An Interesting Image of Transmural Migration of a Levonorgestrel-Releasing Intrauterine Device (LNg-IUD)

Abstract

Intrauterine devices (IUDs) are very common as a method of birth control. By adding progesterone (levonorgestrel), a decrease in the risk of complications has been documented, including the risk of perforation. Even though only a few complications have been described, adjacent organs may be involved in the case of migration—a life-threatening situation. A 45-year-old G4P2 woman was seen in our clinic for LNg-IUD removal, according to the medical instructions. Her main complaints were abdominal discomfort, low back pain, and recurrent menorrhagia. A “lost” IUD was initially suspected; the patient confirmed the detection and removal of the control strings, and a subsequent discussion related to delayed transmural migration of the IUD being followed. The ultrasonography revealed the migration of the IUD to the uterine cervix and size-decreased uterine fibroids, confirming the effectiveness of the LNg-IUD. The MRI and ultrasonography being useless, a subsequent X-ray and CT scan were requested, both confirming a myometrium-positioned IUD, adjacent to the serosa and lumbosacral plexus. Even though the IUD is considered a safe device with reversible effect, it can be associated with severe morbidity, with an ultrasound follow-up being required. For more precise detection of the IUD, we strongly recommend an X-ray or CT scan examination, followed by safe removal.

Cervical Cancer or Cervical Endometriosis – Review and Case Report

“…Cervical endometriosis is one of the rare types of endometrioses. In the literature, the prevalence is 0.7-2.4%, but no precise data are available for Romania [5,56,66,67].…”

Efficacy of Oral Medications or Intrauterine Device-Delivered Progestin in Patients with Endometrial Hyperplasia with or without Atypia: A Network Meta-Analysis

“…In addition, the LNG-IUS has the risk of displacement, embedment, and perforation. Patients with LNG-IUS require regular followup in hospital to examine the locations of intrauterine devices (IUD) by using ultrasound or other imaging examination methods, and for some patients with a large uterus cavity or irregular shape of uterine cavity, the LNG-IUS may easily migrate down to the cervical canal or even fall out of the body [16,17]. For women who are unwilling to use the LNG-IUS or who cannot tolerate its side effects, the best alternative oral medication is unclear.…”