Laparoscopic Retrieval of Perforated Intrauterine Devices at University Hospital, Jamaica

Wynter, S; DaCosta, V; Frederick, J.; Wynter, H.

doi:10.1016/s1074-3804(05)60422-7

Cited by 8 publications

(6 citation statements)

References 6 publications

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“…La perforación uterina al momento de la inserción del DIU depende de distintas variables, entre ellas la experiencia del operador, tamaño y posición del útero (anteversión o retroversión), presencia de malformaciones uterinas y periodo de post-parto o post-aborto, que es donde con más frecuencia se produce esta complicación incrementada por una prolongada contractibilidad uterina, acelerada involución y menor dolor durante la inserción en periodo de lactancia (2,3,8). El manejo de una perforación uterina por DIU es contradictorio, ya que la mayoría de las pacientes son asintomáticas y los DIU pueden permanecer silentes por muchos años, diagnosticándose en forma tardía o accidentalmente al realizarse una radiografía de pelvis o columna como ocurrió con esta paciente, a la que se le hizo el diagnóstico después de 28 años.…”

Section: Discussionunclassified

Manejo Laparoscópico De Dispositivo Intrauterino Migrado a Trompa De Falopio Con Hidrosalpinx Secundario

T¹,

G³

et al. 2007

Rev. chil. obstet. ginecol.

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RESUMENSe presenta el caso clínico de un dispositivo intrauterino ubicado en el lumen de la trompa de Falopio con hidrosalpinx secundario, diagnosticado en forma incidental al realizar una radiografía de columna lumbar, estudio complementado con ecotomografía transvaginal. Se realizó laparoscopia diagnóstica y salpingectomía sin complicaciones. PALABRAS CLAVES: DIU intraabdominal, laparoscopia SUMMARYWe present a case of asymptomatic IUD inserted in the right uterine tube, with secondary hydrosalpinx. The IUD was found during a non-related X-ray examination of lumbar spine. She underwent laparoscopic surgery and removal of the uterine tube, without any further complication. We discuss the current treatment of intraabdominal IUDs. KEY WORDS: Intraabdominal IUD, laparoscopy Casos Clínicos INTRODUCCIÓNLos dispositivos intrauterinos (DIU) son un método de control de la fertilidad reversible ampliamente usado y altamente efectivo. Cerca de 100 millones de mujeres en el mundo utilizan DIU para controlar su fertilidad y Chile es uno de los países latinoamericanos con la mayor proporción de usuarias de DIU, estimándose que cerca de un 70% de las usuarias son controladas en los servicios estatales de planificación familiar (1,2,3).En la actualidad, los más usados son los dispositivos con forma de T medicados con cobre o gestágenos. A diferencia de los DIU no medicados estos son más eficaces y tienen menos efectos adversos (2).La perforación uterina es una seria complicación asociada a la inserción de un dispositivo. Esta complicación es rara, con una frecuencia promedio estimada en 1,2 por 1000 inserciones y solo el 0,1 a 0,9% de las perforaciones se asocian a complicaciones severas, a veces con resultado de muerte como la perforación intestinal (4). Esta complicación muchas veces asintomática, ocurre más frecuentemente en el momento de la inserción, pero también puede ocurrir tardíamente, en caso de quedar parcialmente incrustado en el miometrio, produciéndose la migración del dispositivo a la cavidad abdominal. Una vez en la cavidad pélvica o abdominal, el DIU se ubica con mayor frecuencia en epiplón, recto-sigmoides, peritoneo, vejiga, apéndice y anexos, pero la locali-

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Section: Discussionunclassified

Manejo Laparoscópico De Dispositivo Intrauterino Migrado a Trompa De Falopio Con Hidrosalpinx Secundario

T¹,

G³

et al. 2007

Rev. chil. obstet. ginecol.

