U J All Final for WEB.pdf 818 | Intravesical Migration of an Intrauterine Device Bayram Guner, Ozgur Arikan, Gokhan Atis, Lutfi Canat, Turhan Çaskurlu Keywords: urinary bladder, intrauterine devices, intrauterine device migration, uterine perforation INTRODUCTION Intrauterine device (IUD) is the most commonly used, safe, and reversible method of contra-ception. Uterine perforation is a rare complication of IUD. Migration could occur to the CASE REPORT bladder on computed tomography (CT). Corresponding Author: Bayram Guner, MD Department of 2nd Urology, Goztepe Research and Training Hospital, 34730, Istanbul, Turkey Tel: +90 352 216 570 9162 E-mail: gunerbayram@ yahoo.com Received February 2011 Accepted June 2011 Department of 2nd Urology, Goztepe Research and Training Hospital, Istanbul, Turkey CASE REPORT Case Report 819Vol. 10 | No. 1 | Winter 2013 |U R O LO G Y J O U R N A L Intravesical Migration of Intrauterine Device | Guner et al - traction (Figures 2 and 3). Bladder perforation that occurred - st postoperative - tend annually for outpatient visits and to seek medical help if DISCUSSION Intrauterine device is one of the most effective and reversible complications, such as uterine perforation, undesired preg- - Uterine perfo- literature.(6,7) It becomes more susceptible due to reduction in - genemia in the lactation and postpartum periods. Gener- - Figure 1. Intrauterine device had been partially penetrated to the bladder wall. Figure 2. Gentle traction with grasper for intrauterine device in the bladder lumen. Figure 3. Intrauterine device is taken with grasper. Figure 4. Post-removed image of the intrauterine device. 820 | ever, most authors believe that IUD placement by special- ists is very important in preventing perforation primarily. through the bladder due to infection, adhesion, and tissue damage caused by the vaginal speculum during IUD inser- tion. - cal situation. Related symptoms, such as chronic pelvic pain, dysuria, pollacuria, microscopic hematuria, pyuria, dyspare- unia, recurrent and persistent urinary tract infection, vaginal infections, can occur before the diagnosis ranging from 3 These patients may have multiple antibiotic therapies if they are not evaluated appropriately. been reported in the literature. The most accurate methods for diagnosis of lost IUD are radiography, ultrasonography, intravenous urography, CT, and cystoscopy. Partial perfora- imaging studies. Although CT is the most effective imaging method for diagnosis, but cystoscopy is the optimal thera- peutic approach to manage IUD migration to the bladder. Minimally-invasive methods, such as laparoscopy or endos- copy, are standard approach for removal of migrated IUD. - scopic surgery. CONFLICT OF INTEREST None declared. REFERENCES 1. Ozcelik B, Serin IS, Basbug M, Aygen E, Ekmekcioglu O. Differential diagnosis of intra-uterine device migrating to bladder using radiographic image of calculus formation and review of literature. Eur J Obstet Gynecol Reprod Biol. 2003;108:94-6. 2. Hoscan MB, Kosar A, Gumustas U, Guney M. Intravesical migration of intrauterine device resulting in pregnancy. Int J Urol. 2006;13:301-2. 3. Guvel S, Tekin MI, Kilinc F, Peskircioglu L, Ozkardes H. Bladder stones around a migrated and missed intrauterine contraceptive device. Int J Urol. 2001;8:78-9. 4. Markovitch O, Klein Z, Gidoni Y, Holzinger M, Beyth Y. Ex- trauterine mislocated IUD: is surgical removal mandatory? Contraception. 2002;66:105-8. 5. Harrison-Woolrych M, Ashton J, Coulter D. Uterine perfora- tion on intrauterine device insertion: is the incidence high- er than previously reported? Contraception. 2003;67:53-6. 6. Sepulveda WH, Ciuffardi I, Olivari A, Gallegos O. Sono- graphic diagnosis of bladder perforation by an intrauterine device. A case report. J Reprod Med. 1993;38:911-3. 7. Zakin D, Stern WZ, Rosenblatt R. Complete and partial uterine perforation and embedding following insertion of intrauterine devices. I. Classification, complications, mechanism, incidence, and missing string. Obstet Gynecol Surv. 1981;36:335-53. 8. Atakan r H, Kaplan M, Ertrk E. Intravesical migration of intrauterine device resulting in stone formation. Urology. 2002;60:911. 9. Nceboz US, Ozcakir HT, Uyar Y, Caglar H. Migration of an intrauterine contraceptive device to the sigmoid co- lon: a case report. Eur J Contracept Reprod Health Care. 2003;8:229-32. 10. Disu S, Boret A. Asymptomatic ileal perforation of an in- trauterine device. Arch Gynecol Obstet. 2004;269:230-1. 11. Dietrick DD, Issa MM, Kabalin JN, Bassett JB. Intravesical migration of intrauterine device. J Urol. 1992;147:132-4. 12. Neutz E, Silber A, Merendino VJ. Dalkon Shield perforation of the uterus and urinary bladder with calculus formation: case report. Am J Obstet Gynecol. 1978;130:848-9. 13. Grimaldi L, De Giorgio F, Andreotta P, D'Alessio MC, Piscicelli C, Pascali VL. Medicolegal aspects of an unusual uterine perforation with multiload-Cu 375R. Am J Forensic Med Pathol. 2005;26:365-6. 14. Ozgur A, Sismanoglu A, Yazici C, Cosar E, Tezen D, Ilker Y. Intravesical stone formation on intrauterine contraceptive device. Int Urol Nephrol. 2004;36:345-8. 15. Phupong V, Sueblinvong T, Pruksananonda K, Taneepanich- skul S, Triratanachat S. Uterine perforation with Lippes loop intrauterine device-associated actinomycosis: a case report and review of the literature. Contraception. 2000;61:347-50. Case Report