Surgical options for the retrieval of a migrated intrauterine contraceptive device
A 27-year-old woman with a previous history of two uneventful vaginal deliveries opted for an IUCD (copper coil) as form of contraception. The coil was fitted easily by an experienced family planning physician. During a routine check 6 weeks later the threads of the coil were not visible on speculum examination. An abdominal X-ray confirmed the presence of the coil in the pelvis. To further specify its location, transvaginal ultrasound scan was performed, which showed an IUCD perforating through the uterine serosa. The patient reported no abdominal pain or irregular vaginal bleeding. After a consultation with the gynaecologist she agreed to proceed for the retrieval of the coil by either hysteroscopy or laparoscopy.\nDuring the hysteroscopy 4 weeks later there was no evidence of an IUCD into the uterine cavity and no evidence of a perforation site in the uterus (Fig. ). A laparoscopy followed, locating the coil threads deep in the Pouch of Douglas, with the IUCD perforating through the sigmoid colon into the lumen (Fig. ). The IUCD was retrieved laparoscopically and the defect in the sigmoid colon was repaired by stapling the tear (Fig. ).\nThe patient made a non-eventful postoperative recovery and was discharged after 72 h of observation.