Department of Obstetrics and Gynecology, Universitas Gadjah Mada, Yogyakarta, Indonesia.
Department of Obstetrics and Gynecology, Universitas Gadjah Mada, Yogyakarta, Indonesia
BMJ Case Rep. 2023 Oct 24;16(10):e256547. doi: 10.1136/bcr-2023-256547.
An intrauterine device (IUD) is a popular method of contraception mainly used in developing countries. Perforation is one of the most serious but a rare complication secondary to the insertion of an IUD, while perforation into the intravesical organs such as the bladder is even more rare. A 30-year-old multipara in early 30s, with two previous caesarean sections (CS) and one curettage, was found to have her IUD puncturing the bladder during a cystoscopy procedure to remove her bladder stones. Transvesical migration of an IUD is an uncommon complication with a high rate of calculi formation, which is thought to be caused by the IUD's lithogenic potential. Imaging approaches such as ultrasound and pelvic X-rays are considered imperative in the accurate diagnosis. Any migrated IUD should be removed regardless of location. Prompt and continual monitoring of women using an IUD is essential and in a case where the IUD has migrated, the removal using the endoscopic approach is a safe and effective method.
宫内节育器(IUD)是一种流行的避孕方法,主要在发展中国家使用。穿孔是 IUD 插入后最严重但罕见的并发症之一,而穿孔进入膀胱等内脏器官则更为罕见。一名 30 岁的经产妇,30 岁出头,曾有两次剖宫产和一次刮宫术,在进行膀胱镜检查以取出膀胱结石时发现她的 IUD 刺穿了膀胱。IUD 经阴道迁移是一种罕见的并发症,结石形成率很高,据认为这是由于 IUD 的成石潜力所致。超声和骨盆 X 线等影像学方法被认为对准确诊断至关重要。无论位置如何,任何迁移的 IUD 都应移除。对使用 IUD 的女性进行及时和持续的监测至关重要,而在 IUD 已经迁移的情况下,使用内镜方法取出是一种安全有效的方法。