A case report of removal and uterine suturing of an incarcerated intrauterine sterilization ring

The clinical management of a patient with adenomyosis in whom the levonorgestrel intrauterine release system was completely embedded in the myometrium is reported. The intrauterine device was located in the pelvis using qualitative imaging (plain abdominal X-ray, computed tomography, magnetic resonance imaging); localization (intraoperative ultrasound localization of the device within the myometrium of the anterior wall of the lower uterine segment); and definitive assessment (hysteroscopy to guide surgical manipulation and subsequent uterine suturing after removal of the device). The purpose of this article is to share our surgical procedure for removing an intrauterine device that has completely migrated into the myometrium using color Doppler ultrasound-guided hysteroscopy, thereby providing best practice for the management of complicated intrauterine device insertion and its prevention in clinical practice.