Un trayecto inusual: migración transvesical de un dispositivo intrauterino. A propósito de un caso

Resumen

The intrauterine device (IUD) is a widely used long-acting reversible contraceptive (LARC) method due to its high effectiveness and low maintenance. The most common type is the copper IUD (Cu-IUD), although the levonorgestrel-releasing hormonal IUD is also available. Its complications include dysmenorrhea, menorrhagia, and pelvic infections; however, one of the most serious is uterine perforation, which can lead to device migration. This complication is rare and may be asymptomatic, but up to 24% of migrations involve the bladder, causing urinary symptoms and stone formation.We present the case of a 48-year-old woman with complete transvesical migration of a Cu-IUD many years after its insertion. The patient experienced chronic lower urinary tract symptoms (LUTS), characterized by urinary urgency, frequency, and incontinence, in addition to recurrent cystitis. The diagnosis was confirmed through tomography and ultrasound, which revealed a migrated and calcified IUD. A diagnostic and therapeutic cystoscopy was performed, achieving an effective and minimally invasive resolution.This case highlights the importance of suspecting bladder migration in patients with a history of IUD placement associated to LUTS mentioned above. Proper follow-up after IUD insertion is crucial to prevent major complications, especially in postpartum women, and early removal of ectopic devices is essential to reduce morbidity.