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
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to European Journal of Obstetrics and Gynecology and Reproductive BiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Risk factors for intrauterine device failure: a review.Contraception. 2001; 64: 33-37
- 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
- Management of the lost IUD.Afr J Med Med Sci. 1985; 14: 125-129
- The misplaced or missing IUD.Obstet Gynecol Surv. 1977; 32: 627-641
- Lost intrauterine devices and their localization.J Reprod Med. 1978; 20: 195-199
- Hysteroscopic management of intrauterine devices with lost strings.Br J Fam Plann. 2000; 26: 229-230
- Perforations with intrauterine devices. Report from a Swedish survey.Contraception. 1998; 57: 251-255
- Risk of uterine perforation among users of intrauterine devices.Obstet Gynecol. 1983; 61: 31-36
- Removal of intra-abdominal intrauterine device by laparoscopy.Eur J Contracept Reprod Health Care. 2002; 7: 20-23
- The value of X-ray with uterine sound in the diagnosis of IUDs with missing tails.Adv Contracept. 1986; 2: 161-167
- A rare case of ileal embedding by an intrauterine device.Eur J Contracept Reprod Health Care. 2005; 10: 29-31
- Lost levonorgestrel IUD: diagnosis and therapy.Contraception. 2004; 69: 289-293
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.
