Management of intra-abdominally translocated contraceptive devices, is surgery the only way to treat this problem?

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dc.contributor.authorUcar, Mustafa Gazi
dc.contributor.authorSanlikan, Fatih
dc.contributor.authorIlhan, Tolgay Tuyan
dc.contributor.authorGocmen, Ahmet
dc.contributor.authorCelik, Cetin
dc.date.accessioned2020-03-26T19:42:02Z
dc.date.available2020-03-26T19:42:02Z
dc.date.issued2017
dc.departmentSelçuk Üniversitesien_US
dc.description.abstractThis study was a multi-centre retrospective review of patients with uterine perforation caused by intrauterine contraceptive devices (IUDs). A total of 15 patients were registered, in a seven year period. Among them, five were asymptomatic and the rest were symptomatic. Asymptomatic patients were managed conservatively, except in one case in which the patient requested surgery because she also wanted a tubal ligation. Symptomatic patients all underwent surgery. All the surgeries were elective and all the surgical procedures were initiated laparoscopically. There were seven complications in the surgically managed group: conversion to laparotomy (n=3), bowel injury (n=2), bladder injury (n=1), and wound infection (n=1). Mild and severe adhesions (81.8%), and abscess (18.1%) formation related to translocated IUD (TIUD) were observed during surgery. All the patients were uneventful at 1 to 5 years of follow-up. A TIUD, by causing adhesions, complicates future laparoscopic surgery and increases the likelihood of conversion to laparotomy. While surgery is indicated to prevent TIUD-induced adhesive complications, it may also be the cause of both adhesions and complications, resulting in a vicious cycle. Some asymptomatic women, especially elderly patients with comorbidities, may not need or may be better managed without treatment. IMPACT STATEMENT In this study we try to find an answer for the question of "Should removal of a translocated intrauterine contraceptive device (TIUD) routinely be performed even if patients are asymptomatic?" From only the theoretical point of view there were some reports supporting conservative management in asymptomatic patients. The other studies addressing this issue were case reports including few patients with a short-term follow-up. The novelties of the present study include multi-centre design, detailed clinical and surgical information about the patients and the long period of follow-up. Most clinicians have limited experiences in managing TIUD because perforation is a rare event. So it can be difficult to know exactly what the surgeon will encounter intraoperatively. We undertook this study with the aim of providing a perspective about patients with TIUD for those faced with this situation. This is a descriptive study reporting 15 cases of TIUDs and management. Asymptomatic patients were managed conservatively, and symptomatic patients were operated. There are important implications resulting from this study that in asymptomatic patients leaving the IUD in place may be a reasonable option, mostly as the risk of surgical intervention is quite high with a high rate of complications with surgical management.en_US
dc.identifier.doi10.1080/01443615.2016.1268577en_US
dc.identifier.endpage486en_US
dc.identifier.issn0144-3615en_US
dc.identifier.issn1364-6893en_US
dc.identifier.issue4en_US
dc.identifier.pmid28421909en_US
dc.identifier.scopusqualityQ3en_US
dc.identifier.startpage480en_US
dc.identifier.urihttps://dx.doi.org/10.1080/01443615.2016.1268577
dc.identifier.urihttps://hdl.handle.net/20.500.12395/35274
dc.identifier.volume37en_US
dc.identifier.wosWOS:000399806600014en_US
dc.identifier.wosqualityQ4en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherTAYLOR & FRANCIS INCen_US
dc.relation.ispartofJOURNAL OF OBSTETRICS AND GYNAECOLOGYen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.selcuk20240510_oaigen_US
dc.subjectConservative managementen_US
dc.subjectcontraceptionen_US
dc.subjectcomplicationsen_US
dc.subjectintrauterine deviceen_US
dc.subjectintrauterine device migrationen_US
dc.subjectuterine perforationen_US
dc.titleManagement of intra-abdominally translocated contraceptive devices, is surgery the only way to treat this problem?en_US
dc.typeArticleen_US

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