Successful removal of an intrauterine device perforating the uterus and the bladder with the aid of a transurethral nephroscope

Abstract

Aim

An IUD perforating the uterus and bladder and creating a nidus for stone formation is a rare complication. We aim to demonstrate with a video a novel surgical technique that involves transcervically extracting a perforating IUD with a transurethral nephroscope after removal of the bladder stone on the IUD.

Methods

A 57-year-old woman was referred to our department 4 months ago following a 2-year history of suprapubic pain at the end of urination. Ultrasound and X-ray examination confirmed an IUD perforating the uterus and the bladder. The patient underwent transurethral holmium laser lithotripsy and transcervical removal of the IUD with the aid of a transurethral nephroscope.

Results

The stone on the perforating ectopic IUD was successfully removed and the IUD was extracted without complications.

Conclusion

This video demonstrates a rare case of an IUD that perforated both the bladder and the uterine walls and created a nidus for stone formation in the bladder. The surgical technique involved in removing the stone and extracting the IUD is a new approach to treating this problem. It is suspected that this specific surgical intervention may also help to minimize the formation of a larger vesico-uterine fistula by decreasing the extent of trauma potentially created when extracting the IUD. However, this supposition merits further study.

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References

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Correspondence to Quanxin Qu.

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Written informed consent was obtained from the patient for publication of this video article and any accompanying images.

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Niu, H., Zhang, L., Yao, S. et al. Successful removal of an intrauterine device perforating the uterus and the bladder with the aid of a transurethral nephroscope. Int Urogynecol J 30, 325–326 (2019). https://doi.org/10.1007/s00192-018-3746-8

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Keywords

  • IUD
  • Perforation
  • Bladder
  • Transurethral nephroscope