Operative management of intrauterine device complications: a case series report.
BACKGROUND
There is limited information about the number of intrauterine device (IUD) users requiring operative intervention for device-related complications. This is an evaluation of cases requiring in-hospital operative intervention for IUD perforations, removals and pregnancy-related complications.


METHODS
Large retrospective case series of patients who received operative management of IUD complications.


RESULTS
Charts of patients from 15 hospitals in two health care systems from 2000 to 2007 were reviewed and outcomes of 276 women are reported. There were 95 operative IUD removals for perforations (including 60 levonorgestrel-releasing intrauterine systems), 157 operative procedures for inability to remove an IUD in the office, and 42 pregnancy-related complications that were managed in the operating room. Ectopic pregnancy was the most common diagnosis among pregnant women (23 of 42 pregnant women, 54.8%).


CONCLUSIONS
The majority of operative procedures were performed for intrauterine IUDs, most of which were appropriately positioned IUDs with missing or short strings. In-office techniques for obtaining analgesia and dilation as well as appropriate devices for removal of T-shaped IUDs should make this practice rare.
Turok
David K
DK
University of Utah, Department of Obstetrics and Gynecology, Salt Lake City, UT 84132, USA.
Gurtcheff
Shawn E
SE
Gibson
Keri
K
Handley
Erin
E
Simonsen
Sara
S
Murphy
Patricia A
PA
D000328:Adult; D020878:Device Removal; D005260:Female; D005831:Genital Diseases, Female / Q000209:etiology / Q000601:surgery; D013509:Gynecologic Surgical Procedures / Q000706:statistics & numerical data*; D006801:Humans; D007434:Intrauterine Devices / Q000009:adverse effects*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology / Q000601:surgery; D012189:Retrospective Studies; D014595:Uterine Perforation / Q000209:etiology / Q000601:surgery