Randomised comparative study in 217 women of three disposable plastic IUCD thread retrievers

Area of Science:

• Gynecology
• Family Planning
• Medical Device Efficacy

Background:

• Missing intrauterine contraceptive device (IUCD) threads pose a clinical challenge.
• Effective retrieval methods are crucial for patient management and device removal.

Purpose of the Study:

• To compare the efficacy of three disposable plastic instruments for retrieving 'missing' IUCD threads.
• To evaluate the success rates of different retrieval tools after initial attempts.

Main Methods:

• A prospective, randomized, comparative study involving 217 IUCD users with missing threads.
• Initial exploration with Spencer Wells forceps, followed by random use of up to two plastic IUCD thread retrievers.
• Four entries per instrument allowed, with endocervical canal checks after each retraction.

Main Results:

• Spencer Wells forceps retrieved threads in approximately 40% of patients.
• The Retrievette (59%) and Emmett (53%) retrievers showed significantly higher success rates than the Mi-Mark Helix (37%).
• Success rates were not influenced by thread length, cycle day, device type, or parity.

Conclusions:

• Initial endocervical canal exploration with Spencer Wells forceps is highly valuable.
• The Retrievette or Emmett thread retrievers are effective tools for IUCD thread retrieval in general practice and family planning clinics when initial methods fail.