Laparoscopic management of an intramurally migrated intrauterine contraceptive device (IUCD) without serosal perforation: a case report
Mekyus E. Sanga, Daisy A. Mhando, Justin N. Ilunga, Daniel Michael, Peter MajingeIntroduction and importance:
An intrauterine contraceptive device (IUCD) is a highly effective, long-term, and safe contraceptive method. However, serious complications, such as uterine perforation, can occur, particularly in high-risk women, thereby necessitating close follow-up.
Case presentation:
A 35-year-old woman, para 3 + 3, with 3 living children, all delivered by cesarean section, presented with persistent lower abdominal pain and vaginal bleeding 5 months postdelivery and IUCD insertion. The IUCD string was not visualized on either clinical examination or hysteroscopy. Ultrasonography suggested a migrated IUCD. Laparoscopy revealed an intramurally migrated IUCD, which was successfully removed, and she recovered well.
Clinical discussion:
Postpartum insertion of an IUCD increases the risk of displacement. When the IUCD string is not visualized, thorough evaluation is recommended for early diagnosis and management of this potentially serious complication.
Conclusion:
Routine follow-up after IUCD insertion is crucial, especially for high-risk women, to detect and manage migration early, with laparoscopy as the preferred treatment when feasible. However, laparotomy is still an optimal option in more complex cases.