Re: Lost IUD
From: R. Daniel Braun (rd.braun@gmail.com)
Tue Mar 27 17:59:24 2007
No, just a Novak curette.
Dan
On 3/27/07, Harrison Sheld <hsheld@vwestm.net> wrote:
>
> Mon ami, easy to put the Birnberg Bow in, but getting it out you needed
> a piano tuner.
>
> R. Daniel Braun wrote:
> > You beat me by 2 years, I inserted my first one in 1964 as an intern.
> > It was a Birnberg Bow.
> >
> > Dan
> >
> > On 3/27/07, *Atkinson, Samuel M* <ATKINSONS@ecu.edu
> > <mailto:ATKINSONS@ecu.edu>> wrote:
> >
> > If you don't see it with ultrasound then it is likely in the sewer
> > system. If it was still in the uterus she would in all likelihood be
> > having scant or no menses. Using the withdrawal technique for
> > insertion
> > of Mirena makes it highly unlikely that a perforation has occurred
> and
> > even less likely to be intraperitoneal. I would deplore anything
> > except
> > a flat plate. If it isn't there it ain't there. An intraperitoneal
> > insertion of a Mirena is somewhat unprecedented. Spontaneous
> > passage in
> > a menstrual clot is common. As an aside, copper IUD's are highly
> > inflammatory in the peritoneal cavity and adhere to most everything.
> > Removal with a laparoscope is difficult and laparotomy is usually
> > required. Copper IUD's should be removed. There is debate as to
> > whether
> > a Mirena even needs to be removed if in the peritoneal cavity as
> > it has
> > no copper. The minute amount of progesterone secretion in the
> abdomen
> > would not prevent pregnancy nor affect it.
> > PS: I inserted my first IUD's in 1962. My latest was two weeks ago
> (a
> > Mirena). My only publications were about the Dalkon Shield and I
> > testified in numerous class action claims about it.
> > sAm
> >
> > -----Original Message-----
> > From: ob-gyn-l@obgyn.net <mailto:ob-gyn-l@obgyn.net>
> > [mailto:ob-gyn-l@obgyn.net <mailto:ob-gyn-l@obgyn.net>] On Behalf
> > Of Garry
> > E. Siegel, M.D.
> > Sent: Monday, March 26, 2007 7:17 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
>
--
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
