Embedded or Lost IUD / IUD Removal

Is There a Reason My IUD Won’t Come Out Normally?

If your intrauterine device (IUD) doesn’t come out through a standard office removal procedure, it’s usually due to valid reasons. At Hysteroscopy Center of New York, difficult IUD removals and embedded IUD removals are common reasons women are referred by their physicians to this specialty gynecology practice. Founded by Felix Cohen, MD, FACOG, the Center performs difficult IUD removals that your normal gynecologist can’t do.

Typically, an IUD removal is a quick office procedure. If your IUD becomes embedded in your tissue, that makes it difficult to safely remove. Other common reasons a standard IUD removal fails include:

• Missing or retracted strings
• A mispositioned IUD
• Cervical stenosis
• Fragmentation
• Postmenopausal changes

“If your IUD won’t come out at a routine office visit, it just means you need a hysteroscopy specialist with the right equipment, technology and experience,” says Dr Cohen. “Many of these situations aren’t medical emergencies, although leaving an embedded or lost IUD in place can become unsafe.”

How Does Hysteroscopic IUD Removal Work for Embedded or Lost Devices?

An embedded IUD removal isn’t a complicated procedure. Dr. Cohen and his experienced team use an in-office hysteroscopic visualization technique to locate your UID and remove the device in the same visit through their see-and-treat approach.

Hysteroscopic IUD removal involves using a thin, lighted tool called a hysteroscope. Dr. Cohen passes it through your cervix into your uterine cavity, which provides him a clear, direct view of the IUD and your surrounding tissues. A hysteroscopic IUD removal allows your doctor to see, assess and remove the device with real-time images. The procedure is designed around your comfort for precision. The sequence includes:

• Gaining direct hysteroscopic images of your uterus, using a vaginoscopy with a no-dilation approach
• Identifying the cause of the difficult UID removal before introducing any instrument for the extraction
• Performing the extraction in a minimally invasive hysteroscopy procedure
• Inspecting your uterine cavity after the IUD removal

The procedure takes about 10 to 30 minutes, and your doctor usually completes it in a single visit without needing to put you under anesthesia. “If I locate the IUD and you’re a good candidate for an office hysteroscopy, I don’t delay it,” says Dr Cohen. “A hysteroscopy changes everything in difficult or embedded IUD removals. I don’t have to guess; I see what I’m dealing with and address it precisely.”

Am I a Candidate for Office-Based Hysteroscopy for Embedded IUD Removal?

Most women are usually good candidates for an office-based embedded IUD removal. Your assessment includes reviewing any existing imaging and your medical history. Dr Cohen does a thorough evaluation before attempting a removal to avoid unnecessary risks or hospital procedures.

If an embedded IUD removal is practical, based on the imaging, you may be a good candidate for an office IUD removal. You can’t be pregnant or have any active pelvic infections. Your hysteroscopy expert also checks if your cervix is accessible and your health supports an office procedure. Situations where an office-based IUD removal isn’t a safe choice for you include:

• You have a suspected uterine perforation.
• Your IUD has migrated outside your uterine cavity.
• A deeply embedded device has reached the serosal surface.
• You have a transmural displacement.

Dr. Cohen adds: “I always tell my patients that the office is the first place for the majority of difficult IUD removals, but it’s not for every case. We conduct an evaluation first. If your situation calls for a hospital setting, we let you know before starting the procedure. We have active affiliations with Mount Sinai, NYU Langone and Lenox Hill Hospital, so if you need a higher level of surgical care, anesthesia and pain management, you can stick with us as your chosen medical team.”

Is a Hysteroscopic IUD Removal Procedure Painful?

In a hysteroscopic IUD removal, you’re awake during the procedure. Dr. Cohen and his clinical team are prepared for every clinical variable, and they keep you fully updated. Most women experience mild to moderate cramping similar to a strong menstrual cramp, but it resolves within minutes of the procedure ending. The entire procedure usually takes about 20 minutes.

There’s no operating room transfer for your procedure. Right after your IUD removal, you’re asked to stay in the procedure room to recover briefly. The team makes you comfortable and walks you through the post-procedure instructions. You’re often dressed and ready to leave the office within about an hour of your arrival.

How Will I Feel After My Hysteroscopic IUD Removal Procedure?

Your body’s response to an embedded IUD removal is predictable. Your symptoms usually resolve within a day or two. Recovery after a hysteroscopic IUD removal is mild for most women. You can expect to be 100 percent within 24 to 48 hours. Common symptoms after an IUD removal include:

• Mild to moderate cramping
• Light spotting
• Watery discharge
• Light pelvic pressure
• Fatigue

Although complications are rare, Dr. Cohen discusses the signs of trouble to watch for. Some may require immediate attention. Call your doctor at Hysteroscopy Center of New York if the event of any emergency, such as:

• Heavy bleeding that soaks through more than one pad per hour
• A high fever over 100.4 degrees
• Severe pain in your pelvis that’s not getting better with medicine
• A foul-smelling vaginal discharge

Frequently Asked Questions (FAQs) about IUD Removal