Rationale: Partial intrauterine device (IUD) migration into the abdominal cavity with bladder penetration and secondary calculus formation represents a rare complication. This case underscores the critical role of multimodal imaging and interdisciplinary collaboration. Patient concerns: A 30-year-old woman presented with refractory urinary symptoms and recurrent infections a decade after the insertion of a copper “Mother” IUD (a common type of copper IUD in China). Initial ultrasonography suggested intrauterine metallic echoes. Hysteroscopy retrieved metallic fragments but failed to locate the intact device, necessitating further investigation. Diagnoses: Abdominopelvic computed tomography revealed a migrated intrauterine device within the bladder with a 1.0 cm calculus, with 1 arm having eroded through the anterior bladder wall and a portion of the device located within the abdominal cavity. Interventions: A combined endoscopic approach was performed: cystoscopic extraction of the vesical segment of the migrated IUD arm along with its adherent calculus, followed by laparoscopic repair of the 5-mm bladder defect. Outcomes: The patient had an uneventful postoperative recovery with complete resolution of symptoms and no recurrence of infection or lower urinary tract symptoms at the 6-month follow-up. Lessons: In patients with suggestive symptoms, cross-sectional imaging should be considered early. Failed hysteroscopic retrieval definitively warrants computed tomography imaging to exclude complex ectopic migration. Multidisciplinary coordination is imperative for managing multicompartment migrations.
Liu et al. (Fri,) studied this question.