Lost levonorgestrel IUD: Diagnosis and therapy

Shmuel Nitke, David Rabinerson, Arie Dekel, Eyal Sheiner, Boris Kaplan, Rinat Hackmon

    Research output: Contribution to journalArticlepeer-review

    26 Scopus citations

    Abstract

    A lost intrauterine device (IUD) is an uncommon event. Recently, a new levonorgestrel-releasing intrauterine system was introduced. In view of several cases of an unusual diagnostic discrepancy in the location of a lost levonorgestrel-releasing IUD in our department, we sought to determine if the extrauterine location of lost levonorgestrel-releasing IUDs differs from that of lost copper IUDs. The medical files of all patients with a diagnosis of lost IUD who were admitted to Rabin Medical Center from 2000 to 2003 were reviewed. Fourteen women were identified, 9 with levonorgestrel-releasing IUDs and 5 with copper IUDs. In six of the nine cases of a lost levonorgestrel-releasing IUD, there was a clear discrepancy between the presumed location of the device by diagnostic evaluation and its actual location on surgical extraction. All six devices were embedded in the omentum; four were located in the upper abdomen. No such discrepancies were noted for the copper IUDs (0 vs. 66%, p < 0.05). No significant difference in peritoneal adhesions was noted between the groups (55% vs. 66%, respectively, p = 0.095). It is concluded that lost levonorgestrel-releasing IUDs are associated with a higher rate of localization errors by clinical evaluation than copper IUDs. Lost levonorgestrel-releasing IUDs might be found in the mid-upper abdomen, embedded in omentum tissue, and this area should be explored first during laparoscopy.

    Original languageEnglish
    Pages (from-to)289-293
    Number of pages5
    JournalContraception
    Volume69
    Issue number4
    DOIs
    StatePublished - 1 Apr 2004

    Keywords

    • Diagnostic discrepancy
    • Lost levonorgestrel-releasing IUD
    • Peritoneal adhesions

    ASJC Scopus subject areas

    • Reproductive Medicine
    • Obstetrics and Gynecology

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