A Misplaced CuT Found Decades Later in Hysterectomy Integration “Case Report”

A Misplaced CuT Found Decades Later in Hysterectomy Integration “Case Report” | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article A Misplaced CuT Found Decades Later in Hysterectomy Integration “Case Report” Anjani Dixit, Mitesh Mohan Hood This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4381407/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Introduction: Intrauterine contraceptive devices are vital for long-term contraception, but their potential complications, such as migration and embedment, can present diagnostic challenges. Case Presentation: We present a case study of a 51-year-old woman with symptoms of excessive menstrual bleeding and recurrent abdominal pain. Despite initial ultrasound indications of an IUCD, further evaluations suggested a potential endometrial mass. Hindered by obesity-related imaging limitations, comprehensive clinical assessments guided management decisions. Conclusion The patient opted for laparoscopic hysterectomy, revealing a surprising finding: a misplaced copper intrauterine device embedded within the uterine fundus. This case emphasizes the complexities in diagnosing intrauterine abnormalities and underscores the importance of thorough evaluation and patient-centered care in treatment planning. CuT intrauterine contraceptive device hysterectomy imaging modalities clinical assessment patient preferences Figures Figure 1 Figure 2 Introduction Intrauterine devices (IUDs) are one of the most commonly used forms of contraception as a result of their effectiveness, reversibility, and long-term benefits. 1 According to research conducted by the United Nations, in 2019, approximately 8.4% of women aged 15 to 49 globally were estimated to use Intrauterine Devices (IUDs). Regional breakdowns indicated that usage rates were higher in Asia (10.7%), Europe (8.1%), and North America (7.6%), while lower rates were observed in Latin America and the Caribbean (4.6%), Oceania (3.4%), and Africa (2.6%). 2 Among the various types of IUDs, the copper intrauterine device (CuT) stands out as a popular choice, offering non-hormonal contraception with high efficacy and minimal systemic side effects. 3 However, despite their widespread use and generally favorable safety profile, IUDs can occasionally lead to complications, including displacement, 4 migration, 5 and uterine perforation, 6 presenting diagnostic challenges for clinicians. We present a compelling case study of a 51-year-old patient who sought medical attention for symptoms of excessive menstrual bleeding and recurrent abdominal pain. Initial diagnostic evaluations, including ultrasound imaging, indicated the presence of an intrauterine contraceptive device (IUCD). However, further investigations unveiled complexities beyond the realm of a typical IUD placement, ultimately culminating in a surprising revelation during surgical exploration. Case Report A 51-year-old woman was brought to the clinic with complaints of excessive menstrual bleeding and recurrent abdominal pain. Past history revealed a previous CuT insertion. When asked regarding removal of CuT; the patient informed that she went for the removal 10 years back; but was not sure if CuT was removed. This led to the suspicion of intrauterine abnormalities. Initial ultrasound suggested an IUCD, but further evaluations indicated a potential endometrial mass. Imaging revealed an enlarged uterus with fibroids and thin endometrial lining, compounded by the patient's obesity. Investigation: During examination, the patient's uterus presented with enlargement which resembled to 10 weeks' gestation, and housed two fibroids, each measuring 3.5 cm. Additionally, the endometrial lining displayed thinness, measuring 5 mm, while both ovaries appeared normal. Notably, with a BMI of 36, indicating obesity, the efficacy of abdominal and vaginal examinations was compromised. The patient had no medical, genetic, family, and psycho-social history. Management: Despite initial suggestions for an endometrial biopsy, the patient elected to undergo laparoscopic hysterectomy, which was combined with bilateral salpingo-oophorectomy and executed without complications. Notably, the enlarged uterus, comparable in size to that of 8–10 weeks' gestation, displayed irregular contours attributable to multiple fibroids during the surgical procedure. Subsequent to the hysterectomy, an unforeseen finding emerged: upon making a sagittal incision, it was revealed that a copper intrauterine device (CuT) had been misplaced, horizontally embedded within the fundus, and penetrating through the myometrium. Discussion The case highlights several key aspects relevant to the diagnosis and management of women presenting with symptoms suggestive of gynecological pathology. Firstly, it underscores the importance of a thorough clinical evaluation, including detailed history-taking and physical examination, in elucidating the underlying etiology of presenting symptoms. 