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Retained IUCD

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Overview:

Intra-uterine devices are one of the most cost effective contraceptives which are reversible as well as highly efficient.  It is a small t-shaped device which is made of plastic which is placed in the patient’s uterus.

The patient may want to remove the IUD to for several reasons; one of the most common being desire for pregnancy. Other reasons include side effects such as side effects and pain, device related issues or fear and misconceptions. Expiration of the IUCD is also one of the major causes.


Removal Procedure:

If the device is still in its position and the doctor can find the strings to remove the IUCD then a routine procedure is followed to remove the IUCD. If the IUCD cannot be removed by  a routine procedure then the doctor may remove it with the help of a hysteroscopy.

Following is the procedure for routine removal of IUCD:

  • The doctor will ask you to lie down in the position one takes during a pelvic exam .
  • Then the doctor will insert a speculum through your vaginal opening to widen it.
  • The doctor will look for the strings of the IUCD which are normally approachable near the cervix.
  • Then the doctor will remove the IUCD steadily and remove the speculum as well.

 


Hysteroscopic  Removal:

If the doctor cannot find the strings or the IUCD is not in its original place then a hysteroscopy may be required. The doctor may perform imaging tests to determine the position prior to the hysteroscopy. The doctor may administer anesthesia before performing  hysteroscopy.

Following is the procedure

  • The doctor will use a speculum to widen the cervix.
  • After which the hysteroscope is passed into the womb, this may cause some cramping.
  • Fluid is pumped into the uterus, so that the surgeon can see things clearly.
  • The hysteroscope relays images to a monitor, which helps the doctor to identify the position of the IUCD and how to remove it.
  • The IUCD is removed and the speculum too.
  • Doctor checks for any damage.

Outcome:

Hysteroscopic Resection: Septum resection is performed with hysteroscopy. Hysteroscopy is an outpatient procedure in which the doctor inserts a small and lighted instrument called the hysteroscope into the patient’s vaginal opening. This instrument relays video to a monitor, where the doctor can inspect the organs in the pelvic area. A liquid is pumped gently so that the doctor can examine organs clearly. The doctor passes the surgical instrument along with the hysteroscope.  The septum is resected, thus increasing the area where the fertilized egg can implant itself.