Lost intrauterine devices and their localization.

With the increasing popularity of intrauterine devices for contraception, an increase in the number of IUD-related complications has been observed. A common clinical problem is loss of marker strings at the external os. It could be due to translocation or unnoticed expulsion, both of which reduce the contraceptive effectiveness of the method. Even with the most scrupulous IUD insertion technics, uterine perforation is a recognized complication. Ectopic devices should be removed because extensive sepsis and adhesions between adjacent organs with subsequent bowel strangulation have been reported. Determining the location of the device is facilitated by flat plate X-rays of the abdomen, hysterography, ultrasound or hysteroscopy. The best method of IUD removal depends upon its location, extent of adhesions and the experience of the operator.