Publication:

When contraception goes astray: a case of trans-vesical migration of Copper-T intrauterine device

Intrauterine devices (IUDs) are among the most widely used reversible contraceptive methods worldwide and are generally considered safe and effective. However, rare complications such as uterine perforation and migration into adjacent organs may occur. We report a case of trans-vesical migration of a Copper-T IUD presenting as recurrent urinary tract infection (UTI) with vesical stone formation. A 34-year-old woman presented with recurrent episodes of dysuria, pelvic pain and gross haematuria. She had undergone Copper-T insertion five years earlier. Urinalysis demonstrated pyuria and microscopic haematuria, while urine culture grew Escherichia coli. Although symptoms improved with antibiotic therapy, persistent haematuria prompted further evaluation. Imaging studies revealed an extra-uterine Copper-T lodged within the urinary bladder with associated calcific encrustation. Cystoscopic examination confirmed an intravesical encrusted foreign body embedded in the posterior bladder wall. The patient underwent successful endoscopic cystolitholapaxy with complete removal of the migrated IUD and stone fragments. Postoperative recovery was uneventful and she remained symptom-free during follow-up. This case highlights the importance of considering migrated IUDs in women presenting with recurrent or refractory urinary symptoms, particularly when there is a history of prior IUD insertion. Early diagnosis using appropriate imaging modalities and timely surgical intervention are essential to prevent long-term complications such as recurrent infection, stone formation and bladder injury.