Abstract
Purpose
To evaluate the predisposing factors, diagnosis and surgical treatment options of patients with intra-abdominal, mislocated intrauterine devices (IUDs).
Methods
The diagnosis and management of 18 patients with intra-abdominal, mislocated IUDs were analyzed in this retrospective study.
Results
Trained midwives inserted ten (55%) of the IUDs, while six (33%) were inserted by general practitioners and two (11%) by specialist gynecologists. Ten (55.5%) of the patients were diagnosed by gynecological examination and ultrasonography (USG); abdominal X-ray, in addition, was required in the other eight (44.4%). Eleven patients (61%) were managed by laparoscopy, whereas laparotomy was required in seven (39%). For all patients, laparoscopy was performed initially. No complication was encountered in any of the patients.
Conclusion
Persons who insert IUDs should receive adequate training before certification, because inadequate pelvic examination before insertion and inexperience of the inserting person might be predisposing factors for uterine perforation. If IUD strings are not visible during gynecologic examination, USG should be tried to locate the IUD and pelvic X-ray used only when USG fails to locate the IUD. Laparoscopy can be the first choice for removal.
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References
Ozgun MT, Batukan C, Serin IS, Ozcelik B, Basbug M, Dolanbay M (2007) Surgical management of intra-abdominal mislocated intrauterine devices. Contraception 75:96–100
Heinberg EM, McCoy TW, Pasic R (2008) The perforated intrauterine device: endoscopic retrieval. JSLS 12:97–100
Morgan KW (2006) The intrauterine device: rethinking old paradigms. J Midwifery Womens Health 51:464–470
Demir SC, Cetin MT, Ucunsak IF, Atay Y, Toksoz L, Kadayifci O (2002) Removal of intra-abdominal intrauterine device by laparoscopy. Eur J Contracept Reprod Health Care 7:20–23
Miranda L, Settembre A, Capasso P, Cuccurullo D, Pisaniello D, Corcione F (2003) Laparoscopic removal of an intraperitoneal translocated intrauterine contraceptive device. Eur J Contracept Reprod Health Care 8:122–125
Ikechebelu JI, Mbamara SU (2008) Laparoscopic retrieval of perforated intrauterine device. Niger J Clin Pract 11:394–395
Adoni A, Ben Chetrit A (1991) The management of intrauterine devices following uterine perforation. Contraception 43:77–81
Markovitch O, Klein Z, Gidoni Y, Holzinger M, Beyth Y (2002) Extrauterine mislocated IUD: is surgical removal mandatory? Contraception 66:105–108
WHO (1987) Mechanism of action, safety, and efficacy of intrauterine devices. Geneva 7. World Health Organ Tech Rep Ser 753:1–91
Kassab B, Audra P (1999) The migrating intrauterine device. Case report and review of the literature. Contracept Fertil Sex 27:696–700
Roy KK, Banerjee N, Sinha A (2000) Laparoscopic removal of translocated retroperitoneal IUD. Int J Gynaecol Obstet 71:241–243
Caliskan E, Ozturk N, Dilbaz BO, Dilbaz S (2003) Analysis of risk factors associated with uterine perforation by intrauterine devices. Eur J Contracept Reprod Health Care 8:150–155
Acknowledgments
We thank all the study participants and research staff of the Department of Obstetrics and Gynecology, Faculty of Medicine, Selcuk University. No funding for the study was received.
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Balci, O., Mahmoud, A.S., Capar, M. et al. Diagnosis and management of intra-abdominal, mislocated intrauterine devices. Arch Gynecol Obstet 281, 1019–1022 (2010). https://doi.org/10.1007/s00404-010-1374-8
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DOI: https://doi.org/10.1007/s00404-010-1374-8