Dislocated Intrauterine device in the patient with suspected urinary bladder tumor: a case report and literature review
Autori:
Porin Mašić, Martina Baličević Bošnjak, Ivan Jandrić, Tomislav Vlajnić
Sažetak
Summary
Intrauterine devices (IUD) are one of the most commonly used methods of contraception today, due to their safety and low complication rate. The most serious complication of this contraception method is the uterine wall perforation with possible migration of the IUD into the abdominal cavity, and the damage of the visceral organs. This case report presents a 37-year-old patient with eight months long chronic suprapubic pain that rose a suspicion for neoplastic process. Eleven years ago she had a copper IUD insertion. Three months after the IUD insertion the patient got pregnant. The pregnancy ended up as an incomplete abortion that required dilatation and
curettage. It was assumed that the IUD was spontaneously expulsed from the uterus. The following pregnancy was an induced abortion that was terminated via dilatation and curettage. The third pregnancy was successful and the patient had an uncomplicated term vaginal birth. The patient’s complaint of pain triggered an extensive diagnostic work up. She underwent laboratory tests, urine cytology and CT study which revealed an IUD partially embedded in the patient’s bladder. Cystoscopic biopsy ruled out malignant process while the IUD was removed from the bladder and surrounding omentum via open abdomen. There were no signs of perforation on the uterine wall. The resected portions of the bladder and omentum were benign. Early postoperative course was uncomplicated and the patient
was discharged from the hospital on postoperative day eight. In patients in whom one cannot visualise the IUD string during the gynecological examination, it is necessary to rule out the IUD dislocation before assuming spontaneous expulsion. Surgical removal of a dislocated IUD is curative and prevents potentially dangerous complications.
