The management of translocated intrauterine contraceptive
C. Dane, M. Yayla, B. Dane, A. Çetin
Haseki Training & Research
Hospital, Department of Gynecology and Obstetrics, Istanbul, Turkey
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
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.