UROLOGICAL COMPLICATIONS OF INTRAUTERINE CONTRACEPTIVE DEVICE

Abstract

Objective: To elucidate the urological complications of Intrauterine contraceptive device (IUCD).

This study was conducted in Fauji Foundation Hospital Rawalpindi to elucidate

Material and Methods: the urological complications of IUCD presenting to Urology department from January 2002 to December 2006. During this period 12 ladies having IUCDs presented with lower urinary tract symptoms (LUTS).

After thorough work up, 6 patients were managed surgically and the remaining 6 were managed

conservatively.

Results: In all cases the IUCDs were inserted by paramedics. Out of six cases managed surgically, 3

patients had developed complete intravesical migration of device with stone formation. While in two other

patients there was partial migration of the IUCD and stone formation over the migrated component of the

device. One patient had simultaneously two IUCDs, one in uterus and another in bladder. We successfully

performed cystolitholapaxy and retrieved four IUCDs in these patients endoscopically. A large vesical

stone and the entombed IUCD in one of our patients was also removed endoscopically. The patient who

presented with two IUCDs also got the vesical IUCD removed endoscopically. In remaining six cases, the

IUCDs were in proper location and the cause of LUTS in these patients was urinary tract infection. These

patients were successfully managed conservatively.

Conclusion: Insertion of IUCD necessitates regular follow-up to confirm its correct position. Migration

of an IUCD warrants prompt removal, even in asymptomatic patients. Cases presenting with UTI with

undisplaced IUCD should be managed with appropriate antimicrobial therapy.