Department of Obstetrics and Gynecology, Meram Medicine Faculty, Selcuk University, 42080, Konya, Meram, Turkey.
Arch Gynecol Obstet. 2010 Jun;281(6):1019-22. doi: 10.1007/s00404-010-1374-8. Epub 2010 Feb 16.
To evaluate the predisposing factors, diagnosis and surgical treatment options of patients with intra-abdominal, mislocated intrauterine devices (IUDs).
The diagnosis and management of 18 patients with intra-abdominal, mislocated IUDs were analyzed in this retrospective study.
Trained midwives inserted ten (55%) of the IUDs, while six (33%) were inserted by general practitioners and two (11%) by specialist gynecologists. Ten (55.5%) of the patients were diagnosed by gynecological examination and ultrasonography (USG); abdominal X-ray, in addition, was required in the other eight (44.4%). Eleven patients (61%) were managed by laparoscopy, whereas laparotomy was required in seven (39%). For all patients, laparoscopy was performed initially. No complication was encountered in any of the patients.
Persons who insert IUDs should receive adequate training before certification, because inadequate pelvic examination before insertion and inexperience of the inserting person might be predisposing factors for uterine perforation. If IUD strings are not visible during gynecologic examination, USG should be tried to locate the IUD and pelvic X-ray used only when USG fails to locate the IUD. Laparoscopy can be the first choice for removal.
评估腹腔内异位宫内节育器（IUD）患者的易患因素、诊断和手术治疗选择。
本回顾性研究分析了 18 例腹腔内异位 IUD 患者的诊断和处理。
10 例（55.5%）患者经妇科检查和超声检查（USG）诊断；另外 8 例（44.4%）还需要进行腹部 X 线检查。11 例（61%）患者通过腹腔镜治疗，7 例（39%）需要剖腹手术。所有患者最初均行腹腔镜检查。患者均未出现并发症。
在获得认证之前，放置 IUD 的人员应接受充分的培训，因为在放置前进行不充分的盆腔检查以及放置人员经验不足可能是子宫穿孔的易患因素。如果在妇科检查中看不到 IUD 线，应尝试使用 USG 定位 IUD，仅在 USG 无法定位 IUD 时才使用盆腔 X 线。腹腔镜检查可以作为首选的取出方法。
