Cervical perforation using a levonorgestrel-releasing intrauterine device. A case report

Abstract

Background: Intrauterine contraception is an increasingly common long-term reversible method with good contraceptive results. The rate of uterine perforation due to these intrauterine devices (IUD) is very low (1-2 per 1000) and considering this complication, cervical perforation is much more infrequent (less than 1%).
Objective: To report a very infrequent clinical case of cervical perforation by IUD and review the limited bibliography available.

Clinical case: 46-year-old patient with a levonorgestrel-releasing IUD since 3 years ago with moderate metrorrhagia and mild abdominal pain. The central stem of the IUD was observed to perforate the mucosa of the posterior cervical lip and the IUD strings were visualized through the external cervical os. The device was removed using a Bettocchi hysteroscope without incident and little bleeding. The patient evolved well one month after the intervention and the cervical mucosa was well healed.

Conclusions: In addition to a revision consultation in the months following its insertion, at least annual follow-up should be carried out to avoid associated complications. It is essential to provide patients with complete and quality information before insertion and to provide good advice for the search for a new effective contraceptive in the event that they have presented a complication with some other method.