7 In our case, the patient's history of CuT insertion several years prior served as a crucial clue in guiding subsequent diagnostic investigations. Secondly, the diagnostic challenges posed by the presence of an IUD, particularly in obese patients, are noteworthy. Obesity can limit the accuracy of imaging modalities such as transvaginal ultrasound, complicating the identification and characterization of intrauterine lesions. 9 Our case illustrates the need for clinicians to navigate such challenges with clinical acumen, recognizing the potential limitations of imaging studies and considering alternative diagnostic approaches when necessary. Moreover, the case highlights the importance of multidisciplinary collaboration in complex diagnostic scenarios. 10 In our patient's case, input from gynecologists, radiologists, and surgeons was instrumental in reaching a definitive diagnosis and formulating an appropriate management plan. This collaborative approach facilitated a comprehensive assessment of the patient's condition, ensuring that all potential differential diagnoses were adequately explored and addressed. Finally, the unexpected discovery of a misplaced CuT embedded within the uterine fundus raises important considerations regarding IUD-related complications. 4 , 5 , 6 While migration 4 and uterine perforations 6 of IUDs are known complications, their presentation as mimickers of other gynecological pathologies is less common but equally significant. Clinicians must remain vigilant for such possibilities, particularly in patients with a history of IUD use presenting with atypical symptoms. Conclusion The discovery of a misplaced CuT during hysterectomy exemplifies the challenges in diagnosing intrauterine abnormalities. Thorough evaluation and patient-centered care are essential in guiding management decisions and achieving successful outcomes. Further research is warranted to explore the prevalence and management of misplaced intrauterine devices in clinical practice. Declarations 1. Funding: This research received no specific grant from any funding agency 2. Conflict of interest: The authors declare that they have no conflict of interest. 3. Ethics approval: This study did not require any ethical approval from the institutional review board (IRB). The patient was informed, and permission was obtained to use the medical data. 4. Consent to participate: The patient was informed, and permission was obtained to use the medical data. 5. Consent for publication: Written consent was obtained for publication. 6. Availability of data and material: Not applicable 7. Code availability: Not applicable. 8. Authors' contributions: AD: Conception, treatment decision, and final approval. MMH: Critically revising and adding important intellectual content. All authors commented on previous versions of the manuscript and read and approved the final manuscript. References Kavanaugh ML, Jerman J. Contraceptive method use in the United States: trends and characteristics between 2008, 2012 and 2014. Contraception. 2018;97(1):14–21. Oliveira LS, Hermida PMV, Siqueira EF, Arma JCBS, Thomas LS, Dalmolin IS. Evidence of intrauterine device insertion by nurses in Primary Health Care: an integrative review. Rev Bras Enferm. 2024;77(1):e20230134. 10.1590/0034-7167-2023-0134 . Published 2024 Feb 26. Gupta P, Gupta MM, Sharma R. Intrauterine Copper Device (CuT380A) as a Contraceptive Method in the Indian Context: Acceptability, Safety and Efficacy Depending on the Timing of Insertion. J Obstet Gynaecol India. 2018;68(2):129–35. Aisien AO. Intrauterine contraceptive device (IUCD): acceptability and effectiveness in a tertiary institution. Afr J Med Med Sci. 2007;36(3):193–200. Rasekhjahromi A, Chitsazi Z, Khlili A, Babaarabi ZZ. Complications associated with intravesical migration of an intrauterine device. Obstet Gynecol Sci. 2020;63(5):675–8. Rowlands S, Oloto E, Horwell DH. Intrauterine devices and risk of uterine perforation: current perspectives. Open Access J Contracept. 2016;7:19–32. Rubin M, DaSilva R, Phillibert D Jr, Guelfguat M. Long-term indwelling copper intrauterine device (IUD) found during primary infertility work up. Radiol Case Rep. 2020;15(4):442–4. Anthony MS, Zhou X, Schoendorf J, et al. Demographic, Reproductive, and Medical Risk Factors for Intrauterine Device Expulsion. Obstet Gynecol. 2022;140(6):1017–30. van Doorn LC, Dijkhuizen FP, Kruitwagen RF, et al. Accuracy of transvaginal ultrasonography in diabetic or obese women with postmenopausal bleeding. Obstet Gynecol. 2004;104(3):571–8. Braam A, Buljac-Samardzic M, Hilders CGJM, van Wijngaarden JDH. Collaboration Between Physicians from Different Medical Specialties in Hospital Settings: A Systematic Review. J Multidiscip Healthc. 2022;15:2277–300. