CASE 626: T-SHAPE IUD PENETRATING UTERUS TO URINARY BLADDER, Dr PHAN THANH HẢI, LÊ THỐNG NHẤT, JASMINE THANH XUÂN, VÕ NGUYỄN THÀNH NHÂN, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

 Female patient 46 yo  with trouble of urine discharge for 1 month.

She wore her IUD for 8 years but could not find  it out 4 years before in giving up this contraception measure.

Transabdominal ultrasound and TVS revealed a metallic foreign body in her bladder with strong color comet tail artifact.

And later MSCT confirmed the T- shape IUD which penetrated to urinary bladder and was coated outside surface of it in formation of stone.

Endoscopic surgery successfully performed on March 15 to remove the stone made T- shape IUD in TD hospital.

Through anterior face of uterus, the  body and one branch of T-shape IUD migrated inside the urinary bladder that a part of it was covered by stone.  Another branch of the IUD has been in the muscular layer of the urinary bladder that  adhered the urinary bladder wall to the uterus.

Endoscopy in surgery showed stone in urinary bladder. 

 

Specimen of  the T-shape IUD with stone covered on part, and another broken branch was in uterine muscle that adhered urinary bladder.

CONCLUSIONS:

Migration of T-shape IUD has highly risk of penetration the  hollow organes like rectum, urinary bladder. Ultrasound may help to detect the ectopic T-shape IUD but it needs obviously using other diagnostic imaging modalities,  endoscopic tools to confirm the status and location of it for appropriate management to the patient. 

REFERENCE

CASE 514 VUD