Missing Thread Of Copper-T – Where Has It Gone & What Should The Woman Do

Missing Thread Of Copper-T , Where Has It Gone & What Should The Woman Do

There are many effective contraceptive ( Birth Control ) methods available for women. Placement of a small device in the uterus is ons such method.Intra Uterine Contraceptive Device-IUCD,Intra Uterine Device-IUD are the medical terminology used for this method of birth control. In common man’s language the device is popularly know as’ Copper-T

In this article term ‘Copper-T ‘ is used synonymously for IUCD/IUD

What is Copper-T
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-Cooper –T is a small T shaped device which is placed inside the uterus for the purpose of birth control (Contraception )
-The device once placed will be effective for 3, 5 or 10 years depending upon the type of device.
-The Copper –T is placed inside the uterus but the thread attached to it extends through mouth of uterus (Cervix ) into vagina.
-Checking of thread is done periodically to make sure that the device is in its place.

-Using a ‘Copper-T ‘ is a very popular and safe method of birth control.
-Each method of contraception has its own complications and faliure rates.
-The complications that we are going to discuss in this article are very rare.

Precautions Taken After Insertion Of Copper-T And Likely Complications

-After putting the Copper-T, the woman is called after one month, once her next menses is over.
-The Gynaecologist examines the woman and checks the thread
-At times the Gynaecologist will find that the thread is missing.
-Now, this situation can arise even in the first month after insertion or later on during the life span of Copper-T as cited earlier.
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How To Safeguard Against Losing Copper-T

-Woman should come for first check up as advised by her Gynaecologist in a month after putting of Copper-T
-Subsequently a gynaec check up is suggested at 6 monthly intervals.
-Woman is also taught to palpate the thread herself.
-She is supposed to repeat this procedure every month. She should contact her Gynaecologist immediately if she finds that the thread is missing.
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What Could Have Happened To Copper-T If The Thread Is Found Missing

There are few possibilities-

1) Copper- T is expelled

It may happen that the Copper –T got expelled and the woman did not notice its expulsion.
Diagnosis of this condition is by exclusion

Sonography and X-ray of abdomen and pelvis is done. If both these tests come out normal and no Copper-T is found, the diagnosis of expelled Copper-T is made.

-Woman may come to the Gynaecologist in a pregnant state. Management of pregnancy depends on woman’s wish to either continue or discontinue with the pregnancy.

2) The Copper-T is malpositioned

-In this situation, the Copper-T stays inside the uterus but the thread has curled up inside the uterus.
-One more possibility is that the thread became loose & came out but the Copper-T stayed inside.
 Diagnosis is by Ultrasound.

Hysteroscopy

Management

-Copper-T is removed by a special instrument called ‘IUCD retrieval hook’. This procedure is done under anesthesia in operation theater.
-At times removal by Hysteroscopy becomes necessary.

3) Perforation of wall of uterus by Copper-T
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-In this case patient may present with pain in abdomen and bleeding from vagina.

Diagnosis

Ultrasound (Sonography ), X-Ray  of abdomen, CT-Scan or MRI is done to diagnose this condition.

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Complications of perforation

-Bleeding
– Formation of adhesions among intra abdominal organs. For example the intestines may stick together.
-Perforation of abdominal organs. For example intestines or urinary bladder may get perforated by IUD
-Formation of abnormal tracks between two organs (Fistulas ) .

Management

Patient will require retrieval of Copper-T either by laparoscope or an open operation on abdomen will be required.

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