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Intrauterine device extraction through laparoscopic hysterotomy.

Francesc Simó Alari¹, Israel Gutierrez¹

¹General and Gynaecological Surgery, Centre Hospitalier du Val d'Ariège, Saint Jean de Verges, France.

The European Journal of Contraception & Reproductive Health Care : the Official Journal of the European Society of Contraception

|January 18, 2021

Summary

Laparoscopic surgery successfully removed a long-term retained intrauterine device (IUD) in a patient with a fibrosed cervix who refused hysteroscopy. This minimally invasive approach offers an alternative for complex IUD removal cases.

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Area of Science:

Gynecology
Minimally Invasive Surgery

Background:

Intrauterine devices (IUDs) are common contraceptives, but retained devices can pose health risks.
Removal can be challenging, especially with complications like cervical fibrosis.

Observation:

A 52-year-old woman presented with a retained IUD of over 10 years and a completely fibrosed cervical canal, precluding standard removal attempts.
The patient refused hysteroscopic removal or hysterectomy.

Findings:

A laparoscopic approach with uterine conservation was successfully performed via hysterotomy.
The procedure involved electrocautery for incision and intracorporeal stitches for closure, with the patient discharged within 48 hours.
Six-month follow-up showed no scar complications.

Keywords:

Intrauterine device hysterotomy laparoscopy

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Implications:

Laparoscopy can be a viable alternative for complex intrauterine device (IUD) removal when standard methods fail or are refused.
This case highlights the adaptability of minimally invasive techniques in gynecological procedures.
Uterine conservation is achievable even in challenging IUD extraction scenarios.