Management of the lost IUD

Area of Science:

• Obstetrics and Gynecology
• Reproductive Health
• Medical Device Management

Background:

• Intrauterine devices (IUDs) are common contraceptives.
• Lost or misplaced IUDs can lead to complications and patient anxiety.
• Effective management strategies for 'lost' IUDs are crucial for patient care.

Purpose of the Study:

• To analyze the outcomes of managing patients presenting with 'lost' intrauterine devices (IUDs).
• To determine the location and methods of removal for misplaced IUDs.
• To evaluate the necessity of removing all extrauterine IUDs.

Main Methods:

• Retrospective analysis of 26 patient records with 'lost' IUDs at University College Hospital, Ibadan (1980-1982).
• Data collection on IUD insertion numbers, location (intrauterine vs. extrauterine), and removal procedures.
• Categorization of removal methods: Dilation and Curettage (D&C), laparoscopy, laparotomy, and colpotomy.

Main Results:

• Out of 3476 IUD insertions, 26 patients presented with 'lost' IUDs.
• Eighteen IUDs (69.2%) were intrauterine, with 17 (65.4%) removed by routine D&C.
• Eight IUDs (30.8%) were extrauterine, requiring surgical intervention (6 laparoscopy, 1 laparotomy, 1 colpotomy).

Conclusions:

• Routine D&C is effective for intrauterine IUD removal.
• Extrauterine IUDs necessitate surgical removal via laparoscopy, laparotomy, or colpotomy.
• Complete removal of all extrauterine devices is recommended to prevent associated psychosomatic symptoms.