Khiangte Elbert, Khiangte Iheule Newme, Naiding Nitya Non, Deka Kunal, Bathari Ronald, Doungel Jimmy Henkhomang
Department of Surgery, Apollo Hospitals, Guwahati, Assam, India.
Department of Obstetrics and Gynecology, Apollo Hospitals, Guwahati, Assam, India.
J Minim Access Surg. 2022 Oct-Dec;18(4):613-615. doi: 10.4103/jmas.jmas_216_21.
Intrauterine contraceptive devices (IUCDs) are the most commonly used reversible contraceptive methods. Uterine perforation followed by transmigration is a rare but potentially life-threatening complication associated with the use of IUCDs. Perforation of the bladder by an IUCD is extremely rare. We present the case of a 36-year-old woman with a 3-year history of IUCD placement presenting with symptoms of lower urinary tract infection. X-ray of the pelvis and hysteroscopy revealed an inverted T-shaped metallic shadow resembling an IUCD in the pelvis and an empty uterine cavity, respectively. Using a cystoscope, the IUCD was visualized embedded in the urinary bladder and its retrieval was attempted unsuccessfully with the cystoscope. Hence a rendezvous technique, in which laparoscopy, assisted with cystoscopy was performed. The vertical limb and half of the horizontal limb of the copper-T were retrieved from the outer wall of the urinary bladder laparoscopically, and the intravesical part of the horizontal limb along with the calculus was retrieved per urethra.
宫内节育器(IUCDs)是最常用的可逆性避孕方法。宫内节育器穿孔并迁移是一种罕见但可能危及生命的与使用宫内节育器相关的并发症。宫内节育器导致膀胱穿孔极为罕见。我们报告一例36岁女性病例,该女性放置宫内节育器3年,出现下尿路感染症状。骨盆X线检查和宫腔镜检查分别显示骨盆中有一个类似宫内节育器的倒T形金属阴影和一个空的子宫腔。使用膀胱镜检查时,可见宫内节育器嵌入膀胱,尝试用膀胱镜取出未成功。因此采用了一种会师技术,即进行腹腔镜检查并辅助膀胱镜检查。通过腹腔镜从膀胱外壁取出了铜T形宫内节育器的垂直臂和水平臂的一半,水平臂的膀胱内部分连同结石经尿道取出。