节育器膀胱内异位伴结石形成1例报道

A case report of vesical calculus caused by an ectopic intrauterine device

目的探讨宫内节育器(IUD)异位发生的原因、诊断方法及防范措施,并通过查阅文献总结部分不同情况下异常IUD的取器方式,为减少临床IUD异位及取器并发症提供参考资料。方法对本院1例经宫腔镜、膀胱镜、大力碎石术成功取出节育器膀胱内异位并结石形成病例进行详细分析,并查阅相关文献学习总结。结果 IUD膀胱内异位并结石形成是放置宫内节育器的罕见并发症,一旦发生不仅可致避孕失败,而且增加取器困难及取器过程中子宫穿孔、大出血、周围脏器损伤等并发症的发生。结论采用微创的宫腔镜联合膀胱镜下碎石及取器方案,可减少IUD膀胱内异位并结石形成患者手术的并发症,并可提高取器安全性及成功率。

Objective To investigate the reason, diagnosis and preventive measures of the ectopic intrauterine device（IUD） and summarize the treatment methods of it under different circumstances, in order to provide reference for the decrease of ectopic intrauterine device and complications of dislodgment of abnormal IUD. Methods The study reported and analyzed retrospectively a case of vesical calculus induced by an ectopic intrauterine device which was taken out by the hysteroscopy, cystoscopy and lithotripsy successfully, and then reviewed the referring to related literatures. Results The ectopic IUD of the bladder came with vesical calculus is a rare complication of IUD, which will not only cause the contraceptive failure, but also increase the difficulty of removing the IUD and the occurrence of complications such as uterine perforation, massive bleeding and peripheral organ injury during the process of taking out the device. Conclusion The dislodgment of abnormal IUD and calculus by hysteroscopy combined with cystoscopy lithotripsy, which is safe, effective, but minimally invasive and small damaged,could reduce the operative complications and improve the safety and success rate.