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“…Prior reports of laparoscopic exploration and removal of a translocated IUD have had varying degrees of success. [10][11][12][13][14][15] A free intraperitoneal IUD was easily removed from the right paracolic gutter. 12 An IUD adherent but not perforating through the perirectal fat was successfully removed laparoscopically.…”

Section: Discussionmentioning

confidence: 99%

“…[10][11][12][13][14][15] A free intraperitoneal IUD was easily removed from the right paracolic gutter. 12 An IUD adherent but not perforating through the perirectal fat was successfully removed laparoscopically. 13 Two cases of an IUD embedded in the uterovesicular fold were also removed laparoscopically.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Removal of an Intrauterine Device Perforating the Sigmoid Colon: A Case Report and Review of the Literature

Chi

Rosenfeld

Sokol

2005

The American Surgeon™

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“…To prevent the occurrence of IUAs, several interventions were invented and improved by investigators. In the past, the insertion of an intrauterine contraceptive device (IUD) was a widely used method to prevent adhesions, and recently, the copper‐containing IUDs and hormonal IUDs are also applied in different situations . Another key intervention, the Foley catheter, is also inserted into the uterine cavity after hysteroscopic surgery to prevent recurrence of IUAs .…”

mentioning

confidence: 99%

“…In the past, the insertion of an intrauterine contraceptive device (IUD) was a widely used method to prevent adhesions, and recently, the copper-containing IUDs and hormonal IUDs are also applied in different situations. 6 Another key intervention, the Foley catheter, is also inserted into the uterine cavity after hysteroscopic surgery to prevent recurrence of IUAs. 7 Similarly, the use of an intrauterine balloon with a triangular shape that can conform completely to the configuration of a uterine cavity and sustain separation at the margins of the uterine cavity is also commonly applied in the prevention of IUAs.…”

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confidence: 99%

A Network Meta‐Analysis of Efficacy of Different Interventions in the Prevention of Postoperative Intrauterine Adhesions

Xiong

Zhang

2020

Clinical Translational Sci

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This network meta‐analysis was conducted to compare the efficacy of six interventions, including anti‐blocking agents, intrauterine contraceptive devices (IUDs), estrogens, intrauterine balloon, Foley catheter, and amnion graft for the prevention of intrauterine adhesions (IUAs). We searched PubMed, Embase, and Cochrane Library from inception to December 2016. Cohort studies meeting these six interventions in the prevention of IUAs were included. The combination of direct and indirect evidence was conducted to assess the odds ratio (OR) or weighted mean differences and surface under the cumulative ranking curves of the six interventions in the prevention of postoperative IUAs. Finally, 12 eligible cohort studies were included in this network meta‐analysis. The results of this network meta‐analysis demonstrated that during 1 to 2 months after operation, compared with the surgical group, anti‐blocking agent, and estrogens presented with relatively low ratios of postoperative IUAs (OR = 0.30 95% confidence interval (CI) = 0.10–0.67; OR = 0.12, 95% CI = 0.01–0.78, respectively). Compared with IUDs, estrogens exerted comparatively low ratio of postoperative IUAs (OR = 0.10, 95% CI = 0.01–0.90), which indicated that anti‐blocking agent and estrogens had relatively better prevention efficacy. The cluster analysis showed that estrogens had relatively better efficacy in the prevention postoperative IUAs. Overall, our findings support that estrogens had relatively better efficacy in the prevention of postoperative IUAs.

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Laparoscopic Retrieval of Perforated Intrauterine Devices at University Hospital, Jamaica

Cited by 8 publications

References 6 publications

Manejo Laparoscópico De Dispositivo Intrauterino Migrado a Trompa De Falopio Con Hidrosalpinx Secundario

Manejo Laparoscópico De Dispositivo Intrauterino Migrado a Trompa De Falopio Con Hidrosalpinx Secundario

Laparoscopic Removal of an Intrauterine Device Perforating the Sigmoid Colon: A Case Report and Review of the Literature

A Network Meta‐Analysis of Efficacy of Different Interventions in the Prevention of Postoperative Intrauterine Adhesions

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