Missing intrauterine devices, laparoscopic and a conventional management: A single–center experience

INTRODUCTION: Intrauterine contraception devices (IUCD) are frequently and safely used in pregnancy control. Migration related complications, such as adhesions and perforations, can be encountered as the most important but rare circumstances. In such cases, the laparoscopic approach is beneficial with the least harm principle.
METHODS: This study included ten patients who were admitted to our hospital between 2015–2019 with chronic abdominal pain, induced by migrated intrauterine devices. Patients’ complaints, radiological methods used in diagnosis, IUCD insertion timing, migration of IUCD and time interval to diagnosis, intra–abdominal migration points, and types, as well as surgical interventions, were evaluated retrospectively.
RESULTS: While all patients were diagnosed with abdominal ultrasonography and gynecological examination, some patients underwent computed tomography 60% and plain radiogram 20% as additional imaging. While the intra–abdominal migration site of IUCD was ascertained as the most common localization in the lower right quadrant of the omentum (30%), the placement in the umbilical hernia site was the rarest and the only one in the literature. Three different types of IUCD were detected; Copper–T (80%) was the most common, while IUCDs were laparoscopically removed in all patients except for the patient who underwent open surgery due to acute cholecystitis. All patients who had laparoscopic surgery were discharged the next day.
DISCUSSION AND CONCLUSION: In conclusion, the IUCD’s frequency of use is increasing as the current method of contraception, dislocation of the device may be encountered if the required conditions are not taken into consideration during the application. In such a situation, laparoscopic removal of a dislocated IUCD is a safe, feasible, and less invasive method.