bladderwall containment of a displaced intrauterine device (IUD) discovered in a female case with missed abortion.
In a rare and concerning case, a 28-year-old pregnant woman with a history of five pregnancies and a copper IUD inserted a year ago, was admitted to the hospital due to a case of missed abortion at 11 weeks of gestation.
The patient presented with mild vaginal bleeding but no associated abdominal pain, palpitations, or other complaints. However, upon closer examination, the IUD was unexpectedly found embedded in the wall of her urinary bladder.
Regular follow-up and patient education on the importance of monitoring IUD position can help in early detection of such complications. In this case, the woman had no typical urinary symptoms to suggest a problem before imaging revealed the IUD's migration.
Ultrasonography showed retained products of conception, and an abdominal and pelvic CT scan revealed a copper IUD displaced outside the uterus, in the urinary bladder wall. Approximately 2% of migrated IUDs may involve the urinary bladder.
The management of the intravesical IUD typically involves surgical removal, which can be achieved through endoscopic procedures or, in more complex cases, open surgery. In this case, plans were made for surgical removal of the IUD after managing the pregnancy complications.
IUD migration to the urinary bladder, even without typical urinary symptoms, should be considered in patients with unexplained pelvic issues. Early detection through imaging and prompt removal of the device are essential to prevent further complications.
Intravenous access was established, and intravenous fluids were initiated at a rate of 3 liters per 24 hours. Comprehensive laboratory tests were ordered, including serial complete blood counts every 6 hours and a serial collection of pads for bleeding assessment.
The woman had initial mild vaginal bleeding, but her vital signs were stable upon initial examination. The specialist was informed, and the patient's condition was monitored closely.
Intrauterine devices (IUDs) are a common form of reversible contraception with a range of side effects, including pain, irregular bleeding, and serious complications like pelvic inflammatory disease, contraceptive failure, expulsion, uterine perforation, or migration to adjacent organs. Uterine perforation is one of the serious complications related to IUD use, with a frequency estimated between 0.05 and 13 per 1000 insertions.
Less commonly, patients may also experience dyspareunia or other forms of sexual dysfunction. Regular follow-up and patient education are important to ensure timely identification of potential issues before they escalate.
The name of the doctor or clinic where the woman was treated is not publicly disclosed. It serves as a reminder for all women using IUDs to be vigilant about their health and seek immediate medical attention if they experience any unusual symptoms.
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