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Post by SnowWhite on Oct 19, 2015 20:04:19 GMT
I hope folks realize that when we speak of IUD migration, we aren't talking about it actually fully leaving the uterus. It does not migrate out of the uterus to other parts of the body. Even with the HIGHLY unusual situation of a perforation, it is a little bit of the IUD that penetrated the wall. Often, if it is "stuck" it just became embedded partially in the endometrium. It may be highly unusual, but I do have a friend who had her Mirena migrate to her abdomen. I'm willing to bet her GYN punctured her uterus when it was inserted, but that's just my
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melissa
Pearl Clutcher
Posts: 3,912
Jun 25, 2014 20:45:00 GMT
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Post by melissa on Oct 19, 2015 21:17:44 GMT
UPDATE 10/16- After ultrasound and x ray: My Mirena has left my uterus! I guess it expelled during all of the heavy bleeding. I'm not sure if it was positioned correctly initially. No ultrasound was done on day of insertion. The scarring from previous surgeries possibly looked like the Mirena during an ultrasound check. My OB did not physically examine for strings, just did an ultrasound. I presume that the next one, we will definitely make sure it is in the proper position. In my experience, ultrasound is NOT routinely used to check placement. A perfectly placed IUD can wiggle it's way out. If you had a great deal of cramping with all that bleeding, I would bet that is when it occurred, if not before the heavy bleeding. Did you ever check for the strings yourself? You had also mentioned that the OB couldn't get it out. In that case, she obviously couldn't because she didn't see the strings. Right? Or am I confused?
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Post by 950nancy on Oct 19, 2015 21:29:22 GMT
I hope folks realize that when we speak of IUD migration, we aren't talking about it actually fully leaving the uterus. It does not migrate out of the uterus to other parts of the body. Even with the HIGHLY unusual situation of a perforation, it is a little bit of the IUD that penetrated the wall. Often, if it is "stuck" it just became embedded partially in the endometrium. Generally, "surgery" to remove it isn't really a surgery as there is no incision involved. It is more of a procedure with the use of a scope to actually see inside the uterus and see where it is, which makes removal a piece of cake. Normally, removal IS a piece of cake btw. It slides right out, quick and easy. And, it is true that for whatever reason, women do not seem to notice if it falls out. Always amazes me, I had to have X-rays to make sure it hadn't traveled upward and that it was out of my body. I was told that if they disappeared they were usually expelled (had a huge fibroid), but on occasion they could go elsewhere. I had blot clots the size of lemons coming out of my body. I really didn't notice it coming out. I do realize I was a weird exception to most IUD wearers.
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melissa
Pearl Clutcher
Posts: 3,912
Jun 25, 2014 20:45:00 GMT
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Post by melissa on Oct 19, 2015 21:45:56 GMT
Ah.. I see.
I remember a patient that we only found out that it was gone when she came in pregnant. There were no clues at all. It was the copper T so she still had normal periods. She had even done a string check the month before, after her period. Then she skipped a period, had a positive home pregnancy test and came in, thinking it was still likely in place. No strings, no IUD. It was gone and a baby was there in its place! I put that IUD in myself and know that it was an easy insertion and it was well placed. She was my only case like that!
With heavy bleeding, I can see that it might be missed. I've seen some people come into the ER with IUDs that were in the process of being expelled. They come in for pain. You look and you see the tip of the IUD sticking out of the cervix.
Did you have it placed after your period ended, that is, if it ends?
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melissa
Pearl Clutcher
Posts: 3,912
Jun 25, 2014 20:45:00 GMT
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Post by melissa on Oct 19, 2015 22:22:06 GMT
I hope folks realize that when we speak of IUD migration, we aren't talking about it actually fully leaving the uterus. It does not migrate out of the uterus to other parts of the body. Even with the HIGHLY unusual situation of a perforation, it is a little bit of the IUD that penetrated the wall. Often, if it is "stuck" it just became embedded partially in the endometrium. It may be highly unusual, but I do have a friend who had her Mirena migrate to her abdomen. I'm willing to bet her GYN punctured her uterus when it was inserted, but that's just my Yup. Very unusual, but it does happen. I imagine the uterus is perforated with the tool used to sound the uterus (to determine how large it is before placement.. it helps guide placement). Hard to perforate with just the IUD and insertion tube. Probably had a thin uterus for some reason too. (Thin referring to the thickness of the muscle).
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samantha25
Pearl Clutcher
Posts: 2,914
Jun 27, 2014 19:06:19 GMT
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Post by samantha25 on Oct 20, 2015 4:18:22 GMT
UPDATE 10/16- After ultrasound and x ray: My Mirena has left my uterus! I guess it expelled during all of the heavy bleeding. I'm not sure if it was positioned correctly initially. No ultrasound was done on day of insertion. The scarring from previous surgeries possibly looked like the Mirena during an ultrasound check. My OB did not physically examine for strings, just did an ultrasound. I presume that the next one, we will definitely make sure it is in the proper position. In my experience, ultrasound is NOT routinely used to check placement. A perfectly placed IUD can wiggle it's way out. If you had a great deal of cramping with all that bleeding, I would bet that is when it occurred, if not before the heavy bleeding. Did you ever check for the strings yourself? You had also mentioned that the OB couldn't get it out. In that case, she obviously couldn't because she didn't see the strings. Right? Or am I confused? I did not check for the strings, but I bet I will next time. When I went in for a string check about 2.5 months after insertion, she did not do a string check, just an ultrasound. Which I am thinking that she really didn't see the Mirena, only my funky scarring, which to me did look like a little y shaped object. Then I had another heavy bleeding, clotting period about two weeks later and that's when she could not physically find it, nor the strings and I didn't see the ultrasound during that procedure. What makes the IUD expel in the first place? Fibroids, placement, etc? She said she will use ultrasound to make sure it is placed properly and that 14% of women can potentially expel a second Mirena. I'm going to give it another shot as my first Mirena worked well, no bleeding and no pregnancies.
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Post by penny on Oct 20, 2015 5:17:18 GMT
Thanks melissa for always being so willing to teach us Out of curiosity, does the Mirena have a silver ring or similar like the Jaydess does?
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Post by k8smom on Oct 20, 2015 5:37:44 GMT
I had never heard of this, but just yesterday a friend was in the hospital with severe pain. Apparently her IUD implanted in a muscle. She had surgery to remove it and they were unable to get it out. She may need a hysterectomy now. I never knew this could happen! Oh my!
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melissa
Pearl Clutcher
Posts: 3,912
Jun 25, 2014 20:45:00 GMT
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Post by melissa on Oct 20, 2015 6:55:38 GMT
Out of curiosity, does the Mirena have a silver ring or similar like the Jaydess does? Jaydess or Skyla in the US has a tiny silver ring around the stem. The only reason I am aware that it exists is because it otherwise would look just like Mirena. It's so it looks different on imaging studies. It is actually made from silver, not another metal that just looks silver. It also is not effective as long as it has less of the hormone. As far as expulsion, remember that the uterus is one massive muscle. It's a pretty darn strong muscle too... think about what it is meant to do- expel a full term baby! Pushing an IUD out is easy in comparison. As I mentioned before, a larger uterus can do this more easily. That said, when I think of the handful of women I have cared for over the years with partial or full expulsion, I think it has been about 50/50 with small, never pregnant uteri and larger uteri in general.
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