Clinical Investigation

MANAGEMENT AND OUTCOME OF INTRA-ABDOMINAL INTRAUTERINE DEVICES

  • Mehmet Güney
  • Baha Oral
  • Fuat Demir
  • Demir Özbasar

Turk J Obstet Gynecol 2006;3(1):56-61

OBJECTIVE: To evaluate the diagnostic methods, management and treatment for intrauterine devices being displaced into the abdominal cavity. Design: Retrospective clinical study Setting: This retrospective study was conducted between 1980 and 2004 at the Süleyman Demirel University, Faculty of Medicine, Department of Obstetrics and Gynecology and Isparta Women’s and Children’s Hospital. Patients: Eleven patients with displaced intra-abdominal intrauterine device Main Outcome Measures: Eleven patients with displaced intra-abdominal intrauterine device were evaluated with respect to the demographic characteristics, clinical manifestation, state of current IUD use, duration of IUD use and type of clinical management. RESULTS: The mean age was 36.8±1.8 years, and the mean duration of IUD use was 61.82 ±75.93 months. The diagnostic method was ultrasonography in 5 cases, X-ray examination in 5 cases and cystoscopy in 1 case. The IUD location was the rectosigmoid in 4 cases (36%), the ligamentum latum in 2 cases (18%), the small bowel in 3 cases (27%), vesicouterine space in 1 case (9%) and the bladder in 1 case (9%). The type of IUDs was Cu-T 380A in 7 patients (63%), Lippes- Loop in 2 patients (18%) and Multiload 375 in 2 patients (18%). 45% of the patients were asymptomatic. Removal was performed by laparoscopy (n=8, 72%), laparotomy (n=2, 18%), laparotomy+cystostomy (n=1, 9%). CONCLUSIONS: Although we removed all the intraabdominal intrauterine devices, the removal of an asymptomatic displaced IUD is controvertial. A surgical intervention may cause more adhesions rather than preventing adhesion formation.

Keywords: contraception, intrauterine device, laparoscopy, laparotomy, uterine perforation