Intrauterine Device Migration Into the Rectum: A Case Report

Intrauterine devices (IUDs) are an accepted and popular method of contraception for women looking for long-term pregnancy prevention. There are possible risks and complications, yet migration remains uncommon. Here, we report a case of IUD migration through the uterus into the cul-de-sac and the rectum. A 27-year-old female without any notable medical history had a history of a copper IUD insertion after she had delivered her second baby with the aim of contraception. Six months later, an unintended pregnancy occurred which was delivered successfully. After five years of insertion, she felt like a thread coming out of the anal opening upon defecation with on-and-off abdominal pain and constipation. During a pelvic examination, the IUD string was felt in the rectum. While imaging showed a retroverted uterus with an IUD seen in the left cul-de-sac space, the end of the IUD was seen directed and sited within the left lateral rectal lumen. The patient was referred under the care of the general surgery department electively for IUD removal as a case of anal fissure for lateral internal sphincterotomy. A suspected case of IUD migration should undergo gynecological analysis and radiological imaging. Finally, a prospective investigation and follow-up of the IUD after insertion are needed.