Migration intravésicale d'un dispositif intra-utérin Cas clinique et revue de la littérature. / Migration intravésicale d'un dispositif intra-utérin : Cas clinique et revue de la littérature.

Intravesical migration of intrauterine device (IUD) is a rare complication. We report a case of IUD that migrated into the bladder of a 31-year-old woman who had it for four years, and presented with irritative bladder symptoms following a miscarriage. The diagnosis was first suspected by an ultrasound and confirmed by cystoscopy. Treatment consisted by removing the IUD endoscopically. This case shows the importance of following the medical instructions for the placement of an intrauterine device, and regularly verifying its localization in order to reduce the incidence of uterine perforation and extra-uterine migration.

Is the Fowler-Stephens procedure still indicated for the treatment of nonpalpable intraabdominal testis?

PURPOSE: There are no formal guidelines for the management of boys with nonpalpable testis. In this article, we report our experience in treating all nonpalpable intraabdominal testis (NPIT) with standard inguinal orchidopexy without dividing the spermatic vessels stating that the Fowler-Stephens technique is no longer indicated for the treatment of the intraabdominal testis. METHODS: Between June 2003 and April 2008, we treated 23 boys with NPIT confirmed by ultrasound or laparoscopy. All cases were treated through an inguinal orchidopexy without division of the spermatic vessels by fixing the testis to the scrotum by 2 absorbable stitches even if there was an upward retraction of the scrotal skin. Location and size of testis were reported at 1 week, 1 month, 3 months, and 6 months through physical examination. RESULTS: Average age at presentation was 24 months. Ten patients (43%) had the NPIT on the right side, 8 (35%) on the left side, and 5 (22%) were bilateral. We had no intraoperative complications. All patients were discharged on the same day. In all cases, the testis was normal in size and found in the scrotum after 6 months of follow-up. CONCLUSION: On the basis of our experience, we believe that the Fowler-Stephens procedure is not indicated anymore in the management of NPIT. Orchidopexy without division of the spermatic vessels should be the treatment of choice even for the cases of very high intraabdominal testis because it does not affect normal testicular vascularization and is minimally invasive.