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.