Diagnosis and treatment of missing IUDs by hysteroscopy

The authors used an XG-3 bent tube type hysteroscope and grasping forceps on 35 patients with missing IUDs who had previously undergone unsuccessful dilation and curettage as many as 3 times in order to retrieve the lost IUDs. Hysteroscopic examination alone or in combination with other methods were used. Distension of the uterine cavity was accomplished by a 5% dextrose solution in water. IUD types and hysteroscopic visualization in the 35 cases with missing IUDs are displayed in tabular form. Of the 35 cases in this group abnormal IUDs or their broken pieces were removed by grasping forceps in 19 cases and by miniature hood in 2 cases under hysteroscopic control. After locating the IUDs hy hysteroscopy the missing IUDs were removed by Kellys forceps in 6 cases and by laparotomy in 4. Results are also displayed in tabular form. There was a case of submucus myoma hitched by the metallic contraceptive ring. An IUD was found to be completely broken up inside the uterine cavity in 1 case and the bulk of the broken transversal arm of a T-type IUD was embedded in the myometrium with a small tip projecting into the uterine cavity in another case. All of these were removed by grasping forceps during hysteroscopy. The abovementioned data show that hysteroscopy has been proven a useful technique particularly in the management of patients with broken and/or embedded pieces of IUD in the uterine cavity. (authors modified) (summary in ENG)