Intravesical migration of IUD resulting in stone formation:
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The present case has been reported in the journal Urology Case Reports. A 62-year-old woman was admitted with intermittent severe lower abdominal pain, dysuria and intermittent hematuria for 6 months. She had a medical history of insertion of an IUD inserted 9 years ago.

Urinalysis was indicative of pyuria and hematuria and urine culture was negative. Gynecologic examination reported that there were no visible strings of an IUD and cervix was closed. A plain abdominal radiograph showed a 15-mm calcified mass in the pelvis overlying the Copper-T. Abdominal ultrasonography revealed an echogenic intravesical lesion measuring about 15 mm with distal acoustic shadow suggestive of a foreign body or calculus.

Cystoscopy revealed a large calculus at the end of the IUD wire that was penetrating the posterior wall of bladder and was fixed to the bladder wall, not lying free in the bladder. So the patient underwent endoscopic surgery and the stone around the IUD was crushed using endoscopic ballistic lithotripsy.

After complete disintegration and extraction of fragmented stones, the IUD was removed through the cystoscope using mechanical forceps. The urethral catheter was removed after 10 days. She was followed up for ten months, physical examination and urinalysis were normal.

Key takeaways:-
- An intra-vesical IUD can be calcified if it is embedded in a calcium tone opacity.

- Pelvic ultrasound can usually locate the IUD. Endo-vaginal ultrasound is more efficient for uterine exploration

- In the case of IUD completely encompassed by the calculation, its absence in the uterus associated with urinary signs and bladder stones on the X-ray of urinary tract allow to confirm the diagnosis.

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Dr. K●●●●●a R●●a and 2 other likes this1 share
Dr. H●●●t P●●●●r
Dr. H●●●t P●●●●r Obstetrics and Gynaecology
Well managed . surprisingly patient did not report for follow up. proper instructions to patient after IUD MUST after first period and 6 monthly and removal instructions must.
Jan 15, 2019Like
Dr. M●●●●●a D●●●i
Dr. M●●●●●a D●●●i Obstetrics and Gynaecology
Rightly said, instruction to the patient for a regular follow up and timely removal of an IUCD is a must.
Jan 16, 2019Like