April 18th, 2014

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Title:
Translocated Intrauterine Contraceptive Device: Experiences of Two Medical Centers with Risk Factors and the Need for Surgical Treatment
Authors:  Hatice Ender Soydinc, M.D., Mehmet Siddik Evsen, M.D., Fatmanur Çaça, M.D., Muhammet Erdal Sak, M.D., Mehmet Zeki Taner, M.D., and Sibel Sak, M.D.
  OBJECTIVE: To present experiences of 21 patients with a translocated intrauterine contraceptive device (IUD) who required surgical treatment and to discuss the diagnosis, surgical management, and complications of such cases.

STUDY DESIGN: The cases of 21 patients who were hospitalized with the diagnosis of translocated IUD and had surgical treatment were analyzed retrospectively.

RESULTS: The mean age of the patients was 25.7 (range, 20–35). Of the 21 patients, 17 (81%) were in puerperium. IUDs were inserted by trained midwife nurses in 17 cases (81%). Severe lower abdominal pain was reported by 16 patients (76%) during the insertion procedure. At the time of diagnosis, 13 patients (62%) presented with lower abdominal pain. Surgical treatments included laparoscopic surgery (67%), laparotomy, colpotomy, and hysteroscopy. All of the removed IUDs were TCu-380A models. The most frequent complication due to translocation of the IUD was pelvic abscess (38%).

CONCLUSION: The incidence of IUD translocations was significantly high in the puerperal period and for insertions performed by educated midwife nurses. Uterine perforation must be taken into consideration when there are complaints of unusually severe abdominal pain during the insertion procedure. Surgical treatment is necessary because of the potential complications of extracavitary IUDs.
Keywords:  intrauterine devices, IUD migration, laparoscopy, uterine perforation
   
   
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