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.
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.
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.