Hysteroscopic removal of intrauterine device in early pregnancy

Stabile, Guglielmo; Godina, Caterina; Cracco, Francesco; Mangino, Francesco Paolo; Canton, Melania; Romano, Federico; Ricci, Giuseppe

doi:10.1186/s12905-022-02012-5

Cited by 2 publications

(1 citation statement)

References 10 publications

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“…Based on our center's experience [12], we suggest performing the procedure with caution, preferably avoiding cervical dilation (e.g., using 5 mm hysteroscopes). Lowpressure distension media infusion (50 mmHg during entrance) may help minimize the risk of damage to the gestational sac at the entrance.…”

Section: Discussionmentioning

confidence: 99%

Hysteroscopic Removal of Intrauterine Device in Pregnancy: A Scoping Review to Guide Personalized Care

et al. 2022

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Background and objectives: Pregnancies that occur with an intrauterine device (IUD) in situ are at increased risk for developing severe conditions which may affect the fetus and the mother. The incidence of such adverse consequences significantly drops after device removal. A scoping review of the literature was performed to highlight the risks, benefits, and outcomes of hysteroscopic removal of intrauterine devices in early pregnancy. Materials and Methods: PubMed, Scopus, and Web of Science were searched. The review included all reports from 1990 to October 2022. The research strategy adopted included different combinations of the following terms: (“hysteroscopy”) AND (“pregnancy”) AND (“intrauterine device” or “IUD”) AND (“intrauterine system” or “IUS”). A scoping review of the hysteroscopic removal of IUDs during pregnancy was performed. All studies identified were listed by citation, title, authors, and abstract. Duplicates were identified by an independent manual screening performed by two researchers and then removed. For the eligibility process, two authors independently screened the titles and abstracts of all non-duplicated papers and excluded those not pertinent to the topic. Results: PRISMA guidelines were followed. Nine manuscripts were detected, accounting for 153 patients. Most IUD removals occurred during the first trimester of pregnancy. Most of the time, the procedure was safe and without consequences. Conclusions: This review highlights the safety and efficacy of operative hysteroscopy as a method of IUD removal in early pregnancy. We recommend using a 3 to 5 mm hysteroscope, avoiding cervical dilation, and maintaining low infusion pressure during the procedure to avoid potential damage to the gestational sac and IUD fragment displacement. Heating the distension media to 30 °C should be considered.

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Section: Discussionmentioning

confidence: 99%

Hysteroscopic Removal of Intrauterine Device in Pregnancy: A Scoping Review to Guide Personalized Care

et al. 2022

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Migration of an intrauterine device to the posterior urethra with stone formation: a case report

Liu,

Xia,

Pang

et al. 2024

Front. Med.

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Migration of an intrauterine device (IUD) to the posterior urethra with stone formation has not been previously reported in the literature. A 42-year-old female patient presented to the gynecology clinic with a complaint of “discovered vaginal mass for 2 years, with growth for 5 days.” She was referred to urology on suspicion of IUD migration to the bladder. Physical examination revealed a hard mass palpable on the anterior vaginal wall. Laboratory tests showed normal blood counts, and urinalysis indicated a mild urinary tract infection. Ultrasound and pelvic X-ray indicated IUD migration to the bladder and bladder stones. Cystoscopy revealed that the IUD had migrated to the posterior urethra with stone formation. Holmium laser was used to fragment the stones encasing the IUD’s one arm, and the IUD was successfully removed with grasping forceps. The patient had a urinary catheter placed for 10 days and was followed up for 20 days. During the follow-up, there were no lower urinary tract symptoms (LUTS) or vaginal leakage. To our knowledge, we report the first case of an IUD migrating through the vesicovaginal space to the posterior urethra. Endoscopic removal of the IUD is feasible and safe. Urologists and gynecologists should not limit their diagnosis to IUD migration to the bladder but should also consider the possibility of urethral migration.

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Hysteroscopic removal of intrauterine device in early pregnancy

Cited by 2 publications

References 10 publications

Hysteroscopic Removal of Intrauterine Device in Pregnancy: A Scoping Review to Guide Personalized Care

Hysteroscopic Removal of Intrauterine Device in Pregnancy: A Scoping Review to Guide Personalized Care

Migration of an intrauterine device to the posterior urethra with stone formation: a case report

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