2022, Number 1
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Acta Med 2022; 20 (1)
Asymptomatic perforation by IUD
González MJJ, Cázares RTK, Nájera RIA, Cerda ÁJC
Language: Spanish
References: 10
Page: 88-90
PDF size: 154.71 Kb.
ABSTRACT
Uterine perforation by intrauterine device (IUD) insertion is a rare and potentially severe complication. It is asymptomatic in up to 56% of cases, being laparoscopic surgery the treatment of choice. A 33-year-old woman with a history of levonorgestrel-releasing IUD placement four years earlier, presented nonspecific pelvic symptoms with partial improvement after medical treatment. Ultrasonography for IUD tracking was performed without success; abdomen radiography was requested showing its extrauterine location. Laparoscopy was performed for extraction, founding IUD attached to the omentum, without complications. The most common uterine perforation mechanism occurs during IUD insertion, however, partial perforation could predispose total perforation by uterine contractions. The importance of regular radiographic follow-up after the placement of an IUD is highlighted in this case report.
REFERENCES
Tong JY, Sun WC, Li J, Jin M, Shen XZ, Zhang ZF. Uterine perforation in an adolescent using an intrauterine device with memory function: a case report and review of the published work. J Obstet Gynaecol Res. 2015; 41 (4): 646-649. doi: 10.1111/jog.12591.
Rowlands S, Oloto E, Horwell DH. Intrauterine devices and risk of uterine perforation: current perspectives. Open Access J Contracept. 2016 Mar; 7: 19-32. doi: 10.2147/OAJC.S85546.
Heinemann K, Reed S, Moehner S, Minh TD. Risk of uterine perforation with levonorgestrel-releasing and copper intrauterine devices in the European Active Surveillance Study on Intrauterine Devices. Contraception. 2015; 91 (4): 274-279. doi: 10.1016/j.contraception.2015.01.007.
Boyon C, Giraudet G, Guérin Du Masgenet B, Lucot JP, Goeusse P et al. Diagnosis and management of uterine perforations after intrauterine device insertion: a report of 11 cases. Gynecol Obstet Fertil. 2013; 41 (5): 314-321. doi: 10.1016/j.gyobfe.2012.05.006.
Kho KA, Chamsy DJ. Perforated intraperitoneal intrauterine contraceptive devices: diagnosis, management, and clinical outcomes. J Minim Invasive Gynecol. 2014; 21 (4): 596-601. doi: 10.1016/j.jmig.2013.12.123.
Niu H, Zhang L, Yao S, Qu Q. Successful removal of an intrauterine device perforating the uterus and the bladder with the aid of a transurethral nephroscope. Int Urogynecol J. 2019; 30 (2): 325-326. doi: 10.1007/s00192-018-3746-8.
Norman WV, Stothart D. IUD string perforation through anterior cervix: a case report. J Obstet Gynaecol Can. 2015; 37 (4): 345-348. doi: 10.1016/S1701-2163(15)30285-1.
Gunbey HP, Sayit AT, Idilman IS, Aksoy O. Migration of intrauterine devices with radiological findings: report on two cases. BMJ Case Rep. 2014; 2014: bcr2013202522. doi: 10.1136/bcr-2013-202522.
Kaislasuo J, Suhonen S, Gissler M, Lahteenmaki P, Heikinheimo O. Uterine perforation caused by intrauterine devices: clinical course and treatment. Hum Reprod. 2013; 28 (6): 1546-1551. doi: 10.1093/humrep/det074.
Aydogdu O, Pulat H. Asymptomatic far-migration of an intrauterine device into the abdominal cavity: a rare entity. Can Urol Assoc J. 2012; 6 (3): E134-E136. doi: 10.5489/cuaj.11100.