Unilateral hydroureteronephrosis after introduction of a levonorgestrel-releasing intrauterine system: a case report and literature review

Francesco Giuseppe Martire, Francesco G Martire, Matteo Giorgi, Luca Labanca, Gabriele Centini, Francesco Catania, C. Exacoustós, Caterina Exacoustos, Errico Zupi, Lucia Lazzeri
Minerva obstetrics and gynecology · 2022 · vol. 75(5) , pp. 491–497 · doi:10.23736/s2724-606x.22.05112-0 · PMID:36255159 · W4306730551
review OA: closed CC0
View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by claude@2026-06, 2026-06-13 ⓘ

This case report describes a dislocated levonorgestrel-releasing intrauterine system causing ipsilateral hydroureteronephrosis, and reviews literature on the diagnostic and therapeutic management of this rare complication.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

Abstract

Insertion of a LNG-Intra-uterine System (LNG-IUS) has many gynecological indications. The approved indications worldwide are contraception, treatment of abnormal uterine bleeding depending on not organic disease, and endometrial protection in case of an estrogenic therapy. Instead adenomyosis, fibroids, and fertility-sparing management of endometrial hyperplasia or early endometrial cancer in patients with desire of pregnancy are off label indications. Hydroureteronephrosis is an uncommon complication during LNG-IUS insertion. There are few cases described in the literature. The first diagnostic approach for this complication is an abdominal-pelvic ultrasound scan to identify the abnormal position of the device. Diagnostic management includes computed tomography (CT) or magnetic resonance imaging (MRI), which are necessary to confirm hydroureteronephrosis and to assess the exact location of the LNG-IUS in the abdomen. A minimally invasive approach is the standard of care with the removal of the device, while the therapeutic management of the hydroureteronephrosis depends on ureteral and kidney involvement. We report the history of a dislocated LNG-IUS in the left paracervical space with subsequent ipsilateral hydroureteronephrosis. In our case we removed the device through hysteroscopy and later inserted a J-J stent. Follow-up at three months revealed the persistence of left hydroureteronephrosis, so we performed ureter reimplantation. We also performed a review of the literature to analyze common diagnostic and therapeutic pathways for this rare complication.

My notes (saved in your browser only)

Condition tags

adenomyosis

MeSH descriptors

Endometrial Hyperplasia Endometrial Hyperplasia Endometrial Hyperplasia Endometrial Hyperplasia Endometrial Hyperplasia Endometrial Hyperplasia Endometrial Hyperplasia Endometrial Hyperplasia Endometrial Hyperplasia Endometrial Hyperplasia Endometrial Neoplasms Endometrial Neoplasms Endometrial Neoplasms Endometrial Neoplasms Endometrial Neoplasms Endometrial Neoplasms Endometrial Neoplasms Endometrial Neoplasms Endometrial Neoplasms Endometrial Neoplasms

Citation neighborhood (no data yet)

We don't have any in-corpus citations linked to this paper yet. The paper's references may be in our DB but unresolved to ``paper_id`` (resolution happens at ingest when the cited DOI matches a row we already have). Run the cross-source citation reconcile pass to retry.

References (22)

Source provenance

europepmc
last seen: 2026-06-17T06:13:18.893374+00:00
openalex
last seen: 2026-06-04T00:00:01.174412+00:00
pubmed
last seen: 2026-06-17T06:12:52.047461+00:00
unpaywall
last seen: 2026-06-13T06:42:57.164913+00:00
License: CC0 · commercial use OK