Ultrasound-guided IUD repositioning technique

Posted October 24, 2023

The team of the INCT Hormona Center at Universidade de São Paulo (USP), Ribeirão Preto Campus, implemented an innovative transabdominal ultrasound-guided repositioning technique for partially expelled intrauterine devices (IUDs) from January 2016 to February 2020. The data and results were monitored and presented in the study Ultrasound-guided repositioning technique for partially expelled intrauterine device: descriptive feasibility study, which describes the technique and can be read in full at: https://pubmed.ncbi.nlm.nih.gov/35793228/

According to researcher Dr. Erciliene Yamaguti, the idea of repositioning the devices came up in 2012, when the team started thinking about a solution to compensate for the small number of devices available and the losses that occurred due to the residents’ learning curve in a teaching hospital. “The hormonal IUD is not part of the Brazilian List of Essential Medicines (RENAME, for the acronym in Portuguese) and, at the Center, we received some units donated by a foundation,” she comments. “As the ultrasound was available, we started trying to reposition the hormonal IUDs, guided by ultrasound, with no description of this procedure in the literature until then,” she explains. The expert points out that the procedure can be performed for partially expelled IUDs, that is, those located partially in the cervical canal, without being expelled into the vagina or perforating the myometrium.

According to the researcher, the repositioning success rate was 93% on the day of the procedure, and 80% of these patients kept the IUD in the correct position within 6 months of the procedure. Most procedures (87%) were performed by a resident, showing that the technique is simple, and there were no procedure-related complications.

Dr. Erciliene explains that, currently, the technique is used at the Center and is being disseminated throughout Brazil by physicians who have been trained at the Center. “With the publication of the technique last year at UOG (Ultrasound in Obstetrics and Gynecology), the technique has been presented to the world,” she celebrates.