Doctors at Jaber Al-Ahmad Hospital in Kuwait have reported a rare case of an intrauterine device (IUD) getting lost inside a woman. The 30-year-old patient sought gynecological care two months after having the IUD inserted, thinking that she might be pregnant.
Doctors were surprised not to find the IUD threads in the patient’s vagina or locate it on the transvaginal ultrasound exam – used to monitor whether the contraceptive method is positioned properly to prevent pregnancy. A CT scan and colonoscopy, taken afterwards, revealed that the device had moved and was located 11 centimeters deep in the woman’s rectum.
The story was published in International Journal of Surgery Case Reports. Doctors say the patient was at risk of suffering from peritonitis, an infection of the inner lining of the stomach, as the device was perforating the side of the rectum. Studies show that one in every thousand women have a perforated uterus after having an IUD inserted.
Drilling
They suspect that the provider who inserted the IUD may have perforated the patient’s uterine cavity. But an ultrasound taken shortly after insertion showed that it was in good position before the woman was sent home.
The other hypothesis is that the device has migrated from place eight weeks after being inserted due to an “imbalance” between the size of the IUD and the uterine cavity.
The patient, whose name has not been identified, had the IUD inserted one year after giving birth to her first child. She told doctors at Jaber Al-Ahmad Hospital that the insertion procedure was difficult, leaving her dizzy and sweaty.
The next five days were marked by pelvic discomfort that soon subsided. But, two months later, she sought care thinking she might be pregnant.
For the IUD to fulfill its contraceptive function, it is essential that it is correctly positioned. Otherwise, the woman runs the risk of becoming pregnant. The article does not confirm whether the Kuwaiti woman was pregnant or not.
The IUD was retrieved with the help of forceps and a small camera to guide them. The patient was discharged two days after the procedure. A follow-up visit the following month confirmed that she recovered well with no complications.
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