title: Early hysteroscopic removal of intratubal microinserts with urologic stone retrieval forceps.
abstract: BACKGROUND
  Nickel hypersensitivity reactions can be an indication for the removal of intratubal microinserts used for hysteroscopic sterilization. Although early removal can be attempted hysteroscopically, hysteroscopic grasping forceps may be inadequate to grasp deeply positioned inserts.
  
  
  METHODS
  Three days after hysteroscopic sterilization, the patient presented with a rash consistent with a nickel hypersensitivity reaction. Ten days after placement, we successfully performed hysteroscopic removal of an intratubal microinsert with tri-prong urologic stone retrieval forceps after standard hysteroscopic grasping forceps was unable to reach the deeply positioned device. Within 36 hours of bilateral microinsert removal, all symptoms resolved.
  
  
  CONCLUSIONS
  In difficult cases, 1-mm tri-prong urologic stone retrieval forceps can be useful for early hysteroscopic removal of intratubal microinserts.
authors.affiliation: Division of Family Planning, Department of Obstetrics and Gynecology, University of Colorado Denver School of Medicine, Aurora, Colorado.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Goldthwaite
authors.forename: Lindsay
authors.initials: L
authors.lastname: Edwards
authors.forename: Kristina
authors.initials: K
authors.lastname: Tocce
mesh_terms: D020878:Device Removal / Q000295:instrumentation*; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000209:etiology / Q000601:surgery*; D015907:Hysteroscopy / Q000295:instrumentation*; D008875:Middle Aged; D009532:Nickel / Q000276:immunology*; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery*; D013246:Sterilization, Tubal / Q000295:instrumentation*
chemical_list: D009532:Nickel