In-office retrieval of intrauterine contraceptive devices with missing strings.

Worldwide, over 100 million women rely on intrauterine contraceptive devices for contraception [1]. Removal of intrauterine contraceptive devices (IUC) is typically an uncomplicated procedure, requiring simply grasping the IUC strings and pulling gently [2,3]. Missing IUC strings, i.e., IUC strings that are not visible at the external cervical os, are a commonly encountered complication of IUC removal and use. Between 4.5% and 18.1% of IUC users have missing strings on string checks or at the time of removal [2–5]. The majority of IUCs with missing strings can be retrieved in the office with the use of proper tools and adequate anesthesia [2,5]. Here we describe a variety of tools and procedures available for retrieval of IUCs with missing strings as well as present an algorithm for their management.