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Jahra hospital

Jahra hospital . First case . Talal Alanzi Yr 3 30-1-2014. 38 Yr. Female. Presented to OPD with 1 year history of dysuria and B/L loin pain. Frequency Urgency Straining No constitutional symptoms. No urethral or vaginal discharge. No incontinence. Not stone passer nor former.

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Jahra hospital

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  1. Jahra hospital First case TalalAlanzi Yr 3 30-1-2014

  2. 38 Yr. • Female. • Presented to OPD with 1 year history of dysuria and B/L loin pain.

  3. Frequency • Urgency • Straining • No constitutional symptoms. • No urethral or vaginal discharge. • No incontinence. • Not stone passer nor former.

  4. P.M.H: Nil. • P.S.H: Nil. • No drug allergy. • Housemaid. • P. OBS & GYN: delivered twice 2001- 2003 • IUCD 2004 • Delivered 2005

  5. Vital Sign • T 37 - P 80 - BP 110/70. • On exam: • Abd: soft,lax, non tender. • Vaginal exam normal. • Speculum: normal.

  6. Inv • Urine R/M: RBC 3 + • CBC: HB 13 - WBC 4 - PLT 350. • RFT: creat 70 - urea 5 • LFT: normal. • Urine c/s: normal.

  7. Ultrasound • Vesicle stones. • TVU: device not in place.

  8. Next plan

  9. Consent form:…………..

  10. Cystoscopy and proceed/hysteroscopy • Open surgery

  11. video

  12. about 0.87 per 1,000 insertions. • Insertion performed while women are lactating is associated with 10 times higher risk of uterine perforation. BalciO, Capar M, Mahmoud AS, Colakoglu MC. Removal of intra-abdominal mislocated intrauterine devices by laparoscopy. J ObstetGynaecol 2011;31:650-2.

  13. Post-insertion • Before the first episode of sexual intercourse • After her next menses Maruti Sinha1, Ridhima Gupta2, Minimally invasive surgical approach to retrieve migrated intrauterine contraceptive device.. Int J ReprodContraceptObstet Gynecol. 2013 Jun;2(2):147-151

  14. Mechanisms can explain the spontaneous migrationof IUDs • overlooked iatrogenic uterine perforation • spontaneous uterine contraction • Involuntary bladder contraction • gut peristalsis • peritoneal fluid movement

  15. Risk factor • inexperienced persons • inappropriate positioning of the IUD • susceptible uterine wall because of multiparity. • endometrial atrophy • chronic inflammation to copper containing • recent abortion or pregnancy.

  16. Thank you For listening

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