Application of a hormonal intrauterine device causing uterine perforation: A case report

Author:

Berisavac Milica1,Sparic Radmila1,Argirovic Rajka1,Hudelist Gernot2,Zizic Vojislav1

Affiliation:

1. Klinika za ginekologiju i akušerstvo, Klinički centar Srbije, Beograd

2. Klinika za endometriozu i pelvični bol, Bolnica „Vilhelminen”, Beč, Austrija

Abstract

Introduction. The last decade of the usage of intrauterine contraception has been marked by the application of levonorgestrel-releasing hormonal devices. A hormonal intrauterine device (IUD) releases a certain amount of progestogen, whose effect on endometrium is such that, apart from preventing unwanted pregnancy, also regulates the menstrual bleeding by reducing the quantity and the duration of haemorrhage. This effect of hormonal IUDs has led to their additional indications and use, so that nowadays these IUDs are used not only as contraceptives but for therapeutic purposes as well. Case Outline. After examination and treatment in an out-patient department, a 38-year-old woman was referred to our hospital due to suspected spontaneous uterine perforation caused by hormonal IUD (Mirena?) one month after its application. Clinical and sonographic examinations were unable to determine the uterine perforation or the exact IUD location. Radiographic examination confirmed the presence of the IUD in the abdomen, so it was decided to operate on the patient. Perforation in the isthmus of the uterus and to the right was identified intraoperatively. By exploration of the genital organs and the abdominal cavity, the IUD was finally located in the omentum. Conclusion. Even in cases of adequate indications for hormonal IUD application, the doctor?s experience and complying with all the principles of appropriate insertion, we should always consider the possibility of the occurrence of serious complications, which sometimes may even require surgery. The extragenital position of IUD, as in this case, may create serious difficulties in the detection of location. A possible development of asymptomatic complications additionally emphasizes the necessity of regular check-ups of all IUD users.

Publisher

National Library of Serbia

Subject

General Medicine

Cited by 2 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Asymptomatic isthmico-cervical uterine perforation with IUD – our experience and literature review;Clinical and Experimental Obstetrics & Gynecology;2016-12-10

2. Pathology of the Uterine Cavity;CT Virtual Hysterosalpingography;2014

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