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Surgical Removal of Mirena IUD

Since its approval in 2000, the Mirena IUD has been implanted in millions of women seeking an alternative to daily birth control pills. Many who get the device are happy with the benefits, but thousands of others have suffered serious complications. By 2012, the FDA had received over 45,000 reports of complications with the device, including uterine perforation and migration to other organs in the body.

When the Mirena spontaneously migrates in the uterus to other areas of the body, it can cause additional injuries and must be removed. Women who’ve had to undergo Mirena removal may experience additional problems associated with the surgery, and some end up suffering permanent injuries. Those who have endured chronic pain and medical trauma because of Mirena surgical removal may be eligible to file a lawsuit against manufacturer Bayer Healthcare to recover damages.

Complications that necessitate Mirena removal

The Mirena is a small, T-shaped plastic device that is inserted into the uterus, where it gradually releases hormones that help prevent pregnancy. It has two small strings attached that extend down and out of the woman’s body, so she can check the security of the device.

Some women forget to check for the presence of the strings, however, especially after having Mirena for an extended period of time. They may go for months where the strings are no longer present outside the body without realizing it. Some women don’t know anything is wrong until they go for their regular gynecological appointment and their doctor notes that the strings have disappeared.

In these cases, it’s possible that the IUD has migrated from its original position in the uterus and traveled elsewhere inside the body. Though this isn’t supposed to happen after the device is implanted, many women have reported delayed Mirena migration, which has caused serious injuries. In such cases, the Mirena IUD must be surgically removed as soon as possible to reduce further risk of complications.

How is Mirena surgical removal performed?

Women who experience no problems with the Mirena may eventually want the IUD removed because they want to become pregnant, they have chosen an alternate birth control method, they have had it for five years (the recommended limit), or they have gone through menopause and no longer need contraception. In these cases, a gynecologist applies gentle traction to the threads with forceps to remove the Mirena from the uterus.

If the threads are not visible, but the Mirena is still in its correct uterine location, the doctor can use narrow forceps to remove the IUD. In these cases, he may need to dilate the cervical canal to do so, which may require anesthesia.

Surgical removal of mirena iudSurgical removal of Mirena IUD

In cases where Mirena has migrated from its normal position, surgical removal of the Mirena IUD may be more complicated.  A physician may use ultrasound imaging, X-rays, or fiber optic instruments to locate the device. Reports have indicated that the Mirena can puncture the uterine wall and move outside of the uterus. It may then migrate to other areas of the abdomen, where it can again perforate other organs like the intestines or the abdominal wall. Locating the device can take time and a number of tests.

Once the doctor has located the IUD, he or she will plan surgery to prevent further complications such as infection and perforation of other organs. How the physician goes about removal at that point depends on where the Mirena has migrated, and what damage has occurred. For most women, laparoscopic retrieval is possible. This is a surgical procedure in which the doctor makes a small incision in the abdomen, and then inserts a small camera called a laparoscope inside. The surgeon can then locate and remove the Mirena through this small incision, reducing the risk of complications and shortening recovery time.

An article published in the Journal of the Society of Laproendoscopic Surgeons reviewed two cases in which laparoscopic surgery was used for Mirena removal. Both women recovered fully.

More complicated Mirena removal

In some women, laparoscopic retrieval is not possible, because of their current health conditions or because of where the Mirena has become embedded. According to a case report published in the Urology Journal (Summer 2007), “Other rare places for IUD migration include the appendix, small intestine, adenexes, iliac veins, secum, perirectal fat, retroperitoneal space, Douglas pouch, and ovaries.”

Some women have also experienced Mirena IUD migration and a new pregnancy at the same time. A report published in the American Journal of Obstetrics & Gynecology (June 2013) noted a 26-year-old women who was told her IUD had fallen out. She later became pregnant, only to discover that the IUD had migrated to her abdomen.

The patient went through removal via a “minilaparotomy,” where doctors again make a small incision, this time above the pubic hairline. The surgery was successful, but the doctors noted that it carried risks, including the possibility of a miscarriage. Women who have to go through these types of operations are always at risk of further injuries, including infections, scarring, pain, and even Mirena infertility.

Recovery after Mirena surgical removal

Recovery after a laparoscopic removal of Mirena IUD typically takes only a couple days to a week, according to multiple case reports. Some women have experienced more serious complications, however, that have significantly affected their quality of life.

Women who’ve had to undergo Mirena removal may be eligible to file a product liability-personal injury claim in an attempt to recover compensation in court. More than 50 injured women have already lodged their complaints in court rooms around the nation. On April 8, 2013, the U.S. Judicial Panel on Multidistrict Litigation (JPML) ordered all federal Mirena lawsuit complaints consolidated in the Southern District of New York. On May 13, all New Jersey state cases were consolidated in Bergen County.