Retroperitoneal Displacement of an Intrauterine Device (IUD): A Case Report

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.