Abdominal migration of Intrauterine contraceptive devices
ESC Congress Library. Silvaramalho I. May 10, 2018; 208189; ESC294
Ines Silvaramalho
Ines Silvaramalho
Login now to access Regular content available to all registered users.

You may also access this content "anytime, anywhere" with the Free MULTILEARNING App for iOS and Android
Abstract
Rate & Comment (0)
Objective(s): To review our experience with the clinical presentation and removal of intra-abdominal intrauterine devices (IUD) after uterine perforation. Design and methods: Retrospective analysis of the cases referred to the Department of Gynecology A of Centro Hospitalar e Universitário de Coimbra due to intraabdominal IUD, which underwent its surgical removal between 2000 and September of 2017. Results: A total of 26 cases were analyzed: 13 with a levonorgestrel-releasing intrauterine system (LNG-IUS) - 12 LNG-IUS 52mg e 1 LNG-IUS 13,5mg - and 13 with a copper IUD. The patients were from our department or referred from primary health-care units or other health-care centers with a suspected IUD migration. The location of the intra-abdominal IUDs was ascertained by abdominal X-ray, when it was not possible visualize them inside the uterus by transvaginal ultrasound . Patients median age was 36.0 ± 6.4 years old. They were all parous, 5 of them with previous cesarean sections. At the time of insertion, 6 women had had a delivery in the previous 12 months and 4 were breastfeeding. In 8 cases, they were diagnosed in the first 15 days after insertion; in 5, the diagnosis happened more than 4 months later. Most patients were symptomatic at the time of diagnosis (n=18), citing pelvic (n=16) or abdominal pain (n=4) and abnormal uterine bleeding (n=2). All patients but one underwent laparoscopy (n=25). The IUD was found in the omentum (n=10), Douglas pouch (n=8), embedded in bowel serosa (n=2) and near the adnexa (n=2). There was no correlation between its location and the presence of symptoms .  Mean operation time was 30.00 ± 19.25 minutes, but in some cases other procedures were associated. In 2 cases the postoperative course was complicated by a pelvic abscess. After IUD removal, the contraceptive method of choice was SURGICAL sterilization at the same time for 10 women and oral contraception for 8; 5 chose another IUD.  Conclusions: Uterine perforation by an IUD is an uncommon complication of this contraceptive method. In this study, the number of perforation cases with LNG-IUSs and copper IUDs was equal. Many women are asymptomatic and the diagnosis can only be suspected after a gynecological follow-up exam. An important consequence of a displaced IUD may be the loss of its contraceptive effect. There is no consensus in the need to remove an asymptomatic intra-abdominal IUD. Laparoscopic surgery facilitates this removal process.
    This eLearning portal is powered by:
    This eLearning portal is powered by MULTIEPORTAL
Anonymous User Privacy Preferences

Strictly Necessary Cookies (Always Active)

MULTILEARNING platforms and tools hereinafter referred as “MLG SOFTWARE” are provided to you as pure educational platforms/services requiring cookies to operate. In the case of the MLG SOFTWARE, cookies are essential for the Platform to function properly for the provision of education. If these cookies are disabled, a large subset of the functionality provided by the Platform will either be unavailable or cease to work as expected. The MLG SOFTWARE do not capture non-essential activities such as menu items and listings you click on or pages viewed.


Performance Cookies

Performance cookies are used to analyse how visitors use a website in order to provide a better user experience.


Save Settings