What to do if your IUD strings are “missing”

Hysteroscopy and the removal of “Lost” IUD

artworkIntrauterine devices (IUDs) are wonderful forms of contraception. Some IUDs –such as the Mirena and Skyla—have the advantage of helping women with heavy or irregular vaginal bleeding. Another IUD that’s still commonly used is a copper-containing IUD known as the ParaGard.

At the time they’re inserted there are typically 1 or 2 strings that are cut and visible within the vagina. These strings are important – they’re what allows your provider to remove them when it’s time to discontinue them or “change them out”. But every once in a while the IUD strings work themselves back up into the uterus and are nowhere to be found.

When this happens many physicians insist on using “blind” techniques. These methods generally involve placing an instrument into the uterus through the cervix and “searching” around for the IUD or its strings “blindly”. If done in a physician’s office this can be painful. Even when done in an operating room setting this can be a risky procedure if done “blindly”.

Instead we recommend hysteroscopy and IUD extraction. Diagnostic hysteroscopy can be performed under intravenous sedation  and allows for accurate localization of the IUD and its simple and straightforward removal.

When this procedure is performed in our office, under intravenous sedation, it is a quick and painless procedure that typically takes no more than 3 to 5 minutes.

Mirena IUD properly located within the uterine cavity There’s no guessing about it—hysteroscopy reveals all!
Mirena IUD properly located within the uterine cavity
There’s no guessing about it—hysteroscopy reveals all!
The blue arrow points to the “missing” IUD string
The blue arrow points to the “missing” IUD string
This is Paragard IUD. The blue arrow points to the “missing” IUD strings
This is Paragard IUD. The blue arrow points to the “missing” IUD strings