Authors :
Godwin Silas Macheku; Fidelis Clarence Jungulu; Ezekiel Kalibugwe Kiyogoma; Kheri Kagya; Salehe Mrutu; Michael Johnson Mahande
Volume/Issue :
Volume 10 - 2025, Issue 3 - March
Google Scholar :
https://tinyurl.com/2sjjdns3
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https://tinyurl.com/4e4dr9c7
DOI :
https://doi.org/10.38124/ijisrt/25mar660
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Abstract :
Copper T intrauterine devices (IUDs) rank among the prevalent contraceptive options in developing nations, yet
they carry risks of significant complications including hemorrhage, uterine perforation, and potential migration to nearby
organs or the omentum. Although perforation of the uterus by an IUD happens rarely, occurrences of its migration into the
retroperitoneal space are very seldom seen. Here, we report a case of Copper T intrauterine devices (IUDs) uterine
perforation and subsequent identification within the retro peritoneum.
Case Presentation:
A 26-year-old woman who had an IUD (Copper T) inserted for 2 years presented to our facility with transient
abdominal pain lasting for 2 months. The IUD was placed 6 weeks after her vaginal delivery. Previously, she had attended
a private hospital several times due to similar complaints, where she was treated with antibiotics and analgesics. However,
for the past two weeks, her symptoms did not improve anymore, and she went to a private clinic for IUD removal and sought
medical advice as well. A speculum examination was done, and no IUD strings were visible. A pelvic ultrasound was done,
and an IUD was not seen in the uterus. Then she was referred to our hospital for expertise review & management as well.
At our hospital, a plain abdominal-pelvic X-ray was done which showed a radio-opaque substance in the left lumbar region.
An explorative laparotomy was performed, and the IUCD was found within the retroperitoneum, overlying the ureter and
iliac vessels. After intact removal, the patient opted for a contraception with implants which was placed without
complications.
Conclusion:
In conclusion, migration of an intrauterine contraceptive device into the retroperitoneum represents a rare but
potentially serious complication. It can cause a range of symptoms and complications, requiring prompt diagnosis and
appropriate management. Prevention through proper insertion techniques and regular follow-up visits is crucial in
minimizing the risk of migration.
Keywords :
Retroperitoneal Migratory IUCD, diagnosis, explorative laparotomy
References :
- Buhling KJ, Zite NB, Lotke P, Black K. Worldwide use of intrauterine contraception: A review. Vol. 89, Contraception. Elsevier USA; 2014. p. 162–73.
- Harrison-Woolrych M, Ashton J, Coulter D. Uterine perforation on intrauterine device insertion: is the incidence higher than previously reported? 2003.
- Huh JM, Kim KS, Cho YS, Suh DK, Lee JU, Baek SD, et al. Colonoscopic removal of an intrauterine device that had perforated the rectosigmoid colon. Ann Coloproctol. 2018 Apr 1;34(2):106–8.
- Kaislasuo J, Suhonen S, Gissler M, Lähteenmäki P, Heikinheimo O. Uterine perforation caused by intrauterine devices: Clinical course and treatment. Human Reproduction. 2013;28(6):1546–51.
- Agha RA, Sohrabi C, Mathew G, Franchi T, Kerwan A, O’Neill N, et al. The PROCESS 2020 Guideline: Updating Consensus Preferred Reporting OfCasE Series in Surgery (PROCESS) Guidelines. International Journal of Surgery. 2020 Dec 1;84:231–5.
- Andersson K, Ryde-Blomqvist E, Lindell K, Odlind V, Milsom I. Perforations With Intrauterine Devices Report From a Swedish Survey. 1998.
- Mansour D, Inki P, Gemzell-Danielsson K. Efficacy of contraceptive methods: A review of the literature. The European Journal of Contraception & Reproductive Health Care. 2010 Dec;15(sup2): S19–31.
- Nde-Ouédraogo NA, Marie B, Tiemtore-Kambou A, Ouattara B, Diallo O, Cissé R. ASPECTS RADIOGRAPHIQUES ET ECHOGRAPHIQUES D’UNE MIGRATION TUBAIRE D’UN DISPOSITIF INTRA UTERIN [RADIOGRAPHIC AND ULTRASONOGRAPHICS ASPECTS OF AN INTRA UTERINE DEVICE TUBAL MIGRATION] [Internet]. Vol. 18, International Journal of Innovation and Applied Studies. 2016. Available from: http://www.ijias.issr-journals.org/
- Christensen AR, Narayanamoorthy S, Apostol R. Intrauterine Device Perforation and Adhesion. J Minim Invasive Gynecol. 2019;26(133):98–231.
- De Silva WSL, Kodithuwakku KASUA, Aponsu GUE, Rathnayake RMM, Rajasegaram E. A large bladder stone caused by the intravesical migration of an intrauterine contraceptive device: A case report. J Med Case Rep. 2017 Oct 22;11(1).
- Benaguida H, Kiram H, Telmoudi EC, Ouafidi B, Benhessou M, Ennachit M, et al. Intraperitoneal migration of an intrauterine device (IUD): A case report. Annals of Medicine and Surgery. 2021 Aug 1;68.
- Sara E. Edwards M, Jonah D. Fleisher MM, Lopa K. Pandya MM, Michelle L. Firlit M, Erica K. Hinz MM. Retroperitoneal Migration of an Intrauterine Device. Vol. 1, North American Proceedings in Gynecology& Obstetrics. Lippincott Williams and Wilkins; 2021. p. 32–4.
- Gill RS, Mok D, Hudson M, Shi X, Birch DW, Karmali S. Laparoscopic removal of an intra-abdominal intrauterine device: Case and systematic review. Vol. 85, Contraception. 2012. p. 15–8.
Copper T intrauterine devices (IUDs) rank among the prevalent contraceptive options in developing nations, yet
they carry risks of significant complications including hemorrhage, uterine perforation, and potential migration to nearby
organs or the omentum. Although perforation of the uterus by an IUD happens rarely, occurrences of its migration into the
retroperitoneal space are very seldom seen. Here, we report a case of Copper T intrauterine devices (IUDs) uterine
perforation and subsequent identification within the retro peritoneum.
Case Presentation:
A 26-year-old woman who had an IUD (Copper T) inserted for 2 years presented to our facility with transient
abdominal pain lasting for 2 months. The IUD was placed 6 weeks after her vaginal delivery. Previously, she had attended
a private hospital several times due to similar complaints, where she was treated with antibiotics and analgesics. However,
for the past two weeks, her symptoms did not improve anymore, and she went to a private clinic for IUD removal and sought
medical advice as well. A speculum examination was done, and no IUD strings were visible. A pelvic ultrasound was done,
and an IUD was not seen in the uterus. Then she was referred to our hospital for expertise review & management as well.
At our hospital, a plain abdominal-pelvic X-ray was done which showed a radio-opaque substance in the left lumbar region.
An explorative laparotomy was performed, and the IUCD was found within the retroperitoneum, overlying the ureter and
iliac vessels. After intact removal, the patient opted for a contraception with implants which was placed without
complications.
Conclusion:
In conclusion, migration of an intrauterine contraceptive device into the retroperitoneum represents a rare but
potentially serious complication. It can cause a range of symptoms and complications, requiring prompt diagnosis and
appropriate management. Prevention through proper insertion techniques and regular follow-up visits is crucial in
minimizing the risk of migration.
Keywords :
Retroperitoneal Migratory IUCD, diagnosis, explorative laparotomy