Misplaced Ballerine intrauterine contraceptive device requiring operative removal

Abstract

A young woman in her 20s presented with a misplaced intrauterine ball Ballerine MIDI intrauterine copper coil device. Her general practitioner had referred her to a tertiary maternity and gynaecology unit after an outpatient pelvic ultrasound scan in the community reported the intrauterine contraceptive device to be ‘low in the cavity’. On review in our unit, a sterile speculum examination revealed the Ballerine coil strings coming out of the anterior lateral lip of the cervix (and not from the cervical os). A transvaginal ultrasound scan demonstrated that the Ballerine device was embedded in the muscle wall of the anterior outer lip of the cervix. A hysteroscopic examination and removal with a hysteroscopic toothed grasper were completed in the operation theatre under general anaesthesia, with minimal blood loss. The patient recovered well, and after review 6 weeks postoperatively, the patient was counselled on alternative forms of contraception.