Management of missing intrauterine device strings and migrated intrauterine devices

The purpose of this review is to review the recent literature with respect to the management of missing intrauterine device (IUD) strings. As IUD use has increased over time, it is important to review management options for this uncommon but possible complication.

This article will cover stepwise approaches to management of missing IUD strings based on the most recent literature. Initial steps include obtaining history and using in office tools to reveal IUD strings. Subsequent steps focus on imaging guidelines including obtaining transvaginal ultrasound when available. Finally, IUD removal with tools for uterine instrumentation are discussed, focusing on using tools that do not require cervical dilation and allow for grasping of the device.

This paper details a stepwise approach to the management of missing IUD strings which, as discussed in the article, may become more frequent given the rise of IUD use in general and postpartum placement in specific.