Intrauterine device extrauterine dislocation in women with previous caesarean section: two case reports and literature review

ABSTRACT
Background. Intrauterine contraceptive devices (IUCDs) are one of the most frequently chosen methods by patients after counseling, especially following a delivery (vaginal or cesarean) or a voluntary abortion. Although displacement of the IUCD into the lower uterine segment or cervix is common (approximately 10.4%), uterine perforation occurs in about 0.1% of cases. Meanwhile, the rate of cesarean sections (CS) has been steadily increasing, and literature reports a higher risk of uterine perforation when the device is placed within the first 4-8 weeks after surgical delivery, with perforation rates plateauing around 22-23 weeks after postpartum insertion.
Case presentation. We describe two similar cases of extrauterine dislocated copper IUCDs in patients with a single previous pregnancy, which ended in a CS more than two years earlier. In both cases, ultrasound examination clearly revealed IUCD displacement. Both patients underwent uncomplicated laparoscopic removal of the device.
Conclusions. Persistent pelvic pain in IUCD users should be thoroughly investigated through clinical and imaging analysis. Diagnosis of IUCD displacement may require urgent or emergent management.