Removal of a Retroperitoneal Foreign Body by Laparoscopic Surgery

Migration of intrauterine devices (IUDs) into the abdominal cavity is rare. In this report, we describe a patient in whom a levonorgestrel intrauterine system (LNG-IUS) device was initially misplaced outside of the uterus, likely due to stenosis of the cervix following a conization procedure for carcinoma in situ. The patient presented with persistent abdominal pain and vaginal bleeding. The LNG-IUS was not visible on physical examination and ultrasound imaging, requiring intraoperative abdominal radiography and postoperative computed tomography for localization. Once localized, we proceeded with the removal of the foreign body in the retroperitoneal space by laparoscopy. Misplacement of an IUD such as LNG-IUS outside of the uterus after a conization procedure should be suspected in women with persisting symptoms, and this possibility should be diligently assessed.