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经膀胱镜检查取出完全自行迁移至膀胱的宫内节育器

Removal of Complete Spontaneous Migration of an Intrauterine Contraceptive Device to the Bladder by Cystoscopy.

作者信息

Saputra Akbar Novan Dwi, Rahman Muhammad Nurhadi, Widyasari Anis

机构信息

Urogynecology and Reconstructive Surgery Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.

出版信息

Case Rep Obstet Gynecol. 2024 May 13;2024:6934178. doi: 10.1155/2024/6934178. eCollection 2024.

Abstract

Intrauterine contraceptive devices (IUCD) are widely used as a reversible method of contraception. Although uterine perforation caused by an IUCD is rare, in some cases, the device may migrate to the pelvic/abdominal cavity or nearby structures. When the IUCD migrate to the bladder, it can lead to various symptoms. These include pain or discomfort in the lower abdomen, difficulties or pain during urination, frequent urinary tract infections, and the development of bladder stones. This article presents a case report of a 24-year-old woman with an intrauterine contraceptive device (IUCD) that had migrated completely into the bladder. She had an IUCD inserted by a midwife four years earlier and became pregnant a year later, unaware of the IUCD's presence. She later presented with lower abdominal pain, hematuria, and dysuria three months before being admitted to our hospital. Imaging confirmed the intravesical location of the IUCD. She underwent successful cystoscopy treatment to remove the migrated IUCD. Prompt diagnosis and appropriate management are crucial in preventing complications and improving patient outcomes. Clinicians should be aware of this potential complication and consider it when patients present with symptoms or complications after IUCD insertion. Regular monitoring and timely intervention can help detect and address IUCD migration effectively.

摘要

宫内节育器(IUCD)作为一种可逆的避孕方法被广泛使用。虽然由宫内节育器引起的子宫穿孔很少见,但在某些情况下,该装置可能会迁移到盆腔/腹腔或附近结构。当宫内节育器迁移到膀胱时,会导致各种症状。这些症状包括下腹部疼痛或不适、排尿困难或疼痛、频繁的尿路感染以及膀胱结石的形成。本文介绍了一例24岁女性的病例报告,其宫内节育器已完全迁移至膀胱。四年前,一名助产士为她放置了宫内节育器,一年后她怀孕了,当时并未意识到宫内节育器的存在。入院前三个月,她出现了下腹部疼痛、血尿和排尿困难。影像学检查证实了宫内节育器位于膀胱内。她接受了成功的膀胱镜检查治疗,取出了迁移的宫内节育器。及时诊断和适当处理对于预防并发症和改善患者预后至关重要。临床医生应意识到这种潜在并发症,并在患者在放置宫内节育器后出现症状或并发症时予以考虑。定期监测和及时干预有助于有效检测和处理宫内节育器迁移问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c3f/11105948/0c7ac89b4f42/CRIOG2024-6934178.001.jpg

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