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Ultrasound-guided retrieval of lost intrauterine devices using very fine grasping forceps: a case series

Moro, F; Knez, J; Pateman, K; Derdelis, G; Foo, X; Jurkovic, D; (2015) Ultrasound-guided retrieval of lost intrauterine devices using very fine grasping forceps: a case series. Journal of Family Planning and Reproductive Health Care , 41 (3) pp. 205-209. 10.1136/jfprhc-2014-101088. Green open access

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Abstract

Aim: To assess the efficacy of a novel ultrasound-guided procedure for the retrieval of intrauterine contraceptive devices (IUDs) when the threads are not visible at the external cervical os (‘lost threads’). / Methods: This was a prospective cohort study of consecutive women referred for ultrasound examination because of lost IUD threads. The procedures were performed under local anaesthesia in the outpatient setting. After injection of local anaesthetic, the anterior cervical lip was grasped with a vulsellum forceps. A 5Fr hysteroscopy grasping forceps was introduced transcervically into the uterine cavity under continuous transabdominal ultrasound guidance. The IUD was then grasped and removed from the uterus. Patients’ demographic data, gynaecological history, ultrasound findings, duration of procedure, success rate and pain score were recorded. / Results: Twenty-three consecutive women were included in the study. Ultrasound examination showed an IUD correctly sited in the centre of the uterine cavity in 20/23 (87%), in 2/23 (9%) it was partially embedded in the myometrium and in 1/23 (4%) the IUD was partially sited in the cervical canal. In 8/23 (35%) women the IUD threads were not visible on ultrasound scan. Removal of the IUD was successful in 22/23 (96%) cases with a median operating time of 3 (interquartile range 1.25–4.75) minutes. 15/23 (65%) women experienced no or minimal pain (pain score ≤3), 4/23 (17%) reported moderate pain (pain score 4–6) and 4/23 (17%) described the pain as severe (pain score 7–10). No complications were recorded during or immediately after the procedure. / Conclusions: Ultrasound-guided retrieval of lost IUDs using fine hysteroscopy grasping forceps is a highly successful technique and is well tolerated by women.

Type: Article
Title: Ultrasound-guided retrieval of lost intrauterine devices using very fine grasping forceps: a case series
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/jfprhc-2014-101088
Publisher version: http://dx.doi.org/10.1136/jfprhc-2014-101088
Language: English
Additional information: This article has been accepted for publication in Journal of Family Planning and Reproductive Health Care following peer review. The definitive copyedited, typeset version is available online at: http://dx.doi.org/10.1136/jfprhc-2014-101088.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health > Reproductive Health
URI: https://discovery.ucl.ac.uk/id/eprint/1462927
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