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Vol 80, No 12 (2009)
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Extrauterine mislocated IUD

Piotr Roszkowski, Beata Szymańska, Agnieszka Gardyszewska, Małgorzata Niewiadomska-Kowalczyk
Ginekol Pol 2009;80(12).

open access

Vol 80, No 12 (2009)
ARTICLES

Abstract

Abstract Intrauterine contraceptive device (IUD) is a safe and effective method of contraception, widely used all over the world. The most common IUD complications include heavy bleeding, painful cramps, expulsion, complete or partial uterine perforation, infertility caused by pelvic inflammatory disease (PID), and an increased risk for septic and spontaneous abortion in cases of pregnancy with an IUD in situ. A potentially serious complication is the perforation of the uterus, with reported incidence of 0,5-1/1000 insertions. After perforation, devices have been found in various locations in the pelvis and abdomen. Between 2000 and 2008 there were five cases with mislocated intrauterine devices in our clinic. All patients were operated by laparoscopy and there was one conversion into laparotomy. Three patients were breast-feeding at the time. An average time between insertion and recognizing expulsion was 19,2 months. Missing strings during gynaecologic examination are the first sign of an expulsion. Transvaginal sonography, combined with abdominal X-ray, is necessary to reach a definitive diagnosis. Laparoscopic treatment may be appropriate in most cases. IUD is a safe and effective method of contraceptive but its insertion may be connected with serious complications.

Abstract

Abstract Intrauterine contraceptive device (IUD) is a safe and effective method of contraception, widely used all over the world. The most common IUD complications include heavy bleeding, painful cramps, expulsion, complete or partial uterine perforation, infertility caused by pelvic inflammatory disease (PID), and an increased risk for septic and spontaneous abortion in cases of pregnancy with an IUD in situ. A potentially serious complication is the perforation of the uterus, with reported incidence of 0,5-1/1000 insertions. After perforation, devices have been found in various locations in the pelvis and abdomen. Between 2000 and 2008 there were five cases with mislocated intrauterine devices in our clinic. All patients were operated by laparoscopy and there was one conversion into laparotomy. Three patients were breast-feeding at the time. An average time between insertion and recognizing expulsion was 19,2 months. Missing strings during gynaecologic examination are the first sign of an expulsion. Transvaginal sonography, combined with abdominal X-ray, is necessary to reach a definitive diagnosis. Laparoscopic treatment may be appropriate in most cases. IUD is a safe and effective method of contraceptive but its insertion may be connected with serious complications.
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Keywords

Intrauterine device, perforation, laparoscopy

About this article
Title

Extrauterine mislocated IUD

Journal

Ginekologia Polska

Issue

Vol 80, No 12 (2009)

Page views

800

Article views/downloads

44577

Bibliographic record

Ginekol Pol 2009;80(12).

Keywords

Intrauterine device
perforation
laparoscopy

Authors

Piotr Roszkowski
Beata Szymańska
Agnieszka Gardyszewska
Małgorzata Niewiadomska-Kowalczyk

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