Chronic kidney disease after vesico-vaginal stone formation around a migrated intrauterine device

Ectopic intrauterine device in the bladder causing cystolithiasis: A case report

BACKGROUND

An intrauterine device (IUD) is a commonly used contraceptive among women in China. It is widely used because it is safe, effective, simple, economic, and reversible. Among the possible complications, an ectopic IUD in the bladder is rare. It occurs insidiously, has a long course, is associated with a high risk for injury, and is difficult to treat.

CASE SUMMARY

A 44-year-old woman was admitted for repeated episodes of urinary frequency, urgency, and dysuria over three months. Laboratory tests revealed significantly elevated urine leukocytes and bacteria. Urine culture suggested colonization with Enterococcus faecalis. Abdominal computed tomography images suggested an abnormally positioned IUD that was protruding into the bladder. Cystoscopy revealed a metallic foreign body with multiple stones on its surface in the left posterior bladder wall. The foreign body measured approximately 1 cm. Hysteroscopy revealed the arm of a V-type metal IUD embedded in the middle and upper sections of the anterior wall of the cervical canal. The majority of the IUD was located in the uterine cavity. Cystoscopy was performed, and a holmium laser was utilized to break the stones attached to the portion of the IUD in the bladder. The IUD was then removed through hysteroscopy.

CONCLUSION

Ectopic IUDs in the bladder can be diagnosed with thorough imaging and safely removed through cystoscopy or hysteroscopy.

Cystoscopic removal of a migrated intrauterine device to the bladder; a case report

Background

An intrauterine device (IUD) is a well-accepted means of reversible contraception. Migration of IUD to the bladder through partial or complete perforation has been rarely reported. This phenomenon could be strongly associated with history of prior cesarean sections (C-section) or early insertion of the device in the postpartum period.

Case presentation

In this study, a case of copper IUD migration through cesarean scar defect is presented, in such a way that was successfully managed by cystoscopic removal. A 31-year-old female with a history of lower urinary symptoms referred to the clinic for her secondary infertility work-up. A copper IUD outside the uterus in the bladder was found using hysterosalpingraphy. A plain abdominal radiography also confirmed the presence of a T-shaped IUD in the pelvis. According to ultrasound, the copper IUD was partly in the bladder lumen and within the bladder wall. The patient had a history of an intrauterine device insertion eight years ago followingher second cesarean delivery. Three years later, her IUD was expelled, and another copper IUD was inserted. Thesecond copper IUD was alsoremoved while she decided to be pregnant. The patient finally underwent a hysteroscopic cystoscopy. The intrauterine device with its short arms embedded in the bladder wall was successfully extracted through the urethra.

Conclusions

IUD insertion seems to be more challenging in women with prior uterine incisions and requires more attention. Cystoscopic removal should be considered as a safe and effective minimally invasive approach tomanage a migrated intrauterine device in the bladder.

A Case of Migrating "Saf-T-Coil" Presenting With a Vesicovaginal Fistula and Vesicovaginal Calculus

Intrauterine devices (IUDs) are reliable method for contraception. Although, they are generally regarded as safe, serious consequences may occur in case of uterine perforation or intravesical migration. We present a rare case of a 74 year old lady with a forgotten IUD for 42 years resulting in intravesical migration, formation of vesicovaginal fistula (VVF) without uterine perforation, complete urinary incontinence, recurrent urinary tract infections (UTIs) and a large vesicovaginal calculus.

Vaginal Stone in a Cynomolgus Macaque (Macaca fascicularis)

A 20-y-old female cynomolgus macaque (Macaca fascicularis) housed in an indoor primate facility presented for poor appetite and acute weakness after several years of no adverse health events. Physical examination revealed a firm, ovoid mass in the caudal abdomen. Further evaluation revealed the mass to be a vaginal calculus composed of calcium carbonate, apatite, and struvite. To our knowledge, this case is the first reported description of a vaginal stone in an NHP.

Lippes Loop Inserted 45 Years Back: The Dilemma to Remove It or Leave It in situ. A Case Report with Review of Literature

IUD's like Lippes Loop (LL), intended for long term use are retained for years and menopausal ladies often present with LL in situ either deliberately or forgotten. We report a case of Lippes Loop removal inserted 45 years back in a woman complaining of post menopausal bleeding. The inserted LL thread was incidentally discovered during clinical examination and Ultrasonography. We also reviewed literature to determine the evidence for and against removal of an inert IUD.