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.
Keywords: Copper-T; intrauterine contraceptive devices; migration; uterine perforation; vesical calculus.