Jahra hospital First case Talal Alanzi Yr 3 30-1-2014.

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Presentation transcript:

Jahra hospital First case Talal Alanzi Yr

38 Yr. Female. Presented to OPD with 1 year history of dysuria and B/L loin pain.

Frequency Urgency Straining No constitutional symptoms. No urethral or vaginal discharge. No incontinence. Not stone passer nor former.

P.M.H: Nil. P.S.H: Nil. No drug allergy. Housemaid. P. OBS & GYN: delivered twice IUCD 2004 Delivered 2005

Vital Sign T 37 - P 80 - BP 110/70. On exam: Abd: soft,lax, non tender. Vaginal exam normal. Speculum: normal.

Inv Urine R/M: RBC 3 + CBC: HB 13 - WBC 4 - PLT 350. RFT: creat 70 - urea 5 LFT: normal. Urine c/s: normal.

Ultrasound Vesicle stones. TVU: device not in place.

Next plan

Consent form:…………..

Cystoscopy and proceed/hysteroscopy Open surgery

video

about 0.87 per 1,000 insertions. Insertion performed while women are lactating is associated with 10 times higher risk of uterine perforation. Balci O, Capar M, Mahmoud AS, Colakoglu MC. Removal of intra-abdominal mislocated intrauterine devices by laparoscopy. J Obstet Gynaecol 2011;31:650-2.

Post-insertion Before the first episode of sexual intercourse After her next menses Maruti Sinha1, Ridhima Gupta2, Minimally invasive surgical approach to retrieve migrated intrauterine contraceptive device.. Int J Reprod Contracept Obstet Gynecol Jun;2(2):

Mechanisms can explain the spontaneous migration of IUDs overlooked iatrogenic uterine perforation spontaneous uterine contraction Involuntary bladder contraction gut peristalsis peritoneal fluid movement

Risk factor inexperienced persons inappropriate positioning of the IUD susceptible uterine wall because of multiparity. endometrial atrophy chronic inflammation to copper containing recent abortion or pregnancy.

Thank you For listening