There are many effective contraceptive ( Birth Control ) methods available for women.Placement of a small device in the uterus is one 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?
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 ) in to 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 failure 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 lifespan of Copper-T as cited earlier.
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 gynae 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.
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.
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
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.
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.