Misplaced Intrauterine Device Research Articles

Vesical stone formation caused by a forgotten and migrated intrauterine contraceptive device: a case report with literature review

BackgroundAs widely known, an intrauterine device (IUD) is a small, typically T-shaped contraceptive device that offers long-term reversible birth control. However, neglecting to remove the IUD can lead to severe complications. This case report showcases an exceptional instance that underscores the potential risks associated with retention of an IUD.Case presentationThis case report documents a 40-year-old female who failed to remove her intrauterine device for eight years. Upon her visit to our clinic, she presented with increased urinary frequency, burning micturition, dysuria, and discomfort while emptying her bladder. Medical review consisting of ultrasound (KUB) and X-ray pelvis revealed the intrauterine device had migrated and was encrusted with a stone. We used Holmium laser lithotripsy to break down the stone, before using cystoscope to manually remove the intrauterine device. She made a rapid recovery without any complications.ConclusionsIn order to raise awareness about forgotten or misplaced IUDs and their complications, we are presenting a case of complete intravesical IUD migration at our clinic. This serves as an educational opportunity to shed light on this uncommon occurrence and emphasize the importance of timely removal and follow-up in patients using intrauterine devices (IUDs).

Misplaced of Intrauterine Devices: The Endoscopic Management

Intra uterine device migration is a relatively rare event. The migration of the IUD in the surrounded viscera can be managed by endoscopy approach. Objectives: We reported our experience to determine the epidemiologic characteristics of patients that presented migrated IUD, to report clinical aspects and describe the laparoscopic management. Method: The study includes 10 patients reported to obstetrics and Gynecology I department of UHC Hassan II FES in the last 4 years (2018-2021). In all the patients a gynecological examination, ultrasound evaluation abdomen and pelvis were done to locate the misplaced IUD. If the device was found to be intrauterine, hysteroscopy was done to locate and retrieve device. In those patients in whom the IUD was confirmed to be extrauterine diagnostic laparoscopy was done. Results: The average of age was 34.5 years. Majority of patients were primipara (53.3%) and 46.6% were multipara. As far as timing of insertion is concerned 6 (60%) were postpartum, 4 (40%) were postmenstrual. The average of time interval between insertion and removal is 3, 12 years. Of the 10 misplaced intrauterine devices 4 were found partially embedded in uterine wall and 6 of the misplaced 1UD’s were found deeply embedded in the uterine cavity. After their location they were removed hysteroscopically One patient reported with 8 weeks pregnancy and misplaced IUD. The device was confirmed to be intrauterine on transvaginal sonography. She had full term normal delivery and IUD was removed after 6 weeks hysteroscopically. None of our patient had an extra uterine migration that required a laparoscopy.

Does Ultrasound Guidance Provide Pain Relief During Intrauterine Contraceptive Device Insertion? A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

To evaluate ultrasound guidance effect in pain relief during intrauterine device (IUD) insertion. Four different databases were searched from inception till June 2022. We selected randomized controlled trials (RCTs) that compared transabdominal ultrasound guidance versus traditional non-guided IUD insertion among women undergoing IUD placement for contraception. We used Revman software during performing our meta-analysis. Our primary outcome was the pain score during IUD insertion as evaluated by the Visual Analog Scale (VAS). Our secondary outcomes were the procedure insertion time, satisfaction, and incidences of complications and misplaced IUDs. Seven RCTs were retrieved with a total number of 1267 patients. There was a significant reduction in the VAS pain score during IUD insertion among the ultrasound-guided group (MD=-1.91, 95% CI [-3.08, -0.73], P=.001). The procedure insertion time was significantly shorter within the ultrasound guidance group compared with the control group (MD=-1.35, 95% CI [-1.81, -0.88], P < .001). Moreover, more women were significantly satisfied with the procedure among the ultrasound-guided group (P < .001). In addition, ultrasound-guided IUD insertion was linked to significant decline in incidences of complications and misplaced IUDs. Ultrasound guidance can be used as a modified technique during IUD insertion as it decreases pain, procedure time, and rates of complications and misplaced IUDs with better patient satisfaction.

Challenges in Management of Misplaced Intrauterine Devices: A Case Series and Review of Literature

Challenges in Management of Misplaced Intrauterine Devices: A Case Series and Review of Literature

Retrieval of an Intrauterine Device Embedded in an Ovary and the Small Intestine

The Intrauterine Devices (IUDs) to include the copper T380A IUD and levonorgestrel intrauterine system are effective reversible contraceptives options for women. A well-known but infrequent complication of the IUD is uterine perforation. Most uterine perforations occur at the time of IUD insertion but can also occur spontaneously after placement. IUDs located within the abdomen have potential to cause significant morbidity for patients to include perforation into surrounding structures such as the omentum, mesentery, small intestine, colon, and ovaries. Surgical management should be pursued upon confirmation of uterine perforation prevent sequel. Most misplaced IUDs can be managed by laparoscopic retrieval; however, laparotomy may be required when there is extensive adhesive disease. We present a case of a 28-year-old female who required laparotomy to remove a copper T380A IUD embedded into the small intestine and ovary after perforating through the uterus. The intent of this case report is to illustrate the importance of proper technique when placing IUDs and the steps in retrieving an IUD which is suspected to have perforated the uterus.

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Extrauterine mislocated IUD: is surgical removal mandatory?

The incidence of intrauterine device perforation is 0.87 per 1000 insertions. An intrauterine device (IUD) may perforate through the uterine wall into the pelvic or abdominal cavity or into adjacent organs. The accepted treatment for displaced IUDs is surgical removal because of the putative risk of adhesion formation or of damage to the intestine or urinary bladder. The purpose of this article is to present three cases of IUD perforation where surgical removal may not have been necessary. In all three cases, the IUD was removed by laparoscopy. No adhesions were found in any of the patients. Criteria for the surgical removal of a displaced IUD, as a result of uterine perforation, should be re-evaluated. Whilst surgical procedures to remove a misplaced IUD must be performed on symptomatic patients, asymptomatic patients, under certain circumstances, may benefit from conservative management.

Role of endoscopy in retrieval of misplaced intrauterine device.

We report a series of 45 patients with misplaced intrauterine devices (30 extrauterine and 15 intrauterine). Only those patients with intrauterine misplacements in whom conventional blind removal was not possible were included in the study. All of the 15 misplaced intrauterine devices could be removed hysteroscopically; 22 of the 30 extrauterine misplaced devices (73%) could be removed laparoscopically. One patient required both laparoscopy and hysteroscopy. Only 7 (15.5%) of 45 patients required laparotomy for safe removal of misplaced devices. Considerable comfort and minimal hospital stay associated with endoscopic procedures should offer these as the first line attempt to remove a misplaced intrauterine or extrauterine translocated device.