[Laparoscopic removal of intraperitoneal IUD: analytical study of 23 cases]

A retrospective study was conducted of 23 cases of laparoscopic surgery for removal of migrating copper IUDs performed between January 1990 and September 1996 at a hospital in Tunis. The average patient age was 27 years. The procedure lasted 56 minutes on average (range 15-260 minutes). The displacement of the IUD was usually noted during routine monitoring. In 6 cases the discovery was prompted by abdominal pain; in 2 cases by metrorrhagia. The uterine perforation was asymptomatic in 15 women. The problems encountered resulted from adhesions and impacting of the IUD in the rectal wall. The direct visualization possible with the laparoscope permitted complete examination of lesions removal of adhesions and control of hemostasis. The improvement of laparoscopic surgical techniques permits removal of migrating IUDs and avoidance of laparotomy in almost all cases.