Urologically silent intravesical migration of a copper intrauterine device presenting as chronic pelvic pain: CT features and comparison with reported cases.
- 1Department of Gynecology and Obstetrics, Kasserine Maternity Center, Université Of Sousse, Kasserine, Tunisia.
Abstract
Uterine perforation with migration of an intrauterine device (IUD) into the urinary bladder is a well-documented complication that usually presents with lower urinary tract symptoms, recurrent urinary tract infection, hematuria, or a secondary bladder calculus. We report a 35-year-old woman (G2P2) with a copper IUD inserted 5 years earlier who presented with progressive chronic pelvic pain and no urinary symptoms. Pelvic ultrasound showed an abnormally positioned device, and contrast-enhanced computed tomography (CT) demonstrated a T-shaped device of metallic density traversing the anterior uterine wall, with one arm protruding into the bladder dome and coated by a small encrustation. The fixed, non-dependent position of the linear metallic core, its continuity with the myometrium, and its T-shaped morphology distinguished the device from a primary bladder calculus. Cystoscopy confirmed partial intravesical protrusion of the encrusted arm, which was extracted intact with forceps without complication, and the patient was asymptomatic at follow-up. Compared with published intravesical cases, in which urinary complaints or a bladder stone usually prompt investigation, this case shows that bladder involvement may remain silent from a urinary perspective. In IUD users with unexplained pelvic pain, imaging should specifically assess the bladder, and a delayed excretory CT phase is advisable to evaluate bladder-wall integrity before removal.
Related
- Comparison of CT-based migration analysis against radiostereometric analysis for assessing two-year migration in an uncemented medial pivot tibial knee implant : clinical implications from a prospective safety study
- An interpretable LASSO-Boruta nomogram for non-muscle-invasive bladder cancer recurrence after intravesical instillation
- Enhancing intravesical bladder cancer therapy: from mucoadhesive to targeted drug delivery strategies
- Tuberculous discitis following traumatic intravesical Bacillus Calmette-Guérin treatment: illustrative case
- Urinary Extracellular Vesicle–Associated EphA2 Predicts Intravesical Recurrence in Bladder Cancer
BibTeX
@article{hafsi2026urologically,
title = {{Urologically silent intravesical migration of a copper intrauterine device presenting as chronic pelvic pain: CT features and comparison with reported cases.}},
author = {Montacer Hafsi and Asma Zouaghi and Oumayma Yaich and Azer Hafsi and Safa Azzouzi and Nejmeddine Jellali},
journal = {Radiology case reports},
year = {2026},
month = oct,
doi = {10.1016/j.radcr.2026.09.084},
url = {https://europepmc.org/article/MED/42921231},
note = {CC BY},
}
RIS
TY - JOUR
TI - Urologically silent intravesical migration of a copper intrauterine device presenting as chronic pelvic pain: CT features and comparison with reported cases.
AU - Montacer Hafsi
AU - Asma Zouaghi
AU - Oumayma Yaich
AU - Azer Hafsi
AU - Safa Azzouzi
AU - Nejmeddine Jellali
PY - 2026
DA - 2026/10/19
JO - Radiology case reports
DO - 10.1016/j.radcr.2026.09.084
UR - https://europepmc.org/article/MED/42921231
AB - Uterine perforation with migration of an intrauterine device (IUD) into the urinary bladder is a well-documented complication that usually presents with lower urinary tract symptoms, recurrent urinary tract infection, hematuria, or a secondary bladder calculus. We report a 35-year-old woman (G2P2) with a copper IUD inserted 5 years earlier who presented with progressive chronic pelvic pain and no urinary symptoms. Pelvic ultrasound showed an abnormally positioned device, and contrast-enhanced computed tomography (CT) demonstrated a T-shaped device of metallic density traversing the anterior uterine wall, with one arm protruding into the bladder dome and coated by a small encrustation. The fixed, non-dependent position of the linear metallic core, its continuity with the myometrium, and its T-shaped morphology distinguished the device from a primary bladder calculus. Cystoscopy confirmed partial intravesical protrusion of the encrusted arm, which was extracted intact with forceps without complication, and the patient was asymptomatic at follow-up. Compared with published intravesical cases, in which urinary complaints or a bladder stone usually prompt investigation, this case shows that bladder involvement may remain silent from a urinary perspective. In IUD users with unexplained pelvic pain, imaging should specifically assess the bladder, and a delayed excretory CT phase is advisable to evaluate bladder-wall integrity before removal.
SN - 1930-0433
ER -