İKİNCİ TRİMESTER GEBELİKTE MESANEYE MİGRASYONU SAPTANAN RAHİM İÇİ ARACIN SİSTOSKOPİK OLARAK ÇIKARILMASI
Abstract
Bu olgu sunumu ile rahim içi araç
(RİA)’ların nadir görülen komplikasyonlarından biri olan mesaneye migrasyonu sonrasında
oluşan gebelikte hastanın yönetiminin tartışılmasını amaçladık. Yirmi
yaşında 4 gebelik ve 3 vajinal doğumu
olan 15 haftalık gebe tekrarlayan dizüri, hematüri, yürümede zorluk şikayetleri
ile gebe polikliniğine başvurmuştur. Hastaya 2013 yılında ikinci normal vajinal
doğumundan 6 hafta sonra bir klinikte RİA takıldığı, sonrasında hastanın üçüncü kez gebe kaldığı, kendisine RIA’nın
düştüğü ve bu nedenle gebe kaldığının söylendiği, gebeliğinin son aylarında
tekrarlayan hematüri, dizüri ve kasık ağrısı nedeni ile idrar yolu enfeksiyonu
tedavisinin uygulandığı, hastanın üçüncü doğumundan sonra şikayetlerinin
azaldığı ancak dördüncü gebeliğinde benzer şikayetlerin daha erken gebelik
haftasında ortaya çıktığı öğrenildi. Hastanın yapılan obstetrik ultrasonografisinde
tek canlı 15 hafta ile uyumlu gebelik ve mesane lümeninde RİA ekosu izlendi. RİA
sistoskopik olarak çıkarıldı. RİA taktırma öyküsü olan ve kontrol
muayenelerinde RİA saptanmayan hastalar mutlaka ayrıntılı olarak
değerlendirilmeli, ileri incelemeler yapılmalı RİA lokalizasyonu
belirlenmelidir. Uterin kavitede izlenmeyen RİA’larda uterin perforasyon akılda
tutulmalıdır.
References
- 10-Dietrick DD, Issa MM, Kabalin JN, Basssett JB: Intravesicalmigration of intrauterindevice. J Urol. 1992; 147: 132-134
- 11- Intrauterinecontraception: The IUD. Clinical Gyneclogic Endocrynology And Infertility’ de. Ed. Speroff L, Fritz MA. 7. Bask›. Philadelphia , Lippincott Williams &Wilkins, 2005; 975- 96.
- 12- Soderstrom RM. Trailing and treating the wandering IUD. Am J Gynecol Health 1989 ;3 (3-S): 33-5.
- 13- Demir SC, Cetin MT, Ucunsak IF, Atay Y, Toksoz L, Kadayifci O. Removal of intra-abdominal intrauterine device by laparoscopy. Eur J Contracept Reprod HealthCare. 2002; 7(1):20- 3.
- 14- Dunn JS Jr, Zerbe MJ, Bloomquist JL, Ellerkman RM, Bent AE. Ectopic IUD complicating pregnancy. A casereport. Reprod Med 2002; 47(1): 57- 9.
- 1. Peterson H, Curtic K, Meirk O, D’Arcargues C. Contraception. In: Scott JR, Gibbs RS, Karlan BY, Haney AF, eds. Danforth’s Obstetrics and Gynecology. 9th ed. Philadelphia: Lippincott Williams &Wilkins, 2003:541-61.
- 2- Dede FS, Dilbaz B, Sahin D, Dilbaz S: Vesical calculus formation around a migrated copper-T 380-A. Eur J Contracept Reprod Health Care. 2006; 11: 50-52.
- 3. Heartwell SF, Schlesselman S. Risk of uterine perforation among users of intrauterine devices. Obstet Gynecol. 1983;61:31-6.
- 4. Stuckey A, Dutreil P, Aspuru E, Nolan TE. Symptomatic cecal perforation by an intrauterine device with appendectomy removal. Obstet Gynecol. 2005;105:1239-41.
- 5.Zhou, L., Harrison-Woolrych, M., and Coulter, D.M. Use of the New Zealand Intensive Medicines Monitoring Programme to study the levonorgestrel-releasing intrauterine device (Mirena).Pharmaco epidemiol Drug Saf. 2003; 12: 371–377
- 6.Harrison-Woolrych, M.,Ashton, J., and Coulter, D. Insertion of the Multiload Cu375 intrauterine device; experience in over 16,000 New Zeal and women. Contraception. 2002; 66: 387–391
- 7.Van Houdenhoven, K., van Kaam, K.J.A.F., van Grootheest, A.C., Salemans, T.H.B., and Dunselman, G.A.J. Uterine perforation in women using a levonorgestrel-releasing intrauterine system.Contraception. 2006; 73: 257–260
- 8.Caliskan, E.,Oztürk, N., Dilbaz, B.O., and Dilbaz, S. Analysis of risk factors associated with uterine perforation by intrauterine devices. Eur J Contracept Reprod Health Care. 2003; 8: 150–155
- 9-Atakan H, Kaplan M, Erturk E: Intravesical migration of intrauterine device resulting in Stone formation. Urolo- gy. 2002;60: 911.
