Missing IUCD strings: an analysis

Upasana Verma, Mamta Gupta, Vandana Saini


Background: Missing IUCD strings, i.e.  IUCD strings that are not visible at the external cervical os, are a commonly encountered problem and needs to be analysed.

Methods: IUCD users coming for routine checkup (follow-up / renewal / removal) or with any complaints related to IUCD or gynecological complaints or referred from other health center and found to be having missing threads were included in the study. Complaints by woman, obstetric history, details of IUCD insertion, USG imaging reports were recorded. Removal of IUCD was done if indicated or if the woman desired so, by simple OPD procedure and if required in operation theatre.

Results: Out of 324 IUCD users who were examined in OPD, missing IUCD threads were found in 69.  About half of them were asymptomatic. AUB was the commonest symptom. 82.6% women had IUCD in situ on USG. Displacement was seen in 10.14%, embedment in 4.35%. Expulsion was seen in 4.35% women. Removal was done in only 29 women. Removal was done by simple OPD procedure in 24 women, as minor OT procedure in 3. Only 1 required hysteroscopic removal. Commonest cause of missing threads was found to be broken, detached or severed strings.

Conclusions: As most of these women with missed IUCD strings, IUCD was found to be in situ on ultrasound imaging; hence, these women need counselling regarding continuation of using IUCD.  If required, removal can be done as an OPD procedure.


Extrauterine IUCD, IUCD missed strings, IUCD displacement, IUCD expulsion, IUCD removal, Malposition of IUCD, Migration of IUCD, USG imaging

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