Introduction and importance: An intrauterine device (IUD) perforating the uterus and migrating into the bladder to become a nidus for stone formation is an uncommon scenario with a considerable management challenge. Case presentation: A 28-year-old woman presented with lower urinary tract symptoms (LUTS) along with pelvic pain of 3 years’ duration after 7 years of IUD insertion. A computed tomography scan and cystoscopy confirmed the presence of an IUD with a large stone formation inside the bladder. The stone was successfully fragmented using a pneumatic lithotripter, and the IUD, along with the stone fragments, was extracted without complications using a nephroscope. Clinical discussion: IUD migration into adjacent structures is a rare entity, occurring in one to two cases per 1000 insertions. The urinary bladder represents the second most common site of IUD migration, following the intestine. Affected patients often present with non-specific LUTS and usually report treatment for recurrent urinary tract infections, which causes a diagnostic delay, ultimately leading to calculus formation. Conclusion: Endoscopic management of an intravesically migrated IUD associated with calculus formation is the preferred therapeutic approach, offering favorable outcomes with reduced morbidity compared to more invasive interventions.
Anteneh et al. (Wed,) studied this question.