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4381407","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":301814591,"identity":"b714b8d1-1d38-4073-965a-bc3ebdececaf","order_by":0,"name":"Anjani Dixit","email":"","orcid":"","institution":"Pristyn Care, Bangalore, India","correspondingAuthor":false,"prefix":"","firstName":"Anjani","middleName":"","lastName":"Dixit","suffix":""},{"id":301814592,"identity":"fd33d9fb-767f-4ed5-92f3-bf49775f0ba4","order_by":1,"name":"Mitesh Mohan Hood","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABDUlEQVRIiWNgGAWjYDACZiBmbGBIAFKGDxgYJIjRwgzXYmwA0sJDlDVQLWZgKwhq0W3nP/jw5w6GPH725m3VhXss7O0lcg9++LnHhoG/vTsBmxazw8zMxrxnGIole46V3Z7xTCKxRyIvWbLnWRqDxJmzG3BoYZNmbGNI3HAjx+w2zwGJBB6JHDMGngOHGQwkcnFpYf/5E6qlGKjFHqSF8c+B//i0sDHwQrUwA7Uw9kiAGQfwaTGW5m2TSJzZc6xYesYBoF/OvDGWljmQzIPTL+cPPvz4s80msZ+9eePnggN19uztOYYf3xywk+Nv78WqBQogkc4MJgUSwBQRUQrXwn+AKMWjYBSMglEwcgAAZ+Fd9BjbrBsAAAAASUVORK5CYII=","orcid":"","institution":"Pristyn Care","correspondingAuthor":true,"prefix":"","firstName":"Mitesh","middleName":"Mohan","lastName":"Hood","suffix":""}],"badges":[],"createdAt":"2024-05-07 08:23:19","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4381407/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4381407/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":57299121,"identity":"659b6697-49da-44d0-9aa1-ce5e844890f9","added_by":"auto","created_at":"2024-05-28 20:54:01","extension":"jpeg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":322328,"visible":true,"origin":"","legend":"\u003cp\u003eBulky uterus with multiple fibroids with para tubal cysts with bilateral tubes and ovaries removed laparoscopically\u003c/p\u003e","description":"","filename":"Figure1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-4381407/v1/ff47ff6186ca457ae05db7e1.jpeg"},{"id":57299120,"identity":"a1a4cb7b-e4db-463e-af80-4aedb137bdb6","added_by":"auto","created_at":"2024-05-28 20:54:01","extension":"jpeg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":265533,"visible":true,"origin":"","legend":"\u003cp\u003eCopper T stuck inside for a decade - cutting through the myometrium\u003c/p\u003e","description":"","filename":"Figure2.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-4381407/v1/da42b21aa3b6d6854544ee13.jpeg"},{"id":59417288,"identity":"7d1b63e2-34b9-4d32-ab00-96f9ffe987ae","added_by":"auto","created_at":"2024-07-01 14:01:38","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":817759,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4381407/v1/d898fe47-58a7-4baa-a442-f1a1a16e9fac.pdf"}],"financialInterests":"","formattedTitle":"A Misplaced CuT Found Decades Later in Hysterectomy Integration “Case Report”","fulltext":[{"header":"Introduction","content":"\u003cp\u003eIntrauterine devices (IUDs) are one of the most commonly used forms of contraception as a result of their effectiveness, reversibility, and long-term benefits.\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e According to research conducted by the United Nations, in 2019, approximately 8.4% of women aged 15 to 49 globally were estimated to use Intrauterine Devices (IUDs). Regional breakdowns indicated that usage rates were higher in Asia (10.7%), Europe (8.1%), and North America (7.6%), while lower rates were observed in Latin America and the Caribbean (4.6%), Oceania (3.4%), and Africa (2.6%).\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eAmong the various types of IUDs, the copper intrauterine device (CuT) stands out as a popular choice, offering non-hormonal contraception with high efficacy and minimal systemic side effects.\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e However, despite their widespread use and generally favorable safety profile, IUDs can occasionally lead to complications, including displacement,\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e migration,\u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e and uterine perforation,\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e presenting diagnostic challenges for clinicians.\u003c/p\u003e \u003cp\u003eWe present a compelling case study of a 51-year-old patient who sought medical attention for symptoms of excessive menstrual bleeding and recurrent abdominal pain. Initial diagnostic evaluations, including ultrasound imaging, indicated the presence of an intrauterine contraceptive device (IUCD). However, further investigations unveiled complexities beyond the realm of a typical IUD placement, ultimately culminating in a surprising revelation during surgical exploration.\u003c/p\u003e"},{"header":"Case Report","content":"\u003cp\u003eA 51-year-old woman was brought to the clinic with complaints of excessive menstrual bleeding and recurrent abdominal pain. Past history revealed a previous CuT insertion. When asked regarding removal of CuT; the patient informed that she went for the removal 10 years back; but was not sure if CuT was removed. This led to the suspicion of intrauterine abnormalities. Initial ultrasound suggested an IUCD, but further evaluations indicated a potential endometrial mass. Imaging revealed an enlarged uterus with fibroids and thin endometrial lining, compounded by the patient's obesity.\u003c/p\u003e\n\u003ch3\u003eInvestigation:\u003c/h3\u003e\n\u003cp\u003eDuring examination, the patient's uterus presented with enlargement which resembled to 10 weeks' gestation, and housed two fibroids, each measuring 3.5 cm. Additionally, the endometrial lining displayed thinness, measuring 5 mm, while both ovaries appeared normal.\u003c/p\u003e \u003cp\u003eNotably, with a BMI of 36, indicating obesity, the efficacy of abdominal and vaginal examinations was compromised. The patient had no medical, genetic, family, and psycho-social history.