Spontaneous intrauterine fragmentation of intrauterine device (IUD Novaplus T 380 Ag Normal): uncommon reported case

ABSTRACT

Background. Intrauterine devices (IUDs) are among the most commonly used methods of reversible contraception (1). Complications, although rare and well-documented, can occur during insertion, use, and removal. Fragmentation of an IUD during removal has been known and extensively described, but self-destruction due to the spontaneous degradation of the plastic material is very rarely reported (2-3).
Case presentation. There have been few cases reported in which the lateral arm of the IUD broke off, but fragmentation was almost always observed during extraction (4). We describe the case of a 48-year-old patient who had an IUD inserted six years ago. She experienced an unexpected expulsion of a small IUD fragment at home and subsequently presented it to her gynaecologist.
Conclusions. Detecting retained fragments in the endometrial cavity can be challenging, especially with plastic arms, as sonography, X-ray, and computed tomography are not always successful (5). Retained IUD fragments in the uterus can result in perforation, migration into the abdominal cavity, and infection (6). Based on these considerations, the patient was immediately referred for hysteroscopy. Two IUD fragments were detected, but extraction was difficult as the fragile material crumbled when grasped. However, all fragments were successfully removed.