Laparoscopic removal of intrauterine devices with retracted threads.

ABSTRACT

PIP: From 1980-1985, 16 women between the ages of 24 and 47 years old were referred to the gynecology department of Saint Maria Hospital in Vejle, Denmark, because their IUDs could not be seen on cervical inspection; the threads had become retracted, and attempts by their physicians to remove the IUDs had failed. 7 of the devices were Multiloads, 7 were Nova Ts, and 2 were Gravigards. Ultrasonic scanning resulted in correct identification of the IUD in 12 patients. In the 4 cases in which the IUD was not visible on scanning, roentgenograms of the whole abdomen in 2 planes were obtained, and the IUD was easily identified. In 2 patients, the IUD was removed when dilation and curettage was carried out. In 9 cases the IUD could be removed with hysteroscopy, in 4 with laparoscopy, and in 1 with laparotomy. 2 of the IUDs were found intramurally, and 7 were in the uterine cavity. If an IUD with retracter thread is located within the uterus of intramurally, hysteroscopic removal is advisable; if it is located intraabdominally, laparoscopic removal in recommended.