Vesical calculus around an intra-uterine contraceptive device

Intrauterine device embedded into the bladder wall with stone formation: laparoscopic removal is a minimally invasive alternative to open surgery

Spontaneous perforation of the uterus and intravesical intrauterine device (IUD) is very rare. The treatment options for an intravesical IUD are open surgery or cystoscopic removal. Open surgery has been used generally for the removal of IUDs with formation of big stones or partial penetration of the bladder wall. In this case, we removed an IUD (multiload Cu 375) with calculus that had sunk deeply into the bladder wall via laparoscopic partial cystectomy.

Squamous cell carcinoma of the bladder associated with chronic irritation related to a migrated intrauterine device

Intrauterine devices (IUDs) are one of the most commonly used methods for reversible contraception. This article reports a case of squamous cell carcinoma of the bladder which exhibited a migrated IUD into the bladder. A 66-year-old woman with a 26-year history of IUD use admitted to the clinic with the chief complaint of intermittent macroscopic haematuria. Clinical examination raised a suspicion bladder carcinoma, so cystoscopy and histological sampling were performed and squamous cell carcinoma of bladder was diagnosed, which was related to chronic irritation by a migrated IUD.

Urinary complications of migrated intrauterine contraceptive device

The study aimed to present diagnosis and management of urinary complications resulting from migration of intrauterine contraceptive device (IUD). Between May 2002 and January 2007, eight women were treated for urinary complications because of migrated IUD. Persistent lower urinary tract symptoms were the main complaint in five cases, while one patient presented with urinary incontinence and two had suffered from right loin pain. Diagnosis was established after performing noncontrast computed tomography (NCCT) in all cases. Intravenous urogram (IVU) was carried out for evaluation of hydronephrosis in two cases. Cystoscopy was performed before surgical intervention in six cases. The interval between insertion of IUD and onset of symptoms ranged from 1 week up to 2 years. NCCT revealed complete intravesical position of the IUD with calculus formation on top in four cases and partial bladder wall penetration in the fifth. Cystoscopy confirmed the site of the IUD as detected by NCCT. In the last two cases, retroperitoneal migration of IUD had led to fibrosis around the right pelvic ureter. Intravesical IUDs and stones were successfully retrieved using transurethral endoscopy while suprapubic retrieval of the device was followed by repair of vesicouterine fistula in the fifth case and ureteroneocystostomy in the last two cases. Persistent lower urinary tract symptoms in women with IUD should raise the suspicion of intravesical migration. Noncontrast CT permitted excellent depiction of the site of migrated IUD for selection of proper management. Endoscopic retrieval is feasible and safe in cases with intravesical migrated IUD.

Surgical mesh used for an inguinal herniorrhaphy acting as a nidus for a bladder calculus

We describe an unusual case of surgical mesh used in laparoscopic inguinal herniorrhaphy acting as a nidus for a bladder calculus.

Intravesical migration of an intrauterine contraceptive device complicated by bladder stone: a report of six cases

Intrauterine contraceptive device is the most popular method of reversible contraception in developing countries due to its efficiency and low cost. However, this device is often inserted by paramedics of variable skills, and follow-up evaluations are irregular or absent which can be the source of major complications. The authors report six cases of intravesical migration of intrauterine contraceptive devices complicated by bladder stones. All the six cases were managed endoscopically with excellent outcome. The authors demonstrate that this major complication can be managed endoscopically with decreased morbidity for the patient.

[Stones and foreign bodies of the urethra]

Foreign bodies in the bladder and urethra have been already largely described either by their nature itself as well as by the circumstances of their introduction. If their presence often reveals dubious psychiatric behaviours, one must also evoke possible accidental introductions during transvesical surgery or migration from spaces adjacent to the bladder. The treatment of those foreign bodies can be sorted out through endoscopy or surgical approach.

Differential diagnosis of intra-uterine device migrating to bladder using radiographic image of calculus formation and review of literature

A 28-year-old woman in whom a copper-T 280-A intra-uterine device (IUD) had been placed 6 months previously, presented complaining of urinary system infection and lower abdominal pain. Intra-vesical migration of IUD was confirmed by radiography and cystoscopy. Since 1966, 17 other cases of calculus formation among 41 cases of intra-vesical migration have been reported.

