Weird! The IUD "ran away", and the ultrasound technician repeatedly tracked it down...

Ms. Li (pseudonym), 35 years old, has suffered from lower abdominal pain and painful and bloody urination for the past year.

She went to the local hospital for examination, and both ultrasound and pelvic CT scans showed that the IUD was displaced.

However, the IUD was removed several times without success.

This puzzled the doctors. During the examination, the IUD was found to be displaced, and the IUD was clearly visible during the follow-up CT scan. However, neither the ultrasound nor the hysteroscopy examinations found any trace of the IUD. Where did the IUD go?

Ms. Li, who already has a child, did not consider having another child and chose to have an IUD inserted. Ten years later, there was no abnormality and no relevant examinations, but she recently developed lower abdominal pain.

Finding the "Escaped" IUD

After many twists and turns, Ms. Li came to the gynecology clinic of the Daqiaoshi branch of Xi'an People's Hospital (Xi'an Fourth Hospital), where the gynecologist recommended further examination.

When Dr. Wang Lina from the Ultrasound Medical Center performed an ultrasound examination on her YD, no echo of the IUD was found in the uterine cavity (as shown in the left picture below), but echoes of stones were seen in the bladder cavity (as shown in the right picture below). Dr. Wang asked her superior, Deputy Director Zhang Hui, for advice with questions.

(The picture above shows that no IUD echo was seen in the uterine cavity during vaginal ultrasound examination, and the picture below shows that the echo of stones was visible in the bladder cavity)

Deputy Director Zhang Hui conducted an analysis and believed, based on the CT features, that it was an Aimu-type contraceptive device. This contraceptive device has a special structure, and only the metal sites less than 1CM at the head ends of both arms can be displayed by ultrasound.

(Internet photo: The general shape of the "IUD")

The two doctors performed multiple vaginal and abdominal examinations and found that there was a thin arc-shaped strong echo about 1 cm long in the left posterior wall of Ms. Li's bladder, which was adjacent to the bladder stone, with a faint comet tail sign.

With their rich experience, they considered that this was a metal structure, but then a question arose: This is one end of the IUD, where is the other end?

Accurate positioning and successful removal

After Deputy Director Zhang Hui advised Ms. Li to drink more water and fill her bladder, she conducted repeated transabdominal and transvaginal ultrasound examinations and finally found the other end of the IUD in the serosa of the left uterine corner.

(The red position in the picture is the left uterine horn)

The truth was revealed and the exact location of the IUD was finally found.

Ultrasound diagnosis showed that the IUD had penetrated the uterus into the pelvic cavity and the posterior wall of the bladder, resulting in secondary bladder stones.

It turned out that the IUD had shifted and penetrated the uterus. A small part of the tiny metal wire was in the pelvic cavity, and most of it had pierced into the bladder, causing local damage. Over time, it induced the deposition of urinary crystal substances on its surface, forming stones.

After the ultrasound examination provided accurate positioning, Director Wang Fengyan of the Minimally Invasive Gynecology Center and Associate Chief Physician Duan Zhongqi of the Urology Department performed a joint operation, carefully dissecting and successfully removing the "escaped" IUD for Ms. Li.

(Removed IUD)

The postoperative diagnosis of IUD displacement into the bladder and bladder stones (as shown in the red box in the figure below) was completely consistent with the preoperative ultrasound diagnosis results.

Doctors remind us that once an IUD is placed, it is not a permanent solution.

What should you pay attention to after the IUD is placed?

The IUD is a contraceptive device placed in the uterine cavity. It is safe, effective, simple, economical, and reversible, with a contraceptive effectiveness rate of more than 90%. However, cases of IUD dislocation and displacement have occurred from time to time in clinical practice. In severe cases, it can cause intestinal perforation and other diseases. This patient had uterine and bladder perforations caused by IUD displacement, and stones formed at the site of bladder perforation.

The service life of an intrauterine device varies depending on its type. For example, plastic ones with copper are generally 5 to 10 years; stainless steel single metal rings can be used for more than 10 years, and up to 20 years.

Therefore, female friends who wear IUDs must undergo regular ultrasound examinations to detect the displacement of the IUD and remove it in time to avoid serious complications.

Disclaimer: Some of the pictures in this article are from the Internet. If there is any infringement, please contact us to delete them.