A bent IUD stem along with missing strings indicates a complicated IUD removal situation, requiring a specific approach from a healthcare provider.
Here's how this situation is typically managed:
1. Locate the IUD and assess the situation
The first step is to determine the location of the IUD and the missing strings.
Your healthcare provider will likely use an ultrasound to confirm if the IUD is still within the uterus.
If the IUD is not seen in the uterus, a pregnancy test and potentially an abdominal X-ray may be needed to check for possible perforation or migration outside the uterus.
Resistance encountered during attempts to remove the IUD may indicate that the device has become embedded in the uterine wall.
2. Attempts to retrieve the IUD
Sweeping the cervical canal: If the strings are retracted into the cervix, a cytobrush may be used to try and retrieve them.
Specialized forceps or hooks: If the cytobrush is unsuccessful, the provider may use alligator forceps or an IUD hook to try and grasp the strings or the IUD itself and remove it.
Ultrasound guidance: Using ultrasound guidance during the retrieval process can significantly improve the success rate.
Cervical dilation: If needed, the cervix might be dilated using medication like misoprostol or laminaria to allow for easier retrieval.
3. Potential for more involved procedures
Hysteroscopy: If the in-office procedures are not successful, a hysteroscopy (a procedure that involves inserting a thin, lighted scope into the uterus) may be recommended to visualize and remove the IUD.
Surgical removal: In rare instances, if the IUD is embedded or has perforated the uterus, surgical removal may be required.
Risks and complications
Difficult IUD removal can potentially lead to complications such as uterine perforation, infection, or heavy bleeding.
A broken IUD during removal can lead to serious injuries, including potential damage to the uterus or other organs.
Important considerations
Seek immediate medical attention if you suspect the IUD is broken or if you experience symptoms like severe cramping, heavy bleeding, fever, foul-smelling vaginal discharge, or pain during intercourse.
If your IUD has missing strings, it's crucial to consult with a healthcare provider experienced in IUD management to discuss the best course of action.