Hysteroscopic retrieval of occult IUD.

The direct view of the uterine cavity offered by hysteroscopy can provide valuable information about the position of an IUD, its condition, and its relationship with other formations, thereby facilitating its removal. The diagnostic and therapeutic reliability of this technique was analyzed in 8 women with occult IUDs. Involved were 3 Nova T IUDs, 2 Gravigards, 2 Minigravigards, and 1 Progestasert device. 1 patient had undergone unsuccessful curettage for removal of the IUD; none of the other women had experienced any surgical manipulation prior to the hysteroscopy. The surgery consisted of 4 steps: 1) distention of the uterine cavity by insufflation of carbon dioxide, 2) hysteroscopic location of the IUD, 3) sighted grasping of the IUD or IUD segment with forceps, and 4) removal of the device together with the hysteroscope under dynamic vision. Hysteroscopic location and removal were successful in all 8 patients, with no complications. Hysteroscopy is thus recommended as an alternative retrieval technique, especially in cases when it is necessary to assess the deterioration and possible myometrial penetration of the IUD or the inflammation of the uterine cavity.