Abstract
Purpose
To report three cases of migrated levonorgestrel intrauterine device (LNG-IUS) into the pelvic/abdominal cavity removed laparoscopically with the aid of preoperative computed tomography (CT) scan imaging.
Methods and results
Three patients presenting with a missing LNG-IUS on examination and pelvic ultrasound are presented. A preoperative CT scan was performed, what helped in a successful removal of the LNG-IUS. The patients were discharged home the same day of the procedure.
Conclusion
Our cases reinforce, besides the diagnosis of a migrated LNG-IUS by ultrasound, the fact that preoperative CT scan imaging assists in the diagnosis of the precise location of a migrated LNG-IUS into the pelvic/abdominal cavity and helps the physician in the prediction of the difficulty of the laparoscopic removal.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Dennis J, Hampton N (2002) IUDs: which device? J Fam Plann Reprod Health Care 28:61–68
Andersson K, Ryde-Blomqvist E, Lindell K, Odlind V, Milsom I (1998) Perforations with intrauterine devices. Report from a Swedish survey. Contraception 57:251–255
Ozgun MT, Batukan C, Serin IS, Ozcelik M, Basbug M, Dolanbay M (2007) Surgical management of intra-abdominal mislocated intrauterine devices. Contraception 75:96–100
Miranda L, Settembre A, Capasso P, Cuccurullo D, Pisaniello D, Corcione F (2003) Laparoscopic removal of an intraperitoneal translocated intrauterine contraceptive device. Eur J Contracept Reprod Health Care 8:122–125
Demir SC, Cetin MT, Ucünsak IF, Atay Y, Toksöz L, Kadayifçi O (2002) Removal of intra-abdominal intrauterine device by laparoscopy. Eur J Contracept Reprod Health Care 7:20–23
Markovitch O, Klein Z, Gidoni Y, Holzinger M, Beyth Y (2002) Extrauterine mislocated IUD: is surgical removal mandatory? Contraception 66:105–108
Speroff L, Glass RH, Kase NG (1994) The intrauterine device. Clinical gynecologic endocrinology and infertility, 5th edn. Williams & Wilkins, Baltimore, pp 777–789
Serryan RFM (1989) Endoscopic removal of intrauterine contraceptive devices. State of the art of the IUD, 1st edn. Kluwer, London, pp 173–177
Caliskan E, Ozturk N, Dilbaz BO, Dilbaz S (2003) Analysis of risk factors associated with uterine perforation by intrauterine devices. Eur J Contracept Reprod Health Care 8:150–155
WHO (1987) WHO mechanism of action, safety, and efficacy of intrauterine devices. Geneva World Health Organization, Geneva, pp 48–63
Ortiz ME, Croxatto HB (2007) Copper-T intrauterine device and levonorgestrel intrauterine system: biological bases of their mechanism of action. Contraception 75:S16–S30
Rosenblatt R, Zakin D, Stern WZ, Kutcher R (1985) Uterine perforation and embedding by intrauterine device: evaluation by US and hysterography. Radiology 157:765–770
Richardson ML, Kinard RE, Watters DH (1982) Location of intrauterine devices: evaluation by computed tomography. Radiology 142:690
ACOG Committee Opinion No. 299, September 2004. Guidelines for Diagnostic Imaging During Pregnancy
Bansal N, Herzog TJ, Brunner-Brown A, Wethington SL, Cohen CJ, Burke WM, Wright JD (2008) The utility and cost effectiveness of preoperative computed tomography for patients with uterine malignancies. Gynecol Oncol 111:208–212
Peri N, Graham D, Levine D (2007) Imaging of intrauterine contraceptive devices. J Ultrasound Med 26:1389–1401
Conflict of interest statement
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Mahmoud, M.S., Merhi, Z.O. Computed tomography-assisted laparoscopic removal of intraabdominally migrated levonorgestrel-releasing intrauterine systems. Arch Gynecol Obstet 281, 627–630 (2010). https://doi.org/10.1007/s00404-009-1149-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00404-009-1149-2