Consequences of Global Radiofrequency Endometrial Ablation with an IUD in Situ

Abstract

Abstract

Background: Intrauterine devices (IUDs) should be removed prior to global endometrial ablation procedures although the consequences of not doing so are unknown. Case: Ten years prior to presentation, global radiofrequency endometrial ablation was performed for abnormal uterine bleeding in a premenopausal female with a levonorgestrel intrauterine device left in place. Subsequently, the patient developed chronic pelvic pain. Results: Hysteroscopy with extensive myometrial dissection was necessary to remove the embedded device found below the scarred endometrial surface. The IUD was removed intact without evidence of disintegration or melting. This patient's pelvic pain resolved. Conclusions: This case demonstrates a specific adverse outcome when a plastic IUD is not removed prior to global endometrial ablation. Accordingly, adherence to manufacturer's recommendations to remove IUDs prior to such procedures is prudent. (J GYNECOL SURG 32:348)