Vesicolithiasis Concealing a Migrated Intravesical Copper Intrauterine Device Successfully Treated by Cystolithotripsy and Endoscopic Removal: A Case Report
Abstract
Migration of a copper intrauterine device (Cu-IUD) into the urinary bladder is a rare and often delayed complication of long-term IUD use that may present with vesicolithiasis and recurrent urinary tract infection (UTI), while the migrated device may be concealed by stone formation, making diagnosis challenging. We report the case of a 34-year-old woman who presented with a four-month history of lower urinary tract symptoms (LUTS) and recurrent UTI, with a history of Cu-IUD insertion four years earlier without routine follow-up. Urologic ultrasonography revealed a hyperechoic bladder lesion suggestive of a bladder calculus. Cystoscopy followed by single-session cystolithotripsy revealed a T-shaped encrusted calculus concealing a migrated Cu-IUD. Cystolithotripsy was performed using a stone punch, followed by transurethral extraction of the underlying device, with a total operative duration of approximately 30 minutes. Inspection of the removed device confirmed a copper-containing T-shaped IUD, while stone analysis demonstrated a predominantly struvite, infection-related composition. At the two-week follow-up, the patient experienced complete symptom resolution, with no residual stone or foreign body identified on radiographic evaluation, indicating that intravesical Cu-IUD migration should be considered in women with recurrent UTI and vesicolithiasis, particularly in those with a history of IUD insertion without routine follow-up, and that single-session endoscopic cystolithotripsy with extraction of the migrated device is a safe, feasible, and minimally invasive treatment option with favorable clinical outcomes.
Keywords: Vesicolithiasis, Intrauterine Device Migration, Cystolithotripsy, Urinary Tract Infection, Case Report
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DOI: http://dx.doi.org/10.30829/contagion.v8i3.31198
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