Migration of a fractured ring IUD resulting in vesicovaginal fistula and vaginal calculus

Abstract

Case: Although many complications have been reported with intrauterine contraceptive devices (IUDs), vesicovaginal fistula with secondary vaginal stones is rare. We report the case of a 46-year-old woman who presented with a vaginal discharge lasting 2 months. Two years previously, she had undergone cystoscopic lithotripsy and surgery to remove an IUD, after pelvic radiography had revealed a fractured Chinese stainless steel ring IUD with secondary vesical stones that had been the cause of her urinary tract symptoms. When she again complained of vaginal discharge, vaginal stones and a vesicovaginal fistula were found on physical examination and CT urography. The patient underwent stone removal and concurrent vesicovaginal fistula repair. IUD fragments were found in the vesicovaginal and rectovaginal spaces. No abnormalities were found at follow-up 6 months after surgery.

Conclusion: In any woman undergoing surgery to remove a migrated IUD, complete exposure and removal of the IUD are necessary to avoid fracturing of the IUD, secondary breakage and residue.

摘要

病例：虽然有许多宫内节育器（IUDs）并发症的报道, 但是膀胱阴道瘘继发阴道结石是罕见的。我们报告的病例是一位46岁女性, 阴道分泌物持续2个月。两年前, 因患者行盆腔造影提示, 一个中国环形节育器断裂并伴有继发性膀胱结石导致出现尿路症状, 患者行膀胱镜碎石及IUD移除术。再次以阴道分泌物为主诉就诊, 查体及CT尿路造影发现阴道结石及膀胱阴道瘘。患者接受了结石取出和膀胱阴道瘘修补术。在膀胱阴道及直肠中未见节育器碎片。术后随访6个月, 未发现异常。

结果：在接受任何移除IUD的女性中, 完全暴露和取出节育器是必要的, 避免节育器破裂、继发性断裂和残留。

Keywords:

• Intrauterine device
• vaginal calculus
• vesical calculus
• vesicovaginal fistula

Disclosure statement

No potential conflict of interest was reported by the authors.