International Journal of Modern and Alternative Medicine Research
ISSN: 2053-1834
Vol. 4(1), pp. 1-5, April 2016



Laparoscopic removal of a translocated intrauterine contraceptive device embedded in the fossa ovarica: A case report

Triyadi E., Hapsari K.* and Hadisaputra W.

Department of Obstetrics and Gynecology, Harapan Kita Women and Children Hospital, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia.

*To whom correspondence should be addressed. E-mail: tika_tedjo@icloud.com.

Received 10 March, 2016; Received in revised form 22 March, 2016; Accepted 28 March, 2016.

Abstract


Keywords:
Contraceptive devices, Ultrasound diagnosis, Hysteroscopy, Laparoscopy.


Intrauterine contraceptive devices (IUD) are the most widely used form of reversible contraception worldwide, especially in development country like Indonesia. There are some complications of this method, uterine perforation being the most important complication. A 30 years old woman, presented to the gynaecologic clinic of Harapan Kita Women and Children Hospital, Jakarta, Indonesia; with ultrasound (US) diagnosis of Blighted ovum, and the IUD was not found in the uterine cavity. Physical examination showed normal vital signs with no abnormality of a general state. Gynaecology examination failed to detect the tail of the IUD in the cervix. A second IUD was inserted into the uterus as a marker after uterine evacuation. Plain abdominal X-ray revealed that there were 2 pieces of IUD lying on same region of the minor pelvic with different projections. Diagnostic hysteroscopy and laparoscopy were then carried out. From hysteroscopy, it was found that the second IUD was placed in situ without another IUD inside it. Continuing with laparoscopy, it was found that the string of the translocated IUD was in the right fossa ovarica surrounded with adhesions and adhesiolysis was performed. The IUD was found in the retroperitoneal space embedded in the ovarica; and it was removed from abdominal cavity. This is a case report of a traslocated IUD which perforated the uterus and adhered to the fossa ovarica; and was successfully removed laparoscopically. Uterine perforation and translocated IUD (embedded in the fossa ovarica) are rare complications of IUDs. Laparoscopic removal as an option for translocated IUD, especially with suspected uterine perforation, is recommended.

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