Misplaced of Intrauterine Devices: The Endoscopic Management

Abstract

Intra uterine device migration is a relatively rare event. The migration of the IUD in the surrounded viscera can be managed by endoscopy approach. Objectives: We reported our experience to determine the epidemiologic characteristics of patients that presented migrated IUD, to report clinical aspects and describe the laparoscopic management. Method: The study includes 10 patients reported to obstetrics and Gynecology I department of UHC Hassan II FES in the last 4 years (2018-2021). In all the patients a gynecological examination, ultrasound evaluation abdomen and pelvis were done to locate the misplaced IUD. If the device was found to be intrauterine, hysteroscopy was done to locate and retrieve device. In those patients in whom the IUD was confirmed to be extrauterine diagnostic laparoscopy was done. Results: The average of age was 34.5 years. Majority of patients were primipara (53.3%) and 46.6% were multipara. As far as timing of insertion is concerned 6 (60%) were postpartum, 4 (40%) were postmenstrual. The average of time interval between insertion and removal is 3, 12 years. Of the 10 misplaced intrauterine devices 4 were found partially embedded in uterine wall and 6 of the misplaced 1UD’s were found deeply embedded in the uterine cavity. After their location they were removed hysteroscopically One patient reported with 8 weeks pregnancy and misplaced IUD. The device was confirmed to be intrauterine on transvaginal sonography. She had full term normal delivery and IUD was removed after 6 weeks hysteroscopically. None of our patient had an extra uterine migration that required a laparoscopy.