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A rendezvous technique using laparoscopy and cystoscopy to remove transmigrated intrauterine contraceptive device from abdomen and urinary bladder

1 Department of Surgery, Apollo Hospitals, Guwahati, Assam, India
2 Department of Obstetrics and Gynecology, Apollo Hospitals, Guwahati, Assam, India
3 Department of Surgery, Haflong Civil Hospital, Haflong, Assam, India
4 Department of Anaesthesiology, Haflong Civil Hospital, Assam, India

Correspondence Address:
Elbert Khiangte,
Niribili Complex, House No.-6, Borsojai, Bhetapara, Assam, Guwahati-28
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jmas.jmas_216_21

Intrauterine contraceptive devices (IUCDs) are the most commonly used reversible contraceptive methods. Uterine perforation followed by transmigration is a rare but potentially life-threatening complication associated with the use of IUCDs. Perforation of the bladder by an IUCD is extremely rare. We present the case of a 36-year-old woman with a 3-year history of IUCD placement presenting with symptoms of lower urinary tract infection. X-ray of the pelvis and hysteroscopy revealed an inverted T-shaped metallic shadow resembling an IUCD in the pelvis and an empty uterine cavity, respectively. Using a cystoscope, the IUCD was visualized embedded in the urinary bladder and its retrieval was attempted unsuccessfully with the cystoscope. Hence a rendezvous technique, in which laparoscopy, assisted with cystoscopy was performed. The vertical limb and half of the horizontal limb of the copper-T were retrieved from the outer wall of the urinary bladder laparoscopically, and the intravesical part of the horizontal limb along with the calculus was retrieved per urethra.

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2004 Journal of Minimal Access Surgery
Published by Wolters Kluwer - Medknow
Online since 15th August '04