Department of Obstetrics and Gynaecology, Ankara Oncology Hospital, Ankara 06160, Turkey.
Eur J Obstet Gynecol Reprod Biol. 2011 Nov;159(1):119-21. doi: 10.1016/j.ejogrb.2011.07.003. Epub 2011 Aug 6.
To evaluate the effectiveness of hysteroscopy and laparoscopy for diagnosis and treatment in women with lost intra-uterine devices (IUDs), and to elucidate the most common extra-uterine locations of lost IUDs.
Retrospective clinical study at Atatürk University Hospital, Erzurum, Turkey. Women with lost IUDs presenting in the last 7 years were referred to the obstetrics and gynaecology clinics. Women whose lost IUDs were removed using a Novak curette were excluded from the study.
Of the 55 cases studied, 29 (52.7%) lost IUDs were located inside the uterine cavity, 23 (41.8%) were located outside the uterine cavity, and three (5.5%) were embedded in the myometrium. The most common extra-uterine location of lost IUDs was around the uterosacral ligaments (n=8, 34.7%). Considerable association was found between the position of the uterus and the extra-uterine location of lost IUDs. In all eight cases where the lost IUD was located around the uterosacral ligaments, the uterine position was anteverted and perforation was found on the posterior side of the uterus. IUD removal was performed successfully in 46 women (83.6%) by either hysteroscopy or laparoscopy.
Lost IUDs inside or outside the uterine cavity can be managed by minimally invasive approaches. If an anteverted uterus is seen on laparoscopy, the initial exploration for the lost IUD should be made around the uterosacral ligaments.
评估宫腔镜和腹腔镜检查用于诊断和治疗宫内节育器（IUD）丢失的有效性，并阐明丢失的 IUD 最常见的子宫外位置。
土耳其埃尔祖鲁姆阿塔图尔克大学医院的回顾性临床研究。在过去 7 年中，将有 IUD 丢失的女性转诊到妇产科诊所。使用 Novak 刮宫器取出丢失的 IUD 的女性被排除在研究之外。
在研究的 55 例病例中，29 例（52.7%）丢失的 IUD 位于子宫腔内，23 例（41.8%）位于子宫腔外，3 例（5.5%）位于子宫肌层内。丢失的 IUD 最常见的子宫外位置是在子宫骶韧带周围（n=8，34.7%）。子宫位置与丢失的 IUD 的子宫外位置之间存在显著相关性。在所有 8 例位于子宫骶韧带周围的丢失的 IUD 中，子宫位置为前倾，并且在子宫的后侧发现穿孔。通过宫腔镜或腹腔镜成功地为 46 名女性（83.6%）取出了 IUD。
子宫内或子宫外的丢失的 IUD 可以通过微创方法进行处理。如果在腹腔镜下看到前倾的子宫，应首先在子宫骶韧带周围探查丢失的 IUD。
