When an Intrauterine Device (IUD) Migrates into the Colon: A Case of Sigmoid Localization Treated Endoscopically

The intrauterine device (IUD) is an effective and widely used contraceptive method, but it may cause rare complications such as extrauterine migration. We report the case of a 35-year-old patient with a copper IUD inserted three and a half years earlier. One year after insertion, she no longer felt the device’s retrieval strings and subsequently developed amenorrhea. Pelvic ultrasound did not visualize the IUD in the intrauterine position and revealed an ongoing pregnancy that was carried to term. Eighteen months after delivery, the patient reported perceiving a string at the anal level. Digital rectal examination confirmed its presence in the anal canal. Colonoscopy identified the IUD in the sigmoid colon, allowing complete endoscopic extraction. The postoperative course was uncomplicated. This case illustrates a rare but potentially serious complication of an intrauterine device and underscores the importance of considering extrauterine migration when the retrieval string is missing or the device is not visualized in an intrauterine position.