Description
A 90-year-old woman, with dementia, presented with fever and shaking chill. She was diagnosed as sepsis by urinary tract infection (UTI). She was admitted to the intensive care unit. Despite aggressive hydration care and antibiotics treatment, she finally died. Additional history revealed she had multiple UTI over 50 years.
An autopsy revealed that a round-shape, a metal plate with a diameter of 5 cm was completely immersed in the centre of the posterior wall of the urinary bladder with stone formation (figures 1 and 2). The plate turned out to be an intrauterine device which was inserted in 1951, 61 years back.
Figure 1.
An autopsy revealed an intrauterine device which was completely immersed in the centre of the posterior wall of the urinary bladder with stone formation.
Figure 2.
A round-shape metal plate with a diameter of 5 cms with stone formation.
Although perforation of the uterus by an intrauterine device is common, intravesical migration with secondary stone formation is an extremely rare complication.1 In this patient, the migration was suspected by CT scan, but she and her family declined any additional invasive investigation. The migrated device was detected by autopsy.
Learning points.
Intravesical migration of intrauterine devices can occur.
If a patient has a recurrent UTI, chronic obstruction of the urinary tract should be ruled out until proven otherwise.
Footnotes
Competing interests: None.
Patient consent: Obtained.
Provenance and peer review: Not commissioned; externally peer reviewed.
Reference
- 1.Tosun M, Celik H, Yavuz E, et al. Intravesical migration of an intrauterine device detected in a pregnant woman. Can Urol Assoc J 2010;4:E141–3 [DOI] [PMC free article] [PubMed] [Google Scholar]