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The management of translocated intrauterine contraceptive devices - contraception-esc.com

The management of translocated intrauterine contraceptive devices

The management of translocated intrauterine contraceptive

devices

C. Dane, M. Yayla, B. Dane, A. Çetin 

Haseki Training & Research

Hospital, Department of Gynecology and Obstetrics, Istanbul, Turkey

Objective

Intrauterine contraceptive device is a safe and effective method of

contraception widely used in various countries. Perforation of the uterine wall

is one of the less common but more serious complications associated with the

intrauterine contraceptive device. This study was planned to answer the

questions regarding what kind of model is to be the determined in diagnosis and

treatment approach for 13 cases in which intrauterine device migrated into

abdomen or into wall of uterus without strings being seen. 

Material and methods

The study is a retrospective analysis of patients’ records at the training and

research hospital during the years 2001-2005, which required admission to

hospital for removal of an intrauterine device which had translocated to outside

of uterus. Thirteen cases of dislocated intrauterine device were diagnosed and

treated in our clinics. 

Results We used laparoscopy to remove the intrauterine

device, except in one case. Two lost intrauterine devices were removed via

hysteroscopy, and laparotomy was necessary in one case, as it could not be found.

In 6 cases, mild adhesion and in 2 cases, severe adhesion was observed; while

there were none in 5 cases. Three of intrauterine devices were in Douglas space,

7 of them were embedded in omentum, one of them was inside broad ligament, two

of them perforated wall of uterus. Any complication related to the operation was

not observed. 

Conclusion The management of an migrated intrauterine device is

controversial. Although intrauterine device was found inside the abdominal

cavity, it didn’t cause a visceral complication. Therefore, we suppose that a

conservative approach could be held in this kind of cases and intrauterine

device could be left at place without removal, unless there is a symptom. A

regular follow up of intrauterine device for visible threads would help in

earlier detection of misplaced intrauterine device.

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