title: Minimally invasive approach to cases of lost intra-uterine device: a 7-year experience.
abstract: OBJECTIVE
  To evaluate the effectiveness of hysteroscopy and laparoscopy for diagnosis and treatment in women with lost intra-uterine devices (IUDs), and to elucidate the most common extra-uterine locations of lost IUDs.
  
  
  METHODS
  Retrospective clinical study at Atatürk University Hospital, Erzurum, Turkey. Women with lost IUDs presenting in the last 7 years were referred to the obstetrics and gynaecology clinics. Women whose lost IUDs were removed using a Novak curette were excluded from the study.
  
  
  RESULTS
  Of the 55 cases studied, 29 (52.7%) lost IUDs were located inside the uterine cavity, 23 (41.8%) were located outside the uterine cavity, and three (5.5%) were embedded in the myometrium. The most common extra-uterine location of lost IUDs was around the uterosacral ligaments (n=8, 34.7%). Considerable association was found between the position of the uterus and the extra-uterine location of lost IUDs. In all eight cases where the lost IUD was located around the uterosacral ligaments, the uterine position was anteverted and perforation was found on the posterior side of the uterus. IUD removal was performed successfully in 46 women (83.6%) by either hysteroscopy or laparoscopy.
  
  
  CONCLUSIONS
  Lost IUDs inside or outside the uterine cavity can be managed by minimally invasive approaches. If an anteverted uterus is seen on laparoscopy, the initial exploration for the lost IUD should be made around the uterosacral ligaments.
authors.affiliation: Department of Obstetrics and Gynaecology, Ankara Oncology Hospital, Ankara 06160, Turkey.
authors.forename: Kadir
authors.initials: K
authors.lastname: Cetinkaya
authors.forename: Yakup
authors.initials: Y
authors.lastname: Kumtepe
authors.forename: Metin
authors.initials: M
authors.lastname: Ingec
mesh_terms: D000328:Adult; D005260:Female; D006785:Hospitals, University; D006801:Humans; D015907:Hysteroscopy; D058736:Intrauterine Device Migration / Q000009:adverse effects; D010535:Laparoscopy; D008022:Ligaments; D008499:Medical Records; D008875:Middle Aged; D009215:Myometrium; D010044:Outpatient Clinics, Hospital; D012189:Retrospective Studies; D014421:Turkey; D014595:Uterine Perforation / Q000209:etiology; D014599:Uterus; D055815:Young Adult