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Related Experiment Videos

Lost levonorgestrel IUD: diagnosis and therapy.

Shmuel Nitke1, David Rabinerson, Arie Dekel

  • 1Soroka University Medical Center, Ben Gurion University of the Negev, Beer Sheva, Israel.

Contraception
|March 23, 2004
PubMed
Summary

Lost levonorgestrel-releasing intrauterine devices (IUDs) are more likely to be misdiagnosed in location compared to copper IUDs. These devices may be found embedded in the omentum in the mid-upper abdomen.

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Area of Science:

  • Gynecology
  • Minimally Invasive Surgery
  • Radiology

Background:

  • Lost intrauterine devices (IUDs) are rare but pose diagnostic challenges.
  • A new levonorgestrel-releasing IUD has been introduced, prompting investigation into its behavior when lost.
  • Diagnostic discrepancies in locating lost levonorgestrel-releasing IUDs have been observed.

Purpose of the Study:

  • To compare the extrauterine locations of lost levonorgestrel-releasing IUDs versus lost copper IUDs.
  • To identify if diagnostic evaluation accurately predicts the location of lost levonorgestrel-releasing IUDs.
  • To guide surgical exploration for lost IUDs.

Main Methods:

  • Retrospective review of medical files for patients with lost IUDs at Rabin Medical Center (2000-2003).

Related Experiment Videos

  • Identification of 14 women: 9 with levonorgestrel-releasing IUDs and 5 with copper IUDs.
  • Comparison of presumed IUD location (diagnostic evaluation) versus actual location (surgical extraction).

    • Main Results:

    • Six of nine (66%) lost levonorgestrel-releasing IUDs showed location discrepancies between diagnosis and extraction.
    • These six devices were embedded in the omentum, with four in the upper abdomen.
    • No location discrepancies were found for the five lost copper IUDs (0%).

    Conclusions:

    • Lost levonorgestrel-releasing IUDs are associated with a higher rate of localization errors than copper IUDs.
    • Surgical exploration for lost levonorgestrel-releasing IUDs should prioritize the mid-upper abdomen and omentum.
    • Accurate localization of lost IUDs is crucial for effective surgical management.