Intrauterine Device Translocation to the Ureter Resulting in Hydronephrosis: A Rare Case Report

Background: Intrauterine device (IUD) translocation is a rare but potentially serious complication that may cause injury of adjacent organs. This case report describes an unusual instance of delayed IUD translocation involving the ureter and highlights its diagnostic and management implications. Case: We report the case of a 57-year-old woman diagnosed with IUD displacement to the right ureter, which subsequently resulted in ureteral injury. Seventeen years after IUD insertion, the patient presented with lower abdominal pain that radiated to the right flank. During laparoscopic exploration, the IUD was partially embedded in the uterine horn and partially within the wall of the right ureter. The IUD was embedded in the ureteral muscular layer but had not penetrated the mucosal layer. The IUD was completely removed, and the abdominal and pelvic cavities were repeatedly irrigated, with purulent fluid suctioned. The uterine and right ureteral walls were repaired. Under guidewire guidance and direct ureteroscopic visualization, a ureteral stent was placed. Conclusions: IUD translocation to the ureter is a rare but serious complication that may occur many years after insertion. Early recognition and appropriate surgical management are essential to prevent severe urological injury.