Surgical instrument migration from the abdominal cavity through the bladder into the vagina: a rare long-term complication

A foreign body in the bladder is a well-recognized, although rare, cause of urinary tract infections. We describe a 15-year-old girl who presented with abdominal pain and recurrent urinary tract infections. On analysis, a forceps was found, with the two legs of the instrument separately perforating both the back wall of the bladder and the trigone, with the top of the forceps lying in the vagina, covered with a large calculus. The forceps must have been left behind during laparotomy for bowel invagination in her first year of life.

[Uterine perforation and vesical migration of intrauterine device]

Cases of uterine perforation through to the bladder during the placement of an intrauterine device are rare. There have been only 25 previous reported cases. This type of perforation is no different to any other by an intravesical foreign body. A detailed anamnesis and sonographic examination is usually sufficient to provide a diagnosis. Complications can be diagnosed by an uretrocytoscopy which is also therapeutic in non-complicated cases. If there are associated complications surgery can be necessary. In conclusion, quick detection of any complication, by sonographic detection after placement, assists in the extraction of the foreign body and avoids the appearance of associated complications such as lithiasis.

Bladder stones around a migrated and missed intrauterine contraceptive device

Bladder stones occasionally develop because of foreign bodies in the bladder. Bladder stones in a 30-year-old woman were found to have formed around an intrauterine contraceptive device that had gone missing many years previously and had migrated into the bladder. Plain abdominal radiograms should be a part of the evaluation in patients with a history of an unretrieved intrauterine contraceptive device.

Clinical management of foreign bodies of the genitourinary tract

PURPOSE

The variety of foreign bodies inserted into or externally attached to the genitourinary tract defies imagination and includes all types of objects. The frequency of such cases renders these objects an important addition to the diseases of the urinary organs.

MATERIALS AND METHODS

We performed a computerized MEDLINE search followed by a manual bibliographic review of cross-references. These reports were analyzed and the important findings summarized.

RESULTS

Our review encompassed approximately 800 single case reports on foreign bodies in the English world literature published between 1755 and 1999. We structured the range of introduced objects, by referring to origin and material as well as the genitourinary organs involved. Furthermore, we noted symptomatology and diagnoses, including psychological involvement, as well as possible treatment options.

CONCLUSIONS

The most common motive associated with foreign bodies of the genitourinary tract is sexual or erotic in nature. The most suitable method of removing a urethral foreign body depends on the size and mobility of the object applied to the genitourinary tract. When possible, endoscopic and minimal invasive techniques of removal should be used. However, surgical retrieval of a foreign body may be required, particularly when there is a severe associated inflammatory reaction.

The vesical calculus

Bladder calculi account for 5% of urinary calculi and usually occur because of foreign bodies, obstruction, or infection. Males with prostate disease or previous prostate surgery and women who undergo anti-incontinence surgery are at higher risk for developing bladder calculi. Patients with SCI with indwelling Foley catheters are at high risk for developing stones. There appears to be a significant association between bladder calculi and the formation of malignant bladder tumors in these patients. Transplant recipients are not at increased risk for developing vesical calculi in the absence of intravesical suture fragments and other foreign bodies. Patients who undergo bladder-augmentation procedures using a vascularized gastric patch appear to be protected from vesicolithiasis, perhaps by the acidic environment. Ileum and colon tissues, however, are colonized by urease-producing organisms, producing an alkaline pH that promotes stone formation. Children remain at high risk for bladder-stone development in endemic areas. Diet, voiding dysfunction, and uncorrected anatomic abnormalities, such as posterior urethral valves and vesicoureteral reflux, predispose them to bladder-calculus formation. Finally, there are a number of techniques and modalities available to remove bladder stones. Relieving obstruction, eliminating infection, meticulous surgical technique, and accurate diagnosis are essential in their treatment.

Partial perforation of bladder by multiload

A rare case of partial perforation of the wall of the bladder by an intrauterine contraceptive device (IUCD) in a puerperal woman and its subsequent laparoscopic removal is described. Cystoscopy revealed an intact bladder mucosa with the IUCD lying submucosally. This case demonstrates that an IUCD embedded in the wall of the bladder, whose mucosa is intact, can be safely removed through a laparoscope without resorting to laparotomy.