The value of X-ray with uterine sound in the diagnosis of IUDs with missing tails.

Missing IUD tails may result from expulsion, retraction of filaments, uterine perforation or pregnancy. Missing IUD tails occur in 5-25% of all IUD insertions, and require a safe and correct diagnostic technique. Plain X-ray with uterine sound in utero is a popular, simple technique which does not require special skills. This study discusses the feasibility and accuracy of this method in 104 women presenting with a history of missed IUD. Twenty women with suspected pregnancy or uterine abnormalities were excluded from the study. The diagnosis was verified by examination of the patient under anesthesia, D & C, laparoscopy or laparotomy. The accuracy rate was 95.23% (80 women). The diagnosis was wrong in 4.76% (4 women) where the X-ray technique wrongly diagnosed intrauterine location of the device, while examination under anesthesia and laparoscopy located these 4 devices in an extrauterine location. Through the use of this technique it was possible to reduce the hospital stay to one day in 95% (80 patients). The technique is feasible, reliable and without complications; it is particularly suitable in hospitals where other diagnostic facilities are not available.