(675) Intravesical IUD Migration: A Systematic Review of a Treatable Cause of Female Sexual Dysfunction

Abstract Introduction Female sexual dysfunction, particularly chronic pelvic pain and dyspareunia, presents a significant diagnostic challenge. While common etiologies are well-understood, rare organic causes are often missed, leading to prolonged patient suffering. Intravesical migration of an Intrauterine Device (IUD) is a severe complication that establishes a nidus for chronic inflammation and calculus formation, directly precipitating symptoms that impair sexual health. Objective To systematically define the clinical, diagnostic, and management landscape of intravesical IUD migration, and to quantify the burden of symptoms that contribute to associated sexual morbidity. Methods We conducted a systematic review of the literature, searching major databases for all published cases of intravesical IUD migration. Data on patient demographics, clinical presentation, and management were extracted and synthesized. For data with high variance, such as symptom duration, the median and range were prioritized as the most accurate measures of central tendency to ensure robust analysis. Results The final analysis included 329 unique cases. The mean patient age was 37.8 (±10.1) years. A critical finding was the significant delay in diagnosis; while the mean symptom duration was 34.4 months, the data was widely dispersed (SD: 41.5), with a median duration of 24 months (range: 1 to 240 months). Symptoms directly impacting sexual function were highly prevalent, including chronic pelvic pain (40.4%) and recurrent UTIs (35.6%). The most common clinical presentation was irritative LUTS (69.6%). A key diagnostic finding was absent IUD strings in 94.2% of patients. A major complication was bladder stone formation, occurring in 63.8% of cases. The condition was highly treatable, with endoscopic removal being successful in 90.3% of patients. Conclusions Intravesical IUD migration is a significant and treatable organic cause of chronic pain and recurrent infections that directly underpin female sexual dysfunction. The extensive delay in diagnosis highlights a critical awareness gap. Clinicians in sexual medicine should maintain a high index of suspicion for this condition in patients presenting with chronic pelvic pain, deep dyspareunia, and a history of a "lost" IUD, as a definitive, minimally invasive cure is available. Disclosure No