Intraabdominal IUD Removal Perlaparascopy, A Case Report from Dr. Zainoel Abidin Hospital in Banda Aceh

Background: Intrauterine device (IUD) is the most effective long-term contraceptive method; easy to get and easy to use for trained health workers. IUD users are estimated more than 100 million in the world. In Indonesia, the percentage of IUD users is 6.97%. Serious complications from an IUD both during insertion and using are rare, dislocation is one of the complication. The initial detection of dislocation is by touching the thread at the cervix, examining the sondage and pelvic photographs. Management of IUD dislocation is by laparotomy or laparoscopy. Case: A case of a 25-year-old woman, Para1Abortus 0, complaining about cannot palpable IUD thread and not seen IUD for 1 years before operation and now she wants to remove the IUD. Abdominal x-ray appears IUD outside the uterine cavity and from ultrasound could not detect the IUD. We did laparoscopic exploration for IUD removal, showed a perforation in the posterior wall of the uterus that had been covered by the omentum. The IUD was removed, both the adnexa and uterus were in normal limit and after making sure there was no abdominal cavity bleeding. Conclusion: This is a rare case and the risk of complications should be minimized if it is done at the right time and by a well-trained staff, early detection of simple IUD dislocation with IUD thread control. In the case of dislocation, laparoscopic exploration is safe and the main choice if the facility and expert are available.