Abstract
With this case study, we intended to discuss the
patient management during pregnancy after the migration of an intrauterine
device (IUD) to the bladder which is a rare complication of IUDs. A 20
year old 15 weeks pregnant woman with 3 a history of 3 vaginal births and 4
pregnancies presented to our outpatient clinic with complaints for recurring
dysuria, hematuria, and difficulty in walking. It was found out that an IUD had
been inserted in the patient 6 weeks after her second normal vaginal birth in
2013; and then the patient got pregnant for the third time and she was told
that the IUD had fallen out and therefore she got pregnant again and then
received infection treatment for recurring hematuria, dysuria and inguinal pain
and that her complaints subsided after the third delivery but had similar
complaints that emerged earlier in her fourth pregnancy. A single live fetus
compatible with 15 weeks and echoes caused by a IUD in the bladder lumen were
observed during the obstetric ultrasonography of the patient. IUD was removed
with cystoscopy. Patients who have a history of IUD insertion and for whom no
IUD was detected during their follow up examinations should be evaluated in
detail and further examinations should be performed to localise the IUDs
.Uterine perforation should be considered if IUDs cannot be viewed in the
uterine cavity.
References
- 10-Dietrick DD, Issa MM, Kabalin JN, Basssett JB: Intravesicalmigration of intrauterindevice. J Urol. 1992; 147: 132-134
- 11- Intrauterinecontraception: The IUD. Clinical Gyneclogic Endocrynology And Infertility’ de. Ed. Speroff L, Fritz MA. 7. Bask›. Philadelphia , Lippincott Williams &Wilkins, 2005; 975- 96.
- 12- Soderstrom RM. Trailing and treating the wandering IUD. Am J Gynecol Health 1989 ;3 (3-S): 33-5.
- 13- Demir SC, Cetin MT, Ucunsak IF, Atay Y, Toksoz L, Kadayifci O. Removal of intra-abdominal intrauterine device by laparoscopy. Eur J Contracept Reprod HealthCare. 2002; 7(1):20- 3.
- 14- Dunn JS Jr, Zerbe MJ, Bloomquist JL, Ellerkman RM, Bent AE. Ectopic IUD complicating pregnancy. A casereport. Reprod Med 2002; 47(1): 57- 9.
- 1. Peterson H, Curtic K, Meirk O, D’Arcargues C. Contraception. In: Scott JR, Gibbs RS, Karlan BY, Haney AF, eds. Danforth’s Obstetrics and Gynecology. 9th ed. Philadelphia: Lippincott Williams &Wilkins, 2003:541-61.
- 2- Dede FS, Dilbaz B, Sahin D, Dilbaz S: Vesical calculus formation around a migrated copper-T 380-A. Eur J Contracept Reprod Health Care. 2006; 11: 50-52.
- 3. Heartwell SF, Schlesselman S. Risk of uterine perforation among users of intrauterine devices. Obstet Gynecol. 1983;61:31-6.
- 4. Stuckey A, Dutreil P, Aspuru E, Nolan TE. Symptomatic cecal perforation by an intrauterine device with appendectomy removal. Obstet Gynecol. 2005;105:1239-41.
- 5.Zhou, L., Harrison-Woolrych, M., and Coulter, D.M. Use of the New Zealand Intensive Medicines Monitoring Programme to study the levonorgestrel-releasing intrauterine device (Mirena).Pharmaco epidemiol Drug Saf. 2003; 12: 371–377
- 6.Harrison-Woolrych, M.,Ashton, J., and Coulter, D. Insertion of the Multiload Cu375 intrauterine device; experience in over 16,000 New Zeal and women. Contraception. 2002; 66: 387–391
- 7.Van Houdenhoven, K., van Kaam, K.J.A.F., van Grootheest, A.C., Salemans, T.H.B., and Dunselman, G.A.J. Uterine perforation in women using a levonorgestrel-releasing intrauterine system.Contraception. 2006; 73: 257–260
- 8.Caliskan, E.,Oztürk, N., Dilbaz, B.O., and Dilbaz, S. Analysis of risk factors associated with uterine perforation by intrauterine devices. Eur J Contracept Reprod Health Care. 2003; 8: 150–155
- 9-Atakan H, Kaplan M, Erturk E: Intravesical migration of intrauterine device resulting in Stone formation. Urolo- gy. 2002;60: 911.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Case Report |
| Authors | |
| Publication Date | June 27, 2018 |
| Published in Issue | Year 2018 Volume: 49 Issue: 2 |
