title: [Levonorgestrel intrauterine device associated with ureterpyelocaliceal ectasia].
abstract: BACKGROUND
  In 2010, Health Canada, the equivalent to the FDA, reported that the risk of uterine perforation caused by levonorgestrel intrauterine device (IUD) is very serious, warning that its use had increased the number of uterine perforation.
  
  
  METHODS
  A 33 years old patient in who was placed three years before a levonorgestrel IUD; She presented evolution of 10 days with pain in hypogastric and both flanks and chronic constipation of two years; in exploration: moderate abdominal distention, IUD strings were not visible in uterine cervix. With translocated IUD diagnosis, a tomography was performed, finding IUD in abdominal cavity and ureter pyelocalyceal bilateral ectasia; preoperative plasma concentration of levonorgestrel 5.1 nmol/L, leukocytosis of 11,000 cells/mm3, and 20-30 erythrocytes in urine exam. Laparoscopic resection of omentum attached to IUD translocated was performed. One month after surgery plasma levonorgestrel in 0.3 nmol/L, normal urinalysis and hematic cytometry and resolution of the urinary tract ectasia.
  
  
  CONCLUSIONS
  devices translocated with levonorgestrel, must be removed because the inflammatory reaction caused and the perforation of hollow viscera likelihood, with possibility to produce digestive tract and urinary tract ectasia by its pharmacologic action on smooth muscle.
authors: Ramiro
authors: R
authors: Gálvez-Valdovinos
authors: Rogelio
authors: R
authors: Hernández-López
authors: Gustavo
authors: G
authors: López-Ambriz
authors: Christian
authors: C
authors: Ramme-Cruzat
mesh_terms: D000328:Adult; D020878:Device Removal; D004108:Dilatation, Pathologic / Q000209:etiology; D005260:Female; D005548:Foreign-Body Migration / Q000601:surgery*; D006801:Humans; D007436:Intrauterine Devices, Medicated / Q000009:adverse effects*; D007670:Kidney Calices / Q000473:pathology; D007682:Kidney Pelvis / Q000473:pathology; D010535:Laparoscopy / Q000379:methods; D016912:Levonorgestrel / Q000008:administration & dosage*; D014054:Tomography / Q000379:methods; D014513:Ureter / Q000473:pathology
chemical_list: D016912:Levonorgestrel