\u003c/p\u003e\n\u003ch3\u003eManagement:\u003c/h3\u003e\n\u003cp\u003eDespite initial suggestions for an endometrial biopsy, the patient elected to undergo laparoscopic hysterectomy, which was combined with bilateral salpingo-oophorectomy and executed without complications. Notably, the enlarged uterus, comparable in size to that of 8\u0026ndash;10 weeks' gestation, displayed irregular contours attributable to multiple fibroids during the surgical procedure.\u003c/p\u003e \u003cp\u003eSubsequent to the hysterectomy, an unforeseen finding emerged: upon making a sagittal incision, it was revealed that a copper intrauterine device (CuT) had been misplaced, horizontally embedded within the fundus, and penetrating through the myometrium.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe case highlights several key aspects relevant to the diagnosis and management of women presenting with symptoms suggestive of gynecological pathology. Firstly, it underscores the importance of a thorough clinical evaluation, including detailed history-taking and physical examination, in elucidating the underlying etiology of presenting symptoms.\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e In our case, the patient's history of CuT insertion several years prior served as a crucial clue in guiding subsequent diagnostic investigations.\u003c/p\u003e \u003cp\u003eSecondly, the diagnostic challenges posed by the presence of an IUD, particularly in obese patients, are noteworthy. Obesity can limit the accuracy of imaging modalities such as transvaginal ultrasound, complicating the identification and characterization of intrauterine lesions.\u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e Our case illustrates the need for clinicians to navigate such challenges with clinical acumen, recognizing the potential limitations of imaging studies and considering alternative diagnostic approaches when necessary.\u003c/p\u003e \u003cp\u003eMoreover, the case highlights the importance of multidisciplinary collaboration in complex diagnostic scenarios.\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e In our patient's case, input from gynecologists, radiologists, and surgeons was instrumental in reaching a definitive diagnosis and formulating an appropriate management plan. This collaborative approach facilitated a comprehensive assessment of the patient's condition, ensuring that all potential differential diagnoses were adequately explored and addressed.\u003c/p\u003e \u003cp\u003eFinally, the unexpected discovery of a misplaced CuT embedded within the uterine fundus raises important considerations regarding IUD-related complications.\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e,\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e,\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e While migration\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e and uterine perforations\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e of IUDs are known complications, their presentation as mimickers of other gynecological pathologies is less common but equally significant. Clinicians must remain vigilant for such possibilities, particularly in patients with a history of IUD use presenting with atypical symptoms.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe discovery of a misplaced CuT during hysterectomy exemplifies the challenges in diagnosing intrauterine abnormalities. Thorough evaluation and patient-centered care are essential in guiding management decisions and achieving successful outcomes. Further research is warranted to explore the prevalence and management of misplaced intrauterine devices in clinical practice.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003e1.\u003c/strong\u003e\u0026nbsp; \u0026nbsp;\u003cstrong\u003eFunding:\u0026nbsp;\u003c/strong\u003eThis research received no specific grant from any funding agency\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.\u003c/strong\u003e\u0026nbsp; \u0026nbsp;\u003cstrong\u003eConflict of interest:\u0026nbsp;\u003c/strong\u003eThe authors declare that they have no conflict of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.\u003c/strong\u003e\u0026nbsp; \u0026nbsp;\u003cstrong\u003eEthics approval:\u0026nbsp;\u003c/strong\u003eThis study did not require any ethical approval from the institutional review board (IRB). The patient was informed, and permission was obtained to use the medical data.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4.\u003c/strong\u003e\u0026nbsp; \u0026nbsp;\u003cstrong\u003eConsent to participate:\u0026nbsp;\u003c/strong\u003eThe patient was informed, and permission was obtained to use the medical data.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e5.\u003c/strong\u003e\u0026nbsp; \u0026nbsp;\u003cstrong\u003eConsent for publication:\u0026nbsp;\u003c/strong\u003eWritten consent was obtained for publication.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e6.\u003c/strong\u003e\u0026nbsp; \u0026nbsp;\u003cstrong\u003eAvailability of data and material:\u003c/strong\u003e Not applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e7.