Transurethral placement of vaginal contraceptive device in a patient with neurogenic bladder: A case report and review of the literature

Background: The NuvaRing is a vaginal contraceptive device that is placed and later removed by the user herself. Incorrect placement is a possible complication and seems an increased risk in patients with spinal cord abnormalities. Case: A 21-year-old female with a history of a T7-8 level spinal cord injury at birth and subsequent neurogenic bladder dysfunction and bladder augmentation presented with an 8 month history of suprapubic pain, right hip pain and urgency unresponsive to antibiotic therapy. Her symptoms began after her caretaker placed a NuvaRing contraceptive device, which subsequently was unable to be located. A thorough evaluation revealed a NuvaRing in the bladder. Conclusion: Foreign objects should be considered in patients with recurrent symptoms of cystitis which are unrelieved by antibiotic therapy. Intravaginal contraceptive rings should be used cautiously in patients with spinal cord abnormalities who require the assistance of caretakers for management of these devices.