Isikhuemen M E, Idolor A G, Uwagboe C U, Sodje J D K, Anya C J, Okonofua F E
Department of Obstetrics and Gynaecology, University of Benin Teaching Hospital, Edo State, Nigeria.
Department of Obstetrics and Gynaecology, University of Benin Teaching Hospital, Edo State, Nigeria.
Int J Surg Case Rep. 2024 Mar;116:109436. doi: 10.1016/j.ijscr.2024.109436. Epub 2024 Feb 23.
Intrauterine contraceptive device (IUCD) is a safe and effective method of contraception. It is however rarely associated with complications. Migration of this device to the rectum is very rare. We report a case of IUCD migrating to the rectum with the history of missing IUCD strings.
A 32-year-old multipara presented 8 weeks following IUCD insertion with missing thread, ultrasound scan done showed a viable pregnancy with IUCD in-situ. Following vaginal examination, IUCD could not be retrieved. Pregnancy was allowed to continue for IUCD to be retrieved at delivery. She presented again about 6 weeks later with IUCD strings protruding through the rectum and was subsequently removed.
Uterine perforation and migration of IUCD into the pelvic organs is an uncommon but major complication following insertion of the device. The risk of perforation appears to depend on type of device, skill of the operator and position of the uterus. Postpartum insertion, lactation and atrophic uterus also increase risk of perforation.
perforation and migration of IUCD to the rectum is a rare but possible complication of following insertion of the device. Family planning providers should continue to undergo training and retraining to minimize complications associated with the use of IUCD.
宫内节育器(IUCD)是一种安全有效的避孕方法。然而,它很少引发并发症。该装置迁移至直肠的情况极为罕见。我们报告一例宫内节育器迁移至直肠的病例,患者有宫内节育器尾丝缺失史。
一名32岁经产妇在放置宫内节育器8周后因尾丝缺失就诊,超声检查显示宫内节育器在位且妊娠存活。经阴道检查,未能取出宫内节育器。允许妊娠继续,以便在分娩时取出宫内节育器。约6周后,她再次就诊,宫内节育器尾丝经直肠突出,随后将其取出。
宫内节育器子宫穿孔并迁移至盆腔器官是放置该装置后罕见但严重的并发症。穿孔风险似乎取决于装置类型、操作者技术以及子宫位置。产后放置、哺乳期和子宫萎缩也会增加穿孔风险。
宫内节育器穿孔并迁移至直肠是放置该装置后罕见但可能出现的并发症。计划生育服务提供者应持续接受培训和再培训,以尽量减少与使用宫内节育器相关的并发症。