A case of laparoscopic surgery for removal of an intrauterine device that migrated into the uterine myometrium

Abstract

　An intrauterine device (IUD) is a commonly used, reversible contraception. Reports of IUD-related complications have increased, and one of these is uterine perforation at IUD insertion with subsequent migration into the intraperitoneal cavity. This is a rare complication, occurring in approximately 0.2-3.6 per 1000 cases. We report a case of laparoscopic surgery for removal of an IUD that had migrated into the uterine myometrium. A 39-year-old nulliparous woman underwent IUD insertion to prevent intrauterine adhesions after laparoscopic myomectomy (LM). Three months after LM, the IUD could not be removed by pulling the IUD strings. CT and MRI revealed that the IUD had migrated into the uterine myometrium. We removed the IUD by laparoscopic surgery. Insertion of an IUD after myomectomy, especially under anesthesia, carries a risk of uterine perforation. Multiple cross-sectional images on CT and MRI are useful for diagnosing IUD migration into the uterine myometrium.