Persistent Haematuria and Chronic Pelvic Pain Due to a Way-Ward Intra-Uterine Contraceptive Device

Abstract

Background: The bladder is one of the organs that an intra-uterine contraceptive deice can migrate into because of its close proximity to the uterus. Its complication of bladder perforation is seldom diagnosed prior to intervention probably as a result of its rarity. Method: A case report of a Nigerian female who presented with persistent filling-phase lower urinary tract symptoms, haematuria and chronic pelvic pain as a result of migrated IUCD into the bladder. The device was inserted after uterine evacuation of retained products of conception following an incomplete spontaneous miscarriage with the consent of the husband. It was discovered at cystoscopy, retrieved and she was followed up. Result: The patient was a 29-year old woman who presented with a 2 year history of persistent haematuria, dysuria, and chronic pelvic pain despite several episodes of antibiotic treatment for suspected urinary tract infection. Intra-uterine contraceptive device was discovered in the urinary bladderat a diagnostic cystoscopy and was retrieved. Further history revealed that an IUCD was inserted without her knowledge by health personnel immediately after evacuation of the uterus of retained products of conception following an incomplete miscarriage. She recovered without complication within 2 weeks of its removal. Conclusion: This report highlights the need to discourage the insertion of IUCD by untrained health workers and to consider intra-vesical migration of IUCD in women of reproductive age with recurrent or persistent urinary tract symptoms recalcitrant to antibiotic treatment.