Re: Lost IUD

From: Joanne Bulley, MD (islesannie@gmail.com)
Tue Mar 27 19:42:21 2007


I instruct all my patients about checking fo rthe string ... but in my 25+ years in the business - the majority check for about a week - maybe until the first menses then it quickly drops off to no checking whatsoever. If it were NY contraception I would want to check it.

It was interesting when I had a patient from China - who got the IUD after that first delivery: It was meant to never be removed. No string. She was here with a USA husband and they wanted a child. I checked by Us and there was something in the Uterus. I did a hysteroscopy - as there was nothing that was able to be snagged with the IUD hook. It was like the spring of a ball point pen - or a slinky - in a single circle. Grabbed it with a grasper through the h-scope and pulled it out. She conceived the first cycle after removal.

Joanne

At Tue, 27 Mar 2007, Jamie wrote: >
>I need one of those!!! Why are kids so fascinated with flushing thing?
>
>re the patient-you'd be surprised how unfamiliar some women are with
>their anatomy and what's going on with it. I would hope she's been
>checking for the string, but I wouldn't be at all shocked that an IUD
>could be flushed down the toilet and never seen.
>
>At Mon, 26 Mar 2007, ainsron 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
>>
>--
>JFields, RN, BSN
>

--
Joanne Bulley, MD, FACOG
Solo gyn
Keene, NH USA




use when must restrict search to only the ob-gyn-l forum...
Enter search keywords:
Returns per screen: Require all keywords:

Return to  OB-GYN-L Mail a New Message to the Forum: ob-gyn-l@obgyn.net
Forum Administrator: geffrey.klein@obgyn.net
Report Technical Problems: webmaster@obgyn.net
Last Updated: Wed Jul 2 04:46:14 2008

The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.