Minimally invasive approach to remove a displaced intrauterine device with rectal perforation: A case report

Abstract:

The copper intrauterine device (IUD) is a widely available long-acting reversible contraceptive with a low failure rate and a lifespan of up to 10 years. A rare but serious complication is device displacement with perforation of adjacent pelvic organs. A chronic inflammatory reaction to the copper component is thought to contribute to the gradual erosion of the uterine wall, leading to expulsion, displacement, or perforation. Although no standard guideline exists, management of IUD-associated perforation typically involves abdominal surgery via laparotomy or laparoscopy. This report describes a novel minimally invasive technique for removing an IUD embedded in the rectum in a 27-year-old postpartum patient. The procedure involved culdotomy, transvaginal extraction of the short arm, trans anal retrieval of the long arm, followed by transvaginal layered repair of the rectal defect and closure of the culdotomy. This approach resulted in faster recovery and reduced morbidity.