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Re: Lost IUD From: R. Daniel Braun (rd.braun@gmail.com) Mon Mar 26 20:28:00 2007 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: R. Daniel Braun: "Re: Gyn: Lost IUD" Previous message: Schaffer Trenton: "Tonia went to check out this lucky link" In reply to: ainsron: "Re: Lost IUD" Next in thread: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Lost IUD" Reply: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Lost IUD" Mirena's don't show up very well on flat plate especilly if she has a high BMI US is acutally the method of choice. If she is not obese and you don't see it on U/S, it ain't in the uterus. So she has alreaady had all the imaaging tht she needs, Since mirena does not have any closed loops or copper, it really doesn't need to be removed from abdominal cavity. So don't worry about it, except that she needs contraception. Vast majority will have been expelled undetected. Those that perf ute happen at insertion and are almost always associated with severe cramping during the insertion. Dan On 3/26/07, ainsron <ainsron@sbcglobal.net> wrote: > > I would do a flat plate first, if you don't see it there, you aren't going > to find it on laparoscopy. Did she ever check the string after insertion? > It probably went down the toilet. Saw a great commercial on the new > Kohler > toilets the other night. A guy saw a good looking plumber (female) next > door and tried to plug up his Kohler toilet with anything he could throw > (towels, coins, etc.) in it. Nothing worked, so she got away. > > Ronald E. Ainsworth, MD, FACOG > > -----Original Message----- > From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Garry E. > Siegel, M.D. > Sent: Monday, March 26, 2007 4:16 PM > To: Multiple recipients of list OB-GYN-L > Subject: Gyn: Lost IUD > > 25 YO P1001 with a Mirena of around one year's duration, came in for > removal. No string seen, and on exploring the uterus with an IUD hook, > well, no IUD found. > > Ultrasound did NOT find her IUD, so it is lost. > > I have recommended H-scope/lapscope to find it, but she has asked about > having a CT first. Actually, I hadn't thought of that, and it seems > that a plain X-ray may be even the better first choice. > > My real questions is: Is there any role for imaging? My instinct says we > simply need to go to the OR, as she couldn't have expelled it and not > known it, I wouldn't think. That said, if it is up under her diaphagm. > . . > > Garry > > -- > Garry E. Siegel, M.D. > Private Practice > Roswell, GA > -- R. Daniel Braun, MD FACOG(L) CMT Professor Emeritus Dept. of Obstetrics and Gynecology Indiana U. School of Medicine R. Daniel Braun "The way to health is an aromatic bath and scented massage everyday". Hippocrates Next message: R. Daniel Braun: "Re: Gyn: Lost IUD" Previous message: Schaffer Trenton: "Tonia went to check out this lucky link" In reply to: ainsron: "Re: Lost IUD" Next in thread: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Lost IUD" Reply: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Lost IUD"

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