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避孕并发症:膀胱结石的出现——一例报告

Contraceptive complication: Emergence of a bladder stone - A case report.

作者信息

Gazzah Wael, Mansi Zied, Zaidi Bacem

机构信息

University of Sousse, Department of Urology, Ibn El Jazzar Hospital, Kairouan, Tunisia.

University of Sousse, Department of Orthopedic Surgery, Ibn El Jazzar Hospital, Kairouan, Tunisia.

出版信息

Int J Surg Case Rep. 2024 May;118:109622. doi: 10.1016/j.ijscr.2024.109622. Epub 2024 Apr 6.

Abstract

INTRODUCTION AND IMPORTANCE

Bladder stones, although rare in a healthy bladder, can emerge due to various factors, including obstructions in urinary flow, recurrent infections, and foreign bodies. Intrauterine contraceptive devices (IUCDs) are known for their potential to migrate from the uterine cavity, leading to unusual complications such as bladder stone formation.

CASE PRESENTATION

A 52-year-old woman, previously treated for a complicated urinary tract infection, presented with intermittent lower abdominal pain, dysuria, and hematuria. She had a history of an IUCD insertion 15 years earlier, which was later documented as missing. Diagnostic imaging revealed a large bladder stone, encasing the previously inserted IUCD. An open vesicolithotomy was performed, during which a stone measuring 6 × 5 cm was removed, revealing the IUCD within. The patient had an uncomplicated recovery with no further urinary tract infections at a 6-month follow-up.

CLINICAL DISCUSSION

The migration of an IUCD can lead to various complications, depending on its final location. The formation of bladder stones around a migrated IUCD is a rare but significant complication, necessitating a thorough diagnostic approach. Radiography and ultrasonography proved sufficient for diagnosing the intravesical migration in this case.

CONCLUSION

This case underscores the importance of considering a migrated IUCD in the differential diagnosis of patients presenting with urinary symptoms, especially those with a history of a missing IUCD. Timely diagnosis and management are crucial in preventing further complications.

摘要

引言与重要性

膀胱结石在健康膀胱中虽较为罕见,但可因多种因素出现,包括尿流梗阻、反复感染及异物等。宫内节育器(IUCD)因其有从子宫腔移位的可能而闻名,这会导致诸如膀胱结石形成等异常并发症。

病例介绍

一名52岁女性,既往曾治疗复杂性尿路感染,现出现间歇性下腹痛、排尿困难及血尿。她15年前曾放置IUCD,后来记录显示该节育器已丢失。诊断性影像学检查发现一枚大膀胱结石,包裹着先前置入的IUCD。遂行开放性膀胱切开取石术,术中取出一枚6×5厘米的结石,结石内可见IUCD。患者恢复顺利,6个月随访时未再发生尿路感染。

临床讨论

IUCD移位可导致多种并发症,具体取决于其最终位置。移位的IUCD周围形成膀胱结石是一种罕见但严重的并发症,需要采取全面的诊断方法。在本病例中,X线摄影和超声检查足以诊断膀胱内移位情况。

结论

本病例强调了在对有泌尿系统症状的患者,尤其是有IUCD丢失史的患者进行鉴别诊断时,考虑IUCD移位的重要性。及时诊断和处理对于预防进一步并发症至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c04/11033183/795b0b81f72b/gr1.jpg

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