Introduction:

Intrauterine contraceptive devices are a common method of long reversible contraception in women, widely inserted by general practitioners and gynecologists. Although being safe and reliable, these devices can lead to complications, such as perforation or abscess after insertion. There are over 1,000 cases described in the medical literature of intrauterine devices’ migration from the uterus to other locations, such as sigmoid colon or peritoneal cavity.

Case description:

We present the case of a 54 years old woman, from Guinea-Bissau, who presented with recurrent pelvic pain and dyspareunia, for 10 years. She was followed for four years in Gynecology. In the previous years, the patient had repeated and persistent dysuria and urinary urgency, along with positive urocultures and the presence of blood and leukocytes in urine. Despite the appropriate antibiotic treatment, the symptoms recurred. On further examination, gynecological and bladder ultrasounds were performed and a hyperdense structure compatible with an intrauterine contraceptive device was found inside the bladder. After referral to the Emergency Department of Urology, the diagnosis was confirmed and the intrauterine contraceptive device was then removed.

Comment:

In medical literature, almost all extra-uterine intrauterine devices (IUD) are due to migration. Patients with intrauterine devices ought to have regular follow-ups. If there is a suspicion of a “lost” intrauterine device, especially in a woman with chronic pelvic pain, dysuria, or recurrent urinary tract infections, a further radiologic examination is in order to rule out the rare, but possible, hypothesis of migration.

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