1. 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.