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I read with interest Dr MacGregor's letter1 regarding the unusual shape of a Mirena® intrauterine system (IUS) following removal. From the photograph it would appear that the capsule has become displaced and the arms of the device enclosed within it.
We have seen a case of complete detachment of the capsule from the frame, with unrecognised retention of the capsule within the uterine cavity. This was only recognised at hysteroscopy for investigation of subsequent infertility. This was described in a letter to the British Journal of Obstetrics and Gynaecology in 2008.2
It would seem prudent to check the integrity of the IUS at removal.
Competing interests None.
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