aginal administration of hormones, contraceptive or replacement hormone therapy, is rising in market popularity. The vaginal ring, or NuvaRing (Organon USA Inc, Roseland, NJ), is estimated to have more than 1 million users in more than 25 countries, including the United States and Canada. The NuvaRing is a flexible combination contraceptive vaginal ring containing 2 active ingredients: a progestin, etonogestrel, and an estrogen, ethinylestradiol. It is a nonbiodegradable flexible transparent latex-free device with an outer diameter of 54 mm and a cross-sectional diameter of 4 mm. It can easily be compressed to 1 cm or less for self-insertion into the vagina. The ring releases 15 μg of ethinylestradiol and 120 μg of etonogestrel per day and inhibits ovulation.1 The advantages over oral contraceptives include avoidance of first-pass metabolism through the liver, constant serum steroid levels, and simple selfinsertion by the user. It is inserted once every 28 days, left in place for 21 days, and then removed for a 7-day break, during which time withdrawal bleeding takes place . There is an extensive published list of potential adverse reactions predominantly relating to the effects of hormone administration, such as increased risk of thromboembolism, stroke, myocardial infarction, high blood pressure, cancer of the reproductive organs and breast, gallbladder disease, liver tumors, and lipid metabolism defects. Expulsion may occur while removing a tampon, during intercourse, or with straining. Inadvertent placement of the NuvaRing is not a well-recognized or anticipated complication. One case report has been published describing incorrect placement of the NuvaRing into the bladder and subsequent recurrent cystitis.2 We report a second case with a description of the urological technique required for removal. Inadvertent bladder placement of the NuvaRing, although rare, should be considered a potential complication in patients who have “lost” the NuvaRing and have recurrent urinary tract infections.