Endoscopic removal of IUD migrated to the rectum. A simple solution for a rare complication

The intrauterine device (IUD) is a widely used contraceptive method due to its safety, efficacy and reversibility. An infrequent complication is uterine perforation and migration of the device, described in 1/1000 insertions, rectal perforation being even more unusual.

We present the case of a 48-year-old woman, IUD carrier for 15 years, with no subsequent controls and with 3 pregnancies and cesarean sections after implantation. Due to suspicion of eventration, an abdominal CT scan was performed showing, as an incidental finding, IUD in the rectum.

We performed colonoscopy which confirmed its presence at 15 cm from the anal margin, embedded in the rectal wall by means of the cylinder and threads, with free T towards the lumen. It was removed with a polypectomy loop and the fistulous orifice was closed with a hemostasis clip without complications.

IUD migration is a potentially serious complication because it can lead to fistula formation or injury to adjacent viscera, so its removal is recommended.

If rectal perforation is suspected, an initial endoscopic evaluation should be performed and it can be removed at the same time if most of the device is inside the lumen. If it is firmly fixed to the wall, endoscopic removal is not safe due to risk of perforation and surgery is recommended. In our case, the device was almost entirely in the rectal lumen, so endoscopic removal was safe and carried out without complications.

Conflicts of Interest

Authors do not have any conflict of interest to disclose.

Publication History

Article published online:
27 March 2025