We thought Journal readers might be interested to hear about a patient we saw recently in our clinic. A 35-year-old woman attended for a routine change of Mirena® intrauterine system (IUS). Since the insertion of the IUS 5 years before, she had colposcopy for an abnormal (CIN 2) smear and the cervical lesion was cauterised. On insertion of the speculum, the threads were clearly visible but on attempting removal, the opening of the os was noted to be stenosed. The threads of the IUS were caught using sponge forceps and moderate traction was required to remove the device. It was quite a difficult removal although not overtly so. However, on removal of the IUS, its appearance was unusual (Figure 1A). It appeared to have been removed without …