TY - JOUR T1 - Perforated intraperitoneal intrauterine contraceptive devices: diagnosis, management, and clinical outcomes. AU - Kho,Kimberly A, AU - Chamsy,Dina J, Y1 - 2014/01/21/ PY - 2013/11/19/received PY - 2013/12/30/revised PY - 2013/12/31/accepted PY - 2014/1/28/entrez PY - 2014/1/28/pubmed PY - 2015/6/9/medline KW - Intra-abdominal KW - Intraperitoneal KW - Laparoscopy KW - Missing IUD KW - Perforated SP - 596 EP - 601 JF - Journal of minimally invasive gynecology JO - J Minim Invasive Gynecol VL - 21 IS - 4 N2 - STUDY OBJECTIVE: To describe a series of intraperitoneal perforated intrauterine contraception devices (IUDs) and to discuss associated findings, methods for diagnosis, and management of this complication. DESIGN: Retrospective review of surgical database between 1998 and 2012 (Canadian Task Force classification II-2). SETTING: University medical center. PATIENTS: Thirty-seven women with a perforated IUD in the intraperitoneal cavity. MEASUREMENTS AND MAIN RESULTS: Nineteen copper IUDs (51%), 17 levonorgestrel-releasing IUDs (LNG-IUDs) (46%), and 1 Lippes loop (3%) were identified. Twenty women (54%) had abdominal pain, 16 (43%) had no symptoms, and 1 (3%) was found to have strings protruding from her anus. Twenty-six women (70%) underwent laparoscopy to remove the IUD, and 6 (16%) underwent hysteroscopy along with laparoscopy. Conversion to laparotomy was required in 4 patients (11%). Two IUDs (5%) caused full-thickness rectouterine fistulas that required laparotomy for repair. Dense adhesions were found in 21 women (57%); and of those, 15 (71%) were associated with a copper IUD. Copper IUDs were significantly more likely than LNG-IUDs to be associated with dense adhesions (p = .02). CONCLUSIONS: Perforated IUDs can be asymptomatic or cause short-term and long-term symptoms. Long-term complications include abscess and fistula formation. Copper IUDs cause a greater inflammatory process than do LNG-IUDs. Even if asymptomatic, we advocate prompt removal of all IUDs that perforate into the peritoneal cavity once they are identified. Laparoscopic surgical removal of an intraperitoneal IUD is a safe and preferred method. SN - 1553-4669 UR - https://www.unboundmedicine.com/medline/citation/24462588/Perforated_intraperitoneal_intrauterine_contraceptive_devices:_diagnosis_management_and_clinical_outcomes_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1553-4650(14)00028-4 DB - PRIME DP - Unbound Medicine ER -