Diagnosis and management of intrauterine device with missing tail.

Abstract

The author presents various diagnostic procedures for locating an intrauterine device (IUD) with a missing tail and discusses factors contributing to uterine perforation and procedures to avoid the complication. In 9 cases reported 5 devices were found in the abdominal cavity 1 of which was removed by laparoscopy while the other 4 required laparotomy. Incorrect insertion technic is the principal cause of uterine perforation. Bimanual pelvic examination uterine sounding selection of an appropriate device firm uterine traction at time of insertion complete insertion of the introducing instrument into the uterine cavity proper timing in relation to menstruation and delivery cervical dilatation if necessary and hormonal preparation of the cervix are procedures that will help avoid uterine perforation with an IUD.