Abstract
Objectives
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.
Results
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.
Conclusions
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.
Keywords
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Article info
Publication history
Published online: July 29, 2011
Accepted:
July 11,
2011
Received in revised form:
April 17,
2011
Received:
August 24,
2010
Identification
Copyright
© 2011 Published by Elsevier Inc.