Surgical management of extrauterine mislocated intrauterine contraceptive devices and related risks

Abstract

Our aim was to evaluate the value of surgery, mainly laparoscopy in the diagnosis of the location of extrauterine lost intrauterine devices (IUCDs) and their removal. The diagnosis and management of 18 patients with extrauterine lost IUCDs between 2007 and 2011, were recruited in this study. Women whose lost IUCDs were removed by conventional methods (D&C, etc.) and hysteroscopy, were excluded from the study. Laparoscopy was performed initially for the management of these cases. The location of the IUCDs and complications related with surgery were recorded. The results showed that the most common extrauterine localisation of the lost IUCDs was the omentum (n = 10, 55.6%). Overall, 17 laparoscopies and one cystoscopy were performed for IUCD removal. Out of two cases whose IUCD were located adjacent to the bowel, one case required a laparotomy for repair of the perforation site. It was concluded that lost IUCDs outside the uterine cavity can be managed by laparoscopy as a first choice. Since the most common extrauterine localisation of the lost IUCDs is the omentum, a thorough exploration of this area should be carried out initially.