When an IUD/IUS is fitted the threads attached to the base of its plastic stem are usually trimmed such that they protrude approx 1cm from the cervix into the top of the vagina. The woman is instructed to check that she can feel these threads on a monthly basis to reassure her that the IUD is still in its correct position. The threads are used to remove the IUD at the end of its life.
At any one time approximately 7-9% of users report that they cannot feel the threads of their IUD and most will immediately seek medical assistance. The threads may have been drawn up into the cervical canal, or even into the lumen of the uterus itself by its muscular contractions. The device may also have been expelled unnoticed. More worryingly however the absence of threads may indicate the rare occurrence of uterine perforation where the device migrates either partially, or even completely, through the uterine wall into the abdominal cavity. Faced with “missing threads”, clinicians reach for an IUD Thread Retriever.
This small, sterile, single-use, disposable, plastic instrument was designed many years ago by a dynamic British gynecologist, and it really has stood the test of time. To retrieve the missing threads, the slender stem is gently passed through the cervix. Then the posterior, anterior and both lateral walls of the cavity are gently swept in turn with the notched edges of the Retriever, using a slight twisting action, as it is gradually withdrawn from the uterus. The threads become trapped in the notches and are simply brought back down through the cervix. In most cases neither analgesia nor anesthetic is required and the complete procedure takes just minutes in any doctor’s office. As the IUD Thread Retriever is a single-use device, there is no risk of cross-infection and no need for any sterilizing equipment. Once the threads are back where they should be, the woman may continue as before, knowing that her contraceptive cover continues, or the clinician can use them to remove the device if that is the required action.
Approved by MEB Netherlands & Health Canada