Alabi Taiwo O, Keshavamurthy Mohan, Ahmed Shabeer, Ojewola Rufus W, Jain Mahendra, Tijani Kehinde H
Department of Surgery, Urology Unit, College of Medicine, Lagos University Teaching Hospital, University of Lagos, Lagos, Nigeria.
Urology, Andrology, and Transplant Surgery Unit, Fortis Hospital, Bengaluru, Karnataka, India.
Niger J Surg. 2018 Jan-Jun;24(1):48-51. doi: 10.4103/njs.NJS_18_17.
The most commonly used long-term reversible female contraception is intrauterine contraceptive device (IUCD). Its use is however associated with documented complications. Uterine perforation, though rare, is arguably the most surgically important of all these complications. We report a case of a 48-year-old para 4 (4 alive) woman who had IUCD insertion 17 years earlier and had forgotten she had the device having had two children thereafter. The IUCD was subsequently translocated through the dome of the bladder into the peritoneal cavity with calculus formation around the tail and thread of the IUCD in the urinary bladder causing recurrent urinary tract infection. This "Collar Stud" effect made either cystoscopic or laparoscopic retrieval alone unsuccessful necessitating a combined approach. This case report highlights the need for a combined laparoscopic and cystoscopic approach in the retrieval of the unusual presentation of translocated IUCD.
最常用的长效可逆女性避孕方法是宫内节育器(IUCD)。然而,其使用与已记录的并发症相关。子宫穿孔虽然罕见,但可以说是所有这些并发症中在外科手术方面最重要的。我们报告一例48岁经产4次(4个存活子女)的女性病例,她17年前放置了宫内节育器,此后又生育了两个孩子,因而忘记了自己体内有该节育器。随后,宫内节育器通过膀胱穹隆移位至腹腔,节育器尾丝和尾端在膀胱内形成结石,导致反复尿路感染。这种“领扣”效应使得单独通过膀胱镜或腹腔镜取出节育器均未成功,因此需要联合手术方法。本病例报告强调了在取出移位宫内节育器这种异常情况时,采用腹腔镜和膀胱镜联合方法的必要性。