Ureteral Obstruction Complicating the IUD

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Abstract
To the Editor.— Since its introduction ten years ago, the plastic intrauterine contraceptive device (IUD) has been associated with complications including bleeding, infection, perforation, bowel obstruction, peritonitis, and pregnancy. We know of no reported injury to the urinary tract, and present a case of ureteral obstruction secondary to parametritis resulting from long-term use of an IUD. Report of a Case.— A 35-year-old gravida 5 para 4 suffered pain in the right flank of one month's duration. An excretory urogram revealed nonfunction of the right kidney. At the University of Missouri Medical Center, laboratory results included: hemoglobin, 12 gm/100 ml; white blood cell count, 12,000/cu mm; blood urea nitrogen, 12 mg/100 ml; and creatinine, 1.0 mg/100 ml. An intravenous pyelogram showed markedly delayed function on the right associated with hydronephrosis (Fig 1), and a retrograde pyelogram demonstrated stenosis of the right ureter (Fig 2). On pelvic examination, a "woody" induration of

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