Forgotten Intrauterine Device (Copper T) Forming Vesical Calculus

Abstract

Background: An intrauterine device (IUD) is a well-accepted means of reversible contraception. Complete migration of IUD to the bladder through partial or complete perforation though rarely reported, results in lower urinary tract symptoms and stone formation around the migrated IUD. This phenomenon could be strongly associated with history of prior caesarean sections (C-section) or early insertion of the device in the postpartum period.

Case presentation: A 50-year-old female presented with a history of lower urinary symptoms and haematuria. X ray KUB showed  a straight foreign body in the bladder with stone formation. According to ultrasound, the copper IUD was partly in the bladder lumen and within the bladder wall. Cystoscopy showed a bladder stone formation around the IUD anchored to the anterior bladder wall. Patient gave history of medical termination of pregnancy (MTP) 20 years back and she denied the insertion of intrauterine contraceptive device. She had cystolithotomy and retrieval of oblong shaped stone measuring about 4cm and intact IUD (Copper T) after failed endoscopic procedure.

Conclusions: Vesical calculi are uncommon in adult women and their presence should raise the suspicion of the presence of a foreign body. This case highlights the importance of properly informing the patient regarding IUD at the time its insertion. This will reduce the incidence of missing IUD.