Intrauterine Device Migration to the Bladder Discovered Intraoperatively [ID 1740]

INTRODUCTION: Intrauterine devices (IUDs) have been used widely for a long time for their effectiveness, few costs, and longevity. Complications are likely to arise from insertion or later from migration to intestine, omentum, bladder, or colon. We present this case in which an IUD was missing for 15 years, only to be discovered during an uncomplicated cesarean birth. RESULTS: A 40-year-old woman, gravida 6, para 5, full term, and with gestational diabetes came to our hospital for normal delivery. She had a history of missing an IUD 15 years ago, although she was told it was expelled. She was admitted for induction of labor, which later failed, so an emergency cesarean birth was done. After closure of lower uterine segment, threads were found emerging from the bladder, suggesting an IUD embedded in bladder dome with the horizontal arms under the peritoneum while the vertical stem surrounded by stone formation was inside the bladder. Cystotomy was done at the bladder dome over the loop and the IUD was extracted. CONCLUSIONS/IMPLICATIONS: Intrauterine devices are the most widely used contraceptives with rare complications of failure. However, incidences of perforations are noted whether symptomatic or asymptomatic. Usually, they are diagnosed by routine follow-ups or by unusual symptoms suggesting the site affected. Missed IUDs in pregnancy may cause miscarriage and preterm labor. Accidental discovery of missed devices can alter surgical decisions or outcomes, which in turn affect postoperative complications and hospital stay. Although this case was uncomplicated, more documentation would outline the possible challenges and further interventions.