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TOPLINE:

In a large New York healthcare system, 11.4% of intrauterine device (IUD) removals required complex procedures, with age and language barriers significantly affecting complication rates. Among complicated cases, 30.2% needed operating room intervention, and Spanish-speaking patients faced higher rates of complications.

METHODOLOGY:

• Researchers conducted a retrospective chart review of IUD removals in a large New York healthcare system between January 1, 2017, and December 31, 2020, including patients aged 15-55 years who underwent successful removal.
• Analysis included 1803 IUD removals, with complicated removals defined as requiring ultrasound guidance, additional instrumentation, hysteroscopy, or surgical removal in an operating room.
• Data analysis utilized chi-square and t-tests in SAS software, with an alpha of 0.05, incorporating race, ethnicity, and primary language in demographics.
• Two researchers independently reviewed all charts, with the sample size based on available data in the electronic medical record system rather than formal power calculations.

TAKEAWAY:

• Among 1803 IUD removals, 205 (11.4%) were classified as complicated, with an incidence of 113.7/ 1000 IUD removals (95% CI, 99-129.3).
• Age was significantly associated with complicated removal (P = .02). Spanish-speaking patients showed higher rates of complicated removals (17.8%) than English-speaking patients (11.2%), and those speaking other languages (4.8%; P = .03 for all).
• Of the complicated removals, 143 (69.8%) occurred in the medical office and 62 (30.2%) required operating room intervention, with hysteroscopy used in 50.2% and ultrasonography in 21.0% of cases.
• Age and race or ethnicity were independently associated with operating room removal (P = .04 and P = .005, respectively).

IN PRACTICE:

“These results may support improved patient counseling on the potential risks of IUD removal. Notably, 30.2% of complicated removals, and 3.4% of all removals, required operating room intervention, a risk likely unfamiliar to many patients,” wrote the authors of the study.

SOURCE:

The study was led by Meaghan Coles, MD, Northwell Health South Shore University Hospital in Bay Shore, New York. It was published online in O&G Open.

LIMITATIONS:

The retrospective design of the study relied on the accuracy of documentation and included only successful removals. Additionally, numerous patients were excluded from the study because they never followed up in the healthcare system.

DISCLOSURES:

The authors reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.