\u003c/strong\u003e\u0026nbsp; \u0026nbsp;\u003cstrong\u003eCode availability:\u0026nbsp;\u003c/strong\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e8.\u003c/strong\u003e\u0026nbsp; \u0026nbsp;\u003cstrong\u003eAuthors\u0026apos; contributions:\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003cbr\u003e\u0026nbsp;\u0026nbsp;\u003c/strong\u003eAD: Conception, treatment decision, and final approval. MMH: Critically revising and adding important intellectual content. All authors commented on previous versions of the manuscript and read and approved the final manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eKavanaugh ML, Jerman J. Contraceptive method use in the United States: trends and characteristics between 2008, 2012 and 2014. Contraception. 2018;97(1):14\u0026ndash;21.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOliveira LS, Hermida PMV, Siqueira EF, Arma JCBS, Thomas LS, Dalmolin IS. Evidence of intrauterine device insertion by nurses in Primary Health Care: an integrative review. Rev Bras Enferm. 2024;77(1):e20230134. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1590/0034-7167-2023-0134\u003c/span\u003e\u003cspan address=\"10.1590/0034-7167-2023-0134\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Published 2024 Feb 26.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGupta P, Gupta MM, Sharma R. Intrauterine Copper Device (CuT380A) as a Contraceptive Method in the Indian Context: Acceptability, Safety and Efficacy Depending on the Timing of Insertion. J Obstet Gynaecol India. 2018;68(2):129\u0026ndash;35.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAisien AO. Intrauterine contraceptive device (IUCD): acceptability and effectiveness in a tertiary institution. Afr J Med Med Sci. 2007;36(3):193\u0026ndash;200.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRasekhjahromi A, Chitsazi Z, Khlili A, Babaarabi ZZ. Complications associated with intravesical migration of an intrauterine device. Obstet Gynecol Sci. 2020;63(5):675\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRowlands S, Oloto E, Horwell DH. Intrauterine devices and risk of uterine perforation: current perspectives. Open Access J Contracept. 2016;7:19\u0026ndash;32.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRubin M, DaSilva R, Phillibert D Jr, Guelfguat M. Long-term indwelling copper intrauterine device (IUD) found during primary infertility work up. Radiol Case Rep. 2020;15(4):442\u0026ndash;4.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAnthony MS, Zhou X, Schoendorf J, et al. Demographic, Reproductive, and Medical Risk Factors for Intrauterine Device Expulsion. Obstet Gynecol. 2022;140(6):1017\u0026ndash;30.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003evan Doorn LC, Dijkhuizen FP, Kruitwagen RF, et al. Accuracy of transvaginal ultrasonography in diabetic or obese women with postmenopausal bleeding. Obstet Gynecol. 2004;104(3):571\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBraam A, Buljac-Samardzic M, Hilders CGJM, van Wijngaarden JDH. Collaboration Between Physicians from Different Medical Specialties in Hospital Settings: A Systematic Review. J Multidiscip Healthc. 2022;15:2277\u0026ndash;300.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"CuT, intrauterine contraceptive device, hysterectomy, imaging modalities, clinical assessment, patient preferences","lastPublishedDoi":"10.21203/rs.3.rs-4381407/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4381407/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eIntroduction:\u003c/h2\u003e \u003cp\u003eIntrauterine contraceptive devices are vital for long-term contraception, but their potential complications, such as migration and embedment, can present diagnostic challenges.\u003c/p\u003e\u003ch2\u003eCase Presentation:\u003c/h2\u003e \u003cp\u003eWe present a case study of a 51-year-old woman with symptoms of excessive menstrual bleeding and recurrent abdominal pain. Despite initial ultrasound indications of an IUCD, further evaluations suggested a potential endometrial mass. Hindered by obesity-related imaging limitations, comprehensive clinical assessments guided management decisions.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThe patient opted for laparoscopic hysterectomy, revealing a surprising finding: a misplaced copper intrauterine device embedded within the uterine fundus. This case emphasizes the complexities in diagnosing intrauterine abnormalities and underscores the importance of thorough evaluation and patient-centered care in treatment planning.\u003c/p\u003e","manuscriptTitle":"A Misplaced CuT Found Decades Later in Hysterectomy Integration “Case Report”","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-05-28 20:53:56","doi":"10.21203/rs.3.rs-4381407/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"8d76f38a-9089-40d1-b05a-5c1701309b34","owner":[],"postedDate":"May 28th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-07-01T13:53:31+00:00","versionOfRecord":[],"versionCreatedAt":"2024-05-28 20:53:56","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4381407","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4381407","identity":"rs-4381407","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}