title: IUD String Perforation Through Anterior Cervix: A Case Report.
abstract: BACKGROUND
  Intrauterine devices are increasingly the preferred method of contraception chosen by Canadian women. IUD strings are commonly not visible at follow-up, but rarely are visible yet not located within the endocervical canal. We report a case of IUD strings perforating the ectocervix.
  
  
  METHODS
  An asymptomatic, 26-year-old woman presented for removal of her levonorgestrel-releasing intrauterine system, over a year following insertion of the device. Upon examination the IUD strings were found to be emerging from within the cervical tissue, 10 mm above the external os.
  
  
  CONCLUSIONS
  We discuss removal techniques, review the literature, and examine possible reasons for this presentation. These techniques may interest a range of practitioners managing contraceptive care for women.
authors.affiliation: Department of Family Practice, University of British Columbia, Vancouver BC; Women's Health Research Institute, Contraception Access Research Team, British Columbia Women's Hospital, Vancouver BC.
authors.forename: Wendy V
authors.initials: WV
authors.lastname: Norman
authors.affiliation: Women's Health Research Institute, Contraception Access Research Team, British Columbia Women's Hospital, Vancouver BC.
authors.forename: Danielle
authors.initials: D
authors.lastname: Stothart
mesh_terms: D000328:Adult; D002584:Cervix Uteri / Q000293:injuries / Q000601:surgery; D003271:Contraceptive Agents, Female / Q000627:therapeutic use; D020878:Device Removal / Q000379:methods*; D005260:Female; D006801:Humans; D007436:Intrauterine Devices, Medicated / Q000009:adverse effects*; D016912:Levonorgestrel / Q000627:therapeutic use*; D016896:Treatment Outcome; D014595:Uterine Perforation / Q000175:diagnosis / Q000209:etiology / Q000601:surgery
chemical_list: D003271:Contraceptive Agents, Female; D016912:Levonorgestrel
keywords: IUD; IUS; anterior cervical lip; intrauterine device; intrauterine system; levonorgestrel-releasing IUS; missing IUD; missing IUD strings; strings; threads