Kwon Young Suk, Paneque Tomas, Chandra Akhil A, Chua Kevin J, Munshi Faizanahmed I, Findlay Bridget L, Harmon Keith A
Division of Urology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
Division of Urology, Rutgers Robert Wood Johnson University Hospital Somerset, Somerville, New Jersey, USA.
J Endourol Case Rep. 2020 Dec 29;6(4):502-504. doi: 10.1089/cren.2020.0076. eCollection 2020.
Intrauterine device (IUD) migration to the ureter is rare. Symptoms can vary, but often mimic renal colic. Radiographic imaging may aid the diagnosis of a foreign body in the ureter. Reports on endoscopic managements of a migrated IUD are not well described. We present a 36-year-old woman with a history of IUD insertion. Her symptoms included hematuria, dysuria, and suprapubic/abdominal pressure. After the removal of her IUD by her gynecologist, her hematuria eventually stopped, but she presented again with persistent pain. CT revealed a radiopaque foreign body in the distal left ureter protruding into the bladder. A careful resection with a resectoscope uncovered a long cylindrical shaped foreign body, suspicious of a broken piece of the IUD. Although not always feasible and long-term results remain to be determined, endoscopic management is a safe and effective method of identifying and removing a retained IUD in the ureter. When evaluating a woman with abdominal pain who has an indwelling IUD, a spontaneous migration of the IUD should be considered in the differential diagnosis.
宫内节育器（IUD）迁移至输尿管的情况较为罕见。症状可能多种多样，但常类似肾绞痛。影像学检查可能有助于诊断输尿管内的异物。关于迁移至输尿管的IUD的内镜处理报道并不详尽。我们报告一名36岁有IUD置入史的女性。她的症状包括血尿、排尿困难以及耻骨上/腹部压迫感。在妇科医生取出她的IUD后，她的血尿最终停止，但她再次出现持续性疼痛。CT显示左输尿管远端有一不透射线的异物突入膀胱。用切除镜仔细切除后发现一个长圆柱形异物，怀疑是IUD的碎片。尽管并非总是可行且长期结果仍有待确定，但内镜处理是识别和取出输尿管内残留IUD的一种安全有效的方法。在评估有腹痛且体内有IUD的女性时，鉴别诊断中应考虑IUD的自发迁移。
