Migration of a copper T intrauterine device: A clinical Insight into complications and diagnostic approaches

Intrauterine devices (IUCDs), such as the multi-load copper T, are widely used long-acting reversible contraceptive methods due to their effectiveness and convenience. However, complications can arise in rare instances, such as device migration. Case Series Report Case 1: A 26-year-old, G5 P2 A2 L2, presented with 2 months of amenorrhoea and inability to feel CuT thread. USG done revealed intra-uterine pregnancy of approx. 10 weeks gestational age, however intrauterine CuT was not visualized. So, we presumed it a case of expelled CuT. Regular antenatal care continued till term and LSCS was performed at 39 weeks. Intraoperatively a thread was seen embedded in the omentum lying adjacent to the uterus. Further exploration revealed multi-load-copper 375 with pus collection around it. Case 2: A 36-year-old female, Para 2, Live 2, presented with complaints of lower abdominal pain and multiple episodes of haematuria since last 6 months. An initial pelvic ultrasound showed a hyperechogenic intravesical structure of 3.3 cm, suggesting a urinary bladder calculus. A pelvic CT scan revealed a metallic T-shaped structure within the urinary bladder suggestive of a misplaced copper T device. Patient underwent cystoscopic removal of calcified IUCD. Patient had no further urinary symptoms following removal. These cases highlight the importance of monitoring patients with IUCDs for potential complications, especially when threads are missing. They also emphasize considering intravesical migration of CuT as a cause of haematuria in women. Additionally, pelvic cavity exploration during LSCS is vital to locate any migrated IUCDs when such a history exists.