Though rare, complications associated with intrauterine devices (IUDs) can present with atypical symptoms, leading to diagnostic challenges. This case report describes a 36-year-old multiparous woman with a history of IUD insertion who presented with intermittent light bleeding menstrual periods for 1 year, in the without abdominal pain or dysmenorrhea. Imaging studies (including pelvic X-ray and ultrasound) revealed complete uterine perforation and IUD displacement into the pelvic cavity. The IUD was successfully removed through a combined hysteroscopic and laparoscopic procedure. This case emphasizes that severe complications, such as IUD perforation and displacement, may manifest solely as minor abnormal uterine bleeding. This finding suggests that even in the absence of pain, patients with persistent irregular bleeding patterns should remain highly vigilant for IUD-related complications. Since ultrasonography remains the gold standard for assessment, timely diagnosis of these complications is crucial to prevent potential long-term sequelae.
Zou et al. (Wed,) studied this question.