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Inadvertent Vesicular Placement of a Vaginal Contraceptive Ring Presenting as Persistent Cystitis

Teal, Stephanie B. MD, MPH1; Craven, Winfield M. MD2

doi: 10.1097/01.AOG.0000164072.91339.9e
Case Report
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BACKGROUND: The NuvaRing is a soft, flexible, ring-shaped vaginal contraceptive device that is placed by the user herself. Incorrect placement has not been described, because any intravaginal position allows appropriate hormonal delivery through the vaginal mucosa.

CASE: A 22-year-old otherwise healthy woman presented with 2 months of urinary urgency, frequency, and pelvic pain, which were unresponsive to antibiotic therapy. Her symptoms began immediately after placement of a NuvaRing vaginal contraceptive device, which she was subsequently unable to locate. Thorough evaluation revealed the ring in the urinary bladder.

CONCLUSION: Bladder or urethral foreign body should be considered in the evaluation of patients with chronic cystitis, especially if the patient uses vaginal medical devices. Intravesicular placement of a device may occur even without psychiatric or physical comorbidities.

The intravaginal contraceptive ring device may be inadvertently placed into the bladder, even by a patient with no underlying psychiatric or medical conditions.

From the 1Department of Obstetrics and Gynecology, University of Colorado Health Sciences Center, Denver, Colorado; and 2Fort Collins Radiologic Associates, Fort Collins, Colorado.

Corresponding author: Stephanie B. Teal, MD, MPH, University of Colorado Health Sciences Center, 4200 East Ninth Avenue Box B-198, Denver CO 80262; e-mail: Stephanie.Teal@uchsc.edu.

© 2006 The American College of Obstetricians and Gynecologists