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What should I do about my misplaced IUD (IUD perforation)? #1168/7
I have a misplaced IUD.  Help!




I am assuming that what you mean by "misplaced" is that your IUD is outside your uterus... that your IUD has perforated your utrus.

Below is information from the chapter on IUDs in the 19th edition of
Contraceptive Technology:

Perforation of the uterus can occur at the time of IUD insertion; no evidence supports that notion that IUDs "migrate" outside the uterus thereafter. The most important determinant of the risk of perforation is the skill of the person doing the insertion ("the magic is in the magician and not in the wand"). In experienced hands, this risk is 1 per 1,000 insertions
or less.


Copper-bearing IUDs found to be outside the endometrial cavity should be
removed promptly. Copper in the peritoneal cavity induces adhesion
formation, which may involve the adnexa, omentum, and bowel. Laparoscopy is the preferred approach for removal. In contrast, non-medicated and progestin-bearing devices do not evoke similar intraperitoneal adhesions. No clear medical indication exists for removal of T-shaped IUDs not containing copper, although this is commonly done.


String Problems
Missing strings may signal an unsuspected perforation or spontaneous expulsion; alternatively, some strings ascend into the endometrial cavity and descend without known explanation. Ultrasound examination can quickly confirm the presence of an IUD within the endometrial cavity. Should the device be present but no strings visible and should the woman request its removal, a cotton swab or endometrial biopsy instrument can sometimes tease the strings from the endometrium to the endocervix.

Key Words:  IUDs, misplaced, Contraception Technology, migrate, uterus, risk, perforation, insertion, copper-bearing, endometrial cavity, removed, adnexa, omentum, bowel, laparoscopy, progestin-only, strings, ultrasound, cotton swab, endocervix

 

Reference:

 

Grimes D. Intrauterine devices (IUDs) IN Hatcher RA. Et al. Contraceptive Technology 19th Edition; Ardent Media Inc. 2008


Posted 12-5-2007, Updated 12-7-2007, Updated 12-15-2007, Updated 12-22-2007

 

Robert A. Hatcher MD, MPH
Emeritus Professor of Gynecology and Obstetrics
Emory University School of Medicine
Atlanta, GA
---2007-12-22

The directors and owners of this website and any publications and information concerning health matters offered here advise a person with a particular problem to consult a primary-care clinician or a specialist in obstetrics, gynecology, or urology (depending on the problem or the contraceptive) as well as the product package insert and other references before diagnosing, managing, or treating the problem.
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