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宫内节育器迁移至膀胱并伴有结石形成:一种罕见的并发症——病例报告及文献综述

Migration of an intrauterine contraceptive device into the bladder complicated by stone formation an exceptional complication: case report and literature review.

作者信息

Houmaid Hanane, Harou Karam, Fakhir Bouchra, Bassir Ahlam, Boukhanni Lahcen, Aboulfalah Abderrahim, Asmouki Hamid, Soummani Abderraouf

机构信息

Gynecology Obstetrics Departement, Mohammed the VI University Medical Center, Cadi Ayyad University, Marrakesh, Morocco.

出版信息

Contracept Reprod Med. 2024 Aug 28;9(1):42. doi: 10.1186/s40834-024-00302-x.

DOI:10.1186/s40834-024-00302-x
PMID:39192372
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11351088/
Abstract

BACKGROUND

We report a rare and unusual case of intravesical migration of an intrauterine device with stone formation. The intrauterine device (IUD) is the most common method of reversible contraception in women. However, its insertion is not without risk, it can cause early or late complications. IUD can perforate the uterus wall and migrate into adjacent structures.

CASE PRESENTATION

A 35 year-old female 5 gravid, 4 para has been benefited from intrauterine contraceptive device (IUCD) 5 years ago, she was presented to gynecological consultation for chronic pelvic pain with urinary symptoms. There was history of a good IUD insertion 5 years ago, considered expelled after one month of its pose. Physical examination was normal, but a pelvic ultrasound and a plain abdominal radiography allowed the detection of an IUD outside the uterine cavity, but inside bladder. A diagnostic and therapeutic cystoscopy was performed, and the IUD with calculus was successfully removed. There were no postoperative complications.

CONCLUSION

This case is reported to highlight and to reiterate the need to think about one of the rare complication of IUD insertion, which every practitioner must know, it's the transuterovesical migration, before concluding wrongly to its expulsion. It's a consequence of, non-compliance with the rules for inserting an IUD and poor monitoring. The evolution towards calcification is a certain consequence; its screening involves rigorous clinical monitoring.

摘要

背景

我们报告一例罕见的宫内节育器膀胱内迁移并形成结石的病例。宫内节育器(IUD)是女性最常用的可逆避孕方法。然而,其置入并非毫无风险,可能会引起早期或晚期并发症。IUD可穿透子宫壁并迁移至邻近结构。

病例介绍

一名35岁女性,孕5产4,5年前开始使用宫内节育器(IUCD),因慢性盆腔疼痛伴泌尿系统症状前来妇科就诊。5年前IUD置入顺利,置入后1个月曾被认为已排出。体格检查正常,但盆腔超声和腹部平片显示IUD位于子宫腔外但在膀胱内。进行了诊断性和治疗性膀胱镜检查,成功取出了带有结石的IUD。术后无并发症。

结论

报告该病例是为了强调并再次指出,在错误地判定IUD已排出之前,应考虑到IUD置入的一种罕见并发症——经膀胱迁移,这是每位从业者都必须了解的情况。这是不遵守IUD置入规则和监测不力的后果。向钙化发展是必然结果;其筛查需要严格的临床监测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8c5/11351088/21edffe4fac6/40834_2024_302_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8c5/11351088/6ee7d51eb43a/40834_2024_302_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8c5/11351088/4acd926ed2b9/40834_2024_302_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8c5/11351088/21edffe4fac6/40834_2024_302_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8c5/11351088/6ee7d51eb43a/40834_2024_302_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8c5/11351088/4acd926ed2b9/40834_2024_302_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8c5/11351088/21edffe4fac6/40834_2024_302_Fig3_HTML.jpg

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Case Report: Iatrogenic trauma of the bladder due to long-term unidentified intrauterine device malposition inside the bladder with rectovesical fistula.病例报告:因膀胱内长期未被识别的宫内节育器位置异常并伴有直肠膀胱瘘导致的医源性膀胱创伤。
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Migrated intrauterine device: Case series report.宫内节育器移位:病例系列报告
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Urol Case Rep. 2023 May 15;49:102439. doi: 10.1016/j.eucr.2023.102439. eCollection 2023 Jul.
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Intraperitoneal migration of an intrauterine device (IUD): A case report.宫内节育器(IUD)的腹腔内移位:一例报告。
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