Clinical Question - IUD in 71 year old woman

[FullGlass, BSN, MSN, NP]

I was at a job interview and shadowing at a large primary care practice. Doctor is review xrays for 71 y.o. woman with back pain. Radiologist report states IUD is present. Doctor missed this, but I pointed it out, and he was concerned. We went to talk to patient. She said, yes, she did have an IUD and it was because she has a tipped uterus and it hurt like hell on insertion, so she was terrified to get it removed. Doctor recommended she see an Ob/Gyn. Don't know what kind of IUD it is.

Could having an IUD in this long be dangerous? Patient denied any symptoms.

[caliotter3]

All I can say is wow!

[Hoosier_RN, MSN]

yes, it can become imbedded into the walls of the uterus, causing an infection. It should be surgically removed if it has become imbedded. It's a very quick procedure. My ex MIL had one at 75 that she forgot she had, and they found it with abdominal pain exam, the line was gone. She ended up getting a hysterectomy

[ToFNPandBeyond]

That is unbelievable!

[Hoosier_RN, MSN]

The MD who found it and the surgeon who took care of it couldn't believe that she 'forgot' it either, but she was 45, hubby had just died and she said other things took priority at that time. All I could say was 'wow!'

[NurseBlaq]

Oh my!

[Workitinurfava, BSN, RN]

Glad it was taken care of though. Better late than never.

[LibraSunCNM, BSN, MSN, CNM]

Good news is that if it's not embedded, it actually doesn't cause any harm (although it probably won't work to protect against pregnancy anymore ?).

[BSNbound21, BSN, RN]

It's too bad nobody ever told her that insertion is generally more uncomfortable than removal, seeing as it only involves pulling the thing out by the strings...

[cayenne06, MSN, CNM]

On 7/16/2019 at 4:49 PM, BSNbound21 said:

It's too bad nobody ever told her that insertion is generally more uncomfortable than removal, seeing as it only involves pulling the thing out by the strings...

I have learned to make a point of telling this to patients when they come in for insertion. Grasp the strings, and 1-2-3 done! (assuming its not embedded lol)

[cayenne06, MSN, CNM]

On 7/13/2019 at 6:09 PM, FullGlass said:

On 7/13/2019 at 6:09 PM, FullGlass said:

I was at a job interview and shadowing at a large primary care practice. Doctor is review xrays for 71 y.o. woman with back pain. Radiologist report states IUD is present.

I honestly wonder if at this point it is better just to leave it in place. If she has had it for 30+ years without infection or obvious complications, seems safer to leave well enough alone than put her through the risks of removal, esp if it is an old-school device.

ETA- oops. I missed the update. Glad the removal went well!