http://dx.doi.org/10.5455/2320-1770.ijrcog20130607 Volume 2 · Issue 2 Page 147 International Journal of Reproduction, Contraception, Obstetrics and Gynecology Sinha M et al. Int J Reprod Contracept Obstet Gynecol. 2013 Jun;2(2):147-151 www.ijrcog.org pISSN 2320-1770 | eISSN 2320-1789 Research Article Minimally invasive surgical approach to retrieve migrated intrauterine contraceptive device Maruti Sinha 1 , Ridhima Gupta 2 *, Aruna Tiwari 1 INTRODUCTION Intrauterine devices (IUD) are popular, safe and convenient methods of long term reversible birth control. It is estimated that 100 million women worldwide are using IUD and it constitutes the most prevalent form of contraception method in India, after female sterilization. 1 Over the years multiple types of intrauterine devices (IUDs) were introduced and currently, most commonly used IUDs include TCu380A and levonorgesterol (Mirena) IUD. Various complications of IUDs include bleeding, infection, ectopic pregnancy and uterine perforation. Incidence of uterine perforation by an IUD, is reported to range from 0 - 1.3 per 1000 insertions. 2 IUD can erode the uterine wall and can migrate into adjacent pelvic structures like the bladder, bowel, peritoneum and appendix. 3 A case of migration of IUD even into iliac veins has been reported. 4 Such an event leads to tissue destruction, peritonitis, adhesion formation, intestinal obstruction and infertility. Diagnosis of migrated IUD is usually suspected in cases of unexplained lower abdominal pain and non-visualization of IUD string on speculum examination. 5 Surgical removal of displaced symptomatic IUD should be performed using minimally invasive approach. Herein, we report our experience with clinical presentation, diagnosis and management of six patients who presented with misplaced IUD. 1 Department of Obstetrics and Gynecology, Kasturba Hospital, Darya Ganj, New Delhi- 110002, India 2 Department of Obstetrics and Gynecology, Lutheran Medical Center, Brooklyn, New York- 11209, USA Received: 5 February 2013 Accepted: 22 March 2013 *Correspondence: Dr. Ridhima Gupta, E-mail: ridhimagupta.04@gmail.com © 2013 Sinha M et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Background: To present experience with clinical presentation, diagnosis and minimally invasive removal of migrated intrauterine contraceptive device (IUD). Methods: A total of 6 patients were included in retrospective study. Diagnosis was based on clinical presentation, TVS and Abdominopelvic X- ray. Minimally invasive approach was utilized to remove migrated IUD. Results: The mean (range) age of the patient was 36.6 (26-55) years. The mean (range) of parity was 3.5 (2-6). The mean (range) duration of IUD use was 8.1 (3-25) years. Five patients had TCu380A IUD. One patient had Lippes loop type of IUD. Three patients underwent laparoscopy, two had hysteroscopy and one had cystoscopy, for removal of IUD. The mean (range) operative time was 40.8 (18-76) mins. No anesthesia or surgery related complications were observed intraoperatively. The mean (range) duration of hospital stay was 34 (24-48) hours. The postoperative course was uneventful and all the patients were followed for 3-6 months period of time with no complaints. Conclusion: Removal of migrated IUDs is recommended in symptomatic and asymptomatic patients using minimally invasive approach. Keywords: Laparoscopy, Hysteroscopy, Cystoscopy, Intrauterine contraceptive device, Uterine perforation DOI: 10.5455/2320-1770.ijrcog20130607