[A more and more painful intrauterine device… where it is not enough to see the wires to exclude malposition!]

Gynecol Obstet Fertil. 2014 Apr;42(4):261-4. doi: 10.1016/j.gyobfe.2011.08.019. Epub 2012 Apr 20.
[Article in French]


We report a case of a 30-year-old woman with an intrauterine device (IUD) improperly inserted deep within the myometrium, with a muscularis layer injury of the recto-sigmoid colon resulting of a uterine perforation and presented as abdomino-pelvic pain and dyspareunia. The ultrasonographic control of the IUD after the insertion (performed seven months before) was not checked. Cervical examination showed the strings of the IUD. The ultrasonographic exploration identified an intra-myometrial IUD with fundus perforation of the uterus. A laparoscopic exploration permitting the removal of the IUD revealed an insertion through the bowel wall. The lessons to draw of about this case report are discussed through a brief review of the literature.

Keywords: Contraception; Cœlioscopie; Dispositif intra-utérin; Dyspareunia; Dyspareunie; Intrauterine device; Laparoscopy; Perforation; Ultrasonography; Échographie.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain
  • Adult
  • Colon, Sigmoid / injuries
  • Dyspareunia
  • Female
  • Humans
  • Intrauterine Devices / adverse effects*
  • Laparoscopy
  • Myometrium
  • Pelvic Pain
  • Rectum / injuries
  • Ultrasonography
  • Uterine Perforation / diagnostic imaging
  • Uterine Perforation / etiology*