The missing intrauterine device

Authors

  • Rajesh Devassy Department of Advanced Laparoscopy Surgery, Dubai London Clinic and Specialty Hospital, Jumeirah, Dubai, UAE
  • Sreelatha Gopalakrishnan Department of Obstetrics and Gynaecology, Dubai London Specialty Hospital, Jumeirah, Dubai, UAE
  • Luz A. Torres-de la Roche Department of Obstetrics and Gynaecology, University Hospital for Gynecology, Pius-Hospital, Oldenburg, Germany
  • Hugo Verhoeven Department of Obstetrics and Gynaecology, University Hospital for Gynecology, Pius-Hospital, Oldenburg, Germany
  • Maya S. De Wilde Department of Obstetrics and Gynaecology, University Hospital for Gynecology, Pius-Hospital, Oldenburg, Germany
  • Rudy L. De Wilde Department of Obstetrics and Gynaecology, University Hospital for Gynecology, Pius-Hospital, Oldenburg, Germany

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20163449

Keywords:

IUD, Intrauterine device migration, Laparoscopy, Device removal

Abstract

The Intrauterine Contraceptive Device (IUD) is an acceptable and common form of contraception worldwide. The objective of this study was to report the case of an asymptomatic missing intrauterine contraceptive (IUD) inserted to prevent intrauterine adhesions after synechiolysis. A patient presented with missing IUD threads. Ultrasound of the pelvis showed an empty uterine cavity with the missing IUD probably anterior to the uterus. We present a stepwise approach in the management of the “lost IUD”, where the strings of the device are not visible at the time of speculum examination. We suggest first determining sonographically whether the IUD is within the cavity. If it is in situ, options for retrieval are including hysteroscopic retrieval. If the IUD is not within the cavity, X-rays are recommended. The device will not be present on X-ray if expulsion has occurred. If the device is present on the X-ray, cystoscopic or laparoscopic retrieval is required. IUD-providers should not only screen potential users and insert IUD correctly, but also ensure adequate follow-up with localization.

References

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Published

2016-12-15

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Section

Case Reports