Research Article| Volume 159, ISSUE 1, P119-121, November 2011

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Minimally invasive approach to cases of lost intra-uterine device: a 7-year experience



      To evaluate the effectiveness of hysteroscopy and laparoscopy for diagnosis and treatment in women with lost intra-uterine devices (IUDs), and to elucidate the most common extra-uterine locations of lost IUDs.

      Study design

      Retrospective clinical study at Atatürk University Hospital, Erzurum, Turkey. Women with lost IUDs presenting in the last 7 years were referred to the obstetrics and gynaecology clinics. Women whose lost IUDs were removed using a Novak curette were excluded from the study.


      Of the 55 cases studied, 29 (52.7%) lost IUDs were located inside the uterine cavity, 23 (41.8%) were located outside the uterine cavity, and three (5.5%) were embedded in the myometrium. The most common extra-uterine location of lost IUDs was around the uterosacral ligaments (n = 8, 34.7%). Considerable association was found between the position of the uterus and the extra-uterine location of lost IUDs. In all eight cases where the lost IUD was located around the uterosacral ligaments, the uterine position was anteverted and perforation was found on the posterior side of the uterus. IUD removal was performed successfully in 46 women (83.6%) by either hysteroscopy or laparoscopy.


      Lost IUDs inside or outside the uterine cavity can be managed by minimally invasive approaches. If an anteverted uterus is seen on laparoscopy, the initial exploration for the lost IUD should be made around the uterosacral ligaments.


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        • Thonneau P.
        • Goulard H.
        • Goyaux N.
        Risk factors for intrauterine device failure: a review.
        Contraception. 2001; 64: 33-37
        • Zakin D.
        • Stern W.Z.
        • Rosenblatt R.
        Complete and partial uterine perforation and embedding following insertion of intrauterine devices. II. Diagnostic methods, prevention, and management.
        Obstet Gynecol Surv. 1981; 36: 401-417
        • Otolorin E.O.
        Management of the lost IUD.
        Afr J Med Med Sci. 1985; 14: 125-129
        • Gentile J.P.
        • Siegler A.M.
        The misplaced or missing IUD.
        Obstet Gynecol Surv. 1977; 32: 627-641
        • Rao R.P.
        Lost intrauterine devices and their localization.
        J Reprod Med. 1978; 20: 195-199
        • Trivedi S.S.
        • Goel M.
        • Jain S.
        Hysteroscopic management of intrauterine devices with lost strings.
        Br J Fam Plann. 2000; 26: 229-230
        • Andersson K.
        • Ryde-Blomqvist E.
        • Lindell K.
        • Odlind V.
        • Milsom I.
        Perforations with intrauterine devices. Report from a Swedish survey.
        Contraception. 1998; 57: 251-255
        • Heartwell S.F.
        • Schlesselman S.
        Risk of uterine perforation among users of intrauterine devices.
        Obstet Gynecol. 1983; 61: 31-36
        • Demir S.C.
        • Cetin M.T.
        • Ucünsak I.F.
        • Atay Y.
        • Toksöz L.
        • Kadayifçi O.
        Removal of intra-abdominal intrauterine device by laparoscopy.
        Eur J Contracept Reprod Health Care. 2002; 7: 20-23
        • El Kady A.A.
        • Rifat H.A.
        • El Hosseiny M.A.
        • Gaffar G.Y.
        The value of X-ray with uterine sound in the diagnosis of IUDs with missing tails.
        Adv Contracept. 1986; 2: 161-167
        • Ingec M.
        • Kumtepe Y.
        • Kadanali S.
        • Ozdiller O.
        A rare case of ileal embedding by an intrauterine device.
        Eur J Contracept Reprod Health Care. 2005; 10: 29-31
        • Nitke S.
        • Rabinerson D.
        • Dekel A.
        • Sheiner E.
        • Kaplan B.
        • Hackmon R.
        Lost levonorgestrel IUD: diagnosis and therapy.
        Contraception. 2004; 69: 289-293