 hours of delivery. The females were followed up after first menstruation up to 3 to 6 weeks on the phone and were recalled in OPD for assessment. The primary outcome was frequency of expulsion of IUCDs and secondary outcome was pregnancy. Results: Out of the 56 patients in Group-A, 54 (96.4%) didn’t become pregnant. Only 2(3.6%) patients had positive pregnancy test. Forty out of forty-four subjects in Group-B (90.90%) did not develop pregnancy, which shows that IUCD (Cu-T) is an effective means of contraception (p value &lt;0.001). LARC effectiveness was analogous in both study groups with p value 0.232. Similarly, the frequency of expulsion was also comparable in both groups that is 11(25.0%) expulsions in Group-B versus 16(28.6%) in Group-A (p value 0.433). Conclusion: The Intrauterine Contraceptive Device (Cu-T) is effective means of contraception in immediate postpartum period and can be used to decrease the expulsion rate in these women.

Migration of intrauterine device to the bladder with associated vesicolithiasis: a case report

Migration of intrauterine device (IUD) is a frequent complication of IUD insertion. Most IUD migration is only displaced in the uterine cavity, but in rare cases IUD could migrate to other pelvic organs, such as the pelvic cavity, rectum, or the bladder. We reported a case of 80-years old female with one month history of hematuria and pain, which further examination shows vesicolithiasis and bladder mass. During lithotripsy, intrauterine device was visualized inside the stone, which the patient admitted had been inserted 40 years ago. This case is remarkable, as it is rare to have a longstanding IUD placement with intravesical migration, vesicolithiasis, and bladder malignancy.

Lost and found: the late discovery of a migrated intrauterine device after 15 years - a case report

Intrauterine devices (IUDs) are a preferred reversible contraceptive choice for about 159 million women worldwide. While generally safe, they pose risks like uterine perforation and device migration, which happen in about 1 in 1000 insertions. Other common issues include insertion failure, pain, infection, and menstrual changes. This report details a rare case of IUD migration in a 40-year-old woman, discussing the diagnostic challenges and the approaches used to manage such complications. IUD migration to the bladder is uncommon but can lead to serious, often undetected issues, thus underscoring the necessity for regular follow-up after placement. Early diagnosis with imaging is critical for proper treatment, with the World Health Organization recommending surgical removal in symptom-free cases. The rarity of uterine perforation during IUD use highlights the vital need for vigilant monitoring and patient follow-ups to prevent and quickly address such complications. The uncertain timing and cause of IUD migration further stress the importance of comprehensive counseling and regular patient check-ups. Abdominal discomfort may indicate an IUD has migrated, emphasizing the need for patient awareness and routine self-monitoring after placement. CT imaging is crucial for identifying and pinpointing the location of migrated IUDs, facilitating their removal using minimally invasive methods like colonoscopy and laparoscopy. For more complicated scenarios, such as those involving deep embedment, laparotomy may be necessary.