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Re: Gyn: Lost IUD From: R. Daniel Braun (rd.braun@gmail.com) Mon Mar 26 20:33:39 2007 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: DoctorJoe@aol.com: "Re: Gyn: Lost IUD" Previous message: R. Daniel Braun: "Re: Lost IUD" In reply to: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Gyn: Lost IUD" Next in thread: Gordon Goldman: "Re: Gyn: Lost IUD" Reply: Gordon Goldman: "Re: Gyn: Lost IUD" As a general rule foreign bodies, that enter the peritoneal cavity, migrate to the LUQ. The copper bearing ones usually cause enough adhesions to stop this, but if there aren't many adhesions, that is where I would expect to find a Mirena. Many years ago, I removed a Plastic banana from the left upper quadraant of a patient who had insertit through the cul-de-sac during sexual activity. Dan On 3/26/07, Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C. < johnprov@sympatico.ca> wrote: > > At Mon, 26 Mar 2007, Garry E. Siegel, M.D. wrote: > > > >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 > > > > I have had a few of these over the years, but only just recently saw one > with mirena IUD, I have sent her for U.S. and she will get a flat plate > after her BHCG is negative. Most of the copper T's I usually found in > the cul-de sac or pelvic side wall. The problem with the mirena is that > if it is sitting in the cul-de sac or side wall the amenorrehea and > contraceptive effect will persist. Indeed the one I just saw wants to > get pregnant and this is unlikely to happen if it is sitting in the > cul-de sac so unless the flat plate shows nothing I will have to remove > it. In the past I would not necessarily remove it unless I was doing a > laparscopy for tubal factor infertility, I would just advise them they > could get pregnant and to use other contraception. > > -- > Take care, John > -- 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: DoctorJoe@aol.com: "Re: Gyn: Lost IUD" Previous message: R. Daniel Braun: "Re: Lost IUD" In reply to: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Gyn: Lost IUD" Next in thread: Gordon Goldman: "Re: Gyn: Lost IUD" Reply: Gordon Goldman: "Re: Gyn: Lost IUD"

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