A novel device for removal of the retained intrauterine device

Abstract

Objective To evaluate the efficacy and acceptability of the Macaluso stent removal forceps for removal of retained intrauterine devices (IUDs) under direct vision using a hysteroscope in an outpatient setting.Methods Nineteen consecutive patients with a retained IUD who had been referred from primary care to the gynaecologists at the Conquest Hospital, Hastings, UK were included in the study. Attempts were made to remove the IUDs under direct vision using the Gynecare Versascope ® and Macaluso forceps. ResultsThe procedure was successful in 18/19 (94.7%) patients. The patients tolerated the procedure well and none of them complained of severe pain. ConclusionThis device is simple, safe, effective and acceptable for the removal of IUDs with lost threads. G The Macaluso stent removal forceps is a useful device for hysteroscopic IUD removal.

Ultrasound-guided retrieval of lost intrauterine devices using very fine grasping forceps: a case series

“…who reported success rates of 53% (95% CI 40–65) with Emmett and 59% (95% CI 47–70) with Retrievette ® retriever devices. However, our results were similar to the success rate of 94.7% (95% CI 84.6–100.0) reported with the use of outpatient hysteroscopy 9. Another recent study assessed the efficacy of ultrasound-guided use of a bent Cook catheter or a crochet-type hook when the threads were not retrievable using alligator forceps.…”

“…In cases where these procedures fail, women are usually referred for IUD removal under direct vision using hysteroscopy. Although this is a very successful procedure, it has to be performed by highly skilled operators, it cannot be used in pregnant women and it is comparatively costly 6 9…”

The effectiveness and safety of ultrasound-guided removal of a Mirena®intrauterine system when the strings are not visible and conventional office procedures have failed

“…There are several different IUS retrieval devices available, all of which have a similar success rates for removal. 3,5 There are several studies showing that inpatient and outpatient hysteroscopy is successful in most cases. However, blind manipulation does carry the risk of causing cervical or uterine injuries.…”

“…Bounds et al 3 found that approximately 40% of IUSs with missing strings were removed with any device retriever and another 40% of IUSs were removed using the second choice of devices. 5 Safe administration of these anaesthetics requires that the woman be treated in a day-stay facility with all of its additional costs. 4 In cases where such devices have failed, cervical dilatation and or hysteroscopy are generally recommended.…”

“…4 In cases where such devices have failed, cervical dilatation and or hysteroscopy are generally recommended. 3,5 There are several studies showing that inpatient and outpatient hysteroscopy is successful in most cases. However, a cervical block and/or intrauterine anaesthesia, sedation or a light general anaesthetic are usually given.…”