UROLOGICAL COMPLICATIONS OF INTRAUTERINE CONTRACEPTIVE DEVICE

Objective: To elucidate the urological complications of Intrauterine contraceptive device (IUCD).Material and Methods: This study was conducted in Fauji Foundation Hospital Rawalpindi to elucidate the urological complications of IUCD presenting to Urology department from January2002 to December 2006. During this period 12 ladies having IUCDs presented with lower urinary tract symptoms (LUTS). After thorough work up, 6 patients were managed surgically and the remaining 6 were managed conservatively. Results: In all cases the IUCDs were inserted by paramedics. Out ofsix cases managed surgically, 3 patients had developed complete intravesical migration ofdevice with stone formation While in two other patients there was partial migration ofthe IUCD and stone formation over the migrated component ofthe device. One patient had simultaneously two IUCDs, one in uterus and another in bladder. Wt successfully performed cystolitholapaxy and retrieved four IUCDs in these patients endoscopically. A large vesical stone and the entombed IUCD in one ofour patients was also removed endoscopically. The patient who presented with two IUCDs also got the vesical IUCD removed endoscopically. In remaining six cases, the IUCDs were in proper location and the cause of LUTS in these patients was urinary tract infection These patients were successfully managed conservatively.Conclusion: Insertion ofIUCD necessitates regular follow-up to confirm its correct position Migration ofan IUCD warrants prompt removal, even in asymptomatic patients. Cases presenting with UTI with undisplaced IUCD should be managed with appropriate antimicrobial therapy.