Conservative management of postmenopausal woman with prolonged use of the dislocated intrauterine device which was also unnoticed while hysterectomy

Mustafa Gazi Uçar, Tansel Çakır, Tolgay Tuyan İlhan, Çetin Çelik


The objectives of this study are to identify and compare the treatment options of woman with uterine perforation caused by intrauterine device (IUD). A 74-years-old woman presented with irritable voiding symptoms and a dislocated IUD into the peritoneal cavity was discovered incidentally during radiologic imaging. While a Lippes loop IUD had been inserted 35 years previously, she had a history of hysterectomy 10 years after an IUD insertion. Not only the patient had forgotten the presence of the IUD, but also it was unnoticed during hysterectomy. Patient has remained asymptomatic for over the 25 years, with the prolonged use of dislocated IUD. The patient managed conservatively and no need for surgical intervention. Once a gynaecologist is faced with the dilemma of whether it is necessary to remove a dislocated IUD or not, patients should undergo an individualized management, balancing both risks and benefits of surgical intervention. Asymptomatic elderly patients with comorbidities may benefit from conservative management with close monitoring. 


Mislocated IUD, Uterus perforation, Lippes loop, Conservative management, Hysterectomy

Full Text:



Heinemann K, Reed S, Moehner S, Minh TD. Risk of uterine perforation with levonorgestrel-releasing and copper intrauterine devices in the European Active Surveillance Study on Intrauterine Devices. Contraception. 2015;91:274-9.

Kho KA, Chamsy DJ. Perforated intraperitoneal intrauterine contraceptive devices: diagnosis, management, and clinical outcomes. J Minim Invasive Gynecol. 2014;21:596-601.

Kaislasuo J, Suhonen S, Gissler M, Lähteenmäki P, Heikinheimo O. Intrauterine contraception: incidence and factors associated with uterine perforation - a population-based study. Hum Reprod. 2012;27:2658-63.

Vasquez P, Schreiber CA. The missing IUD. Contraception. 2010; 82:126-8.

Caliskan E, Oztürk N, Dilbaz BO, Dilbaz S. Analysis of risk factors associated with uterine perforation by intrauterine devices. Eur J Contracept Reprod Health Care. 2003;8:150-5.

Inal HA, Ozturk Inal Z, Alkan E. Successful conservative management of a dislocated IUD. Case Rep Obstet Gynecol. 2015;2015:130528.

Kaislasuo J, Suhonen S, Gissler M, Lähteenmäki P, Heikinheimo O. Uterine perforation caused by intrauterine devices: clinical course and treatment. Hum Reprod. 2013;28:1546-51.

Markovitch O, Klein Z, Gidoni Y, Holzinger M, Beyth Y. Extrauterine mislocated IUD: is surgical removalmandatory? Contraception. 2002;66:105-8.

Ertopcu K, Nayki C, Ulug P, Nayki U, Gultekin E, Donmez A, et al. Surgical removal of intra-abdominal intrauterine devices at one center in a 20-year period. Int J Gynaecol Obstet. 2015;128:10-3.