Migration of an intrauterine device to the posterior urethra with stone formation: a case report

Abstract

Migration of an intrauterine device (IUD) to the posterior urethra with stone formation has not been previously reported in the literature. A 42-year-old female patient presented to the gynecology clinic with a complaint of “discovered vaginal mass for 2 years, with growth for 5 days.” She was referred to urology on suspicion of IUD migration to the bladder. Physical examination revealed a hard mass palpable on the anterior vaginal wall. Laboratory tests showed normal blood counts, and urinalysis indicated a mild urinary tract infection. Ultrasound and pelvic X-ray indicated IUD migration to the bladder and bladder stones. Cystoscopy revealed that the IUD had migrated to the posterior urethra with stone formation. Holmium laser was used to fragment the stones encasing the IUD’s one arm, and the IUD was successfully removed with grasping forceps. The patient had a urinary catheter placed for 10 days and was followed up for 20 days. During the follow-up, there were no lower urinary tract symptoms (LUTS) or vaginal leakage. To our knowledge, we report the first case of an IUD migrating through the vesicovaginal space to the posterior urethra. Endoscopic removal of the IUD is feasible and safe. Urologists and gynecologists should not limit their diagnosis to IUD migration to the bladder but should also consider the possibility of urethral migration.