Introduction: The intrauterine device (IUD) is the most widely used method of contraception in Tunisia. Its widespread use has led to device-specific complications, including IUD migration. Although this complication is rare, it remains the most serious

Materials and methods: This is a retrospective study of four cases of IUD migration managed in the Department of Obstetrics and Gynecology at Kasserine Regional Hospital. The aim of this study was to evaluate the role of laparoscopy in the management of migrated IUDs.

Results: The mean age of our patients was 35.2 years, with the time since IUD insertion ranging from 20 days to 15 years. The most consistent clinical finding was the disappearance of the IUD strings. Laparoscopy was indicated when the IUD was not visualized within the uterine cavity on transvaginal ultrasound and/or hysteroscopy, but was consistently visible on plain abdominal radiographs. The IUD was located in the omentum in one case, embedded in the serosa of the sigmoid colon in one case, and on the lateral pelvic wall in two cases. In one patient, the IUD could not be visualized. Removal was performed laparoscopically in all cases. All devices were of the Copper T type. Postoperative recovery was uneventful, with a mean hospital stay of 72 hours, ranging from 24 hours to 5 days.

Conclusion: Although some IUD locations can be severe and technically challenging, improvements in and expertise with laparoscopic surgery now enable the removal of most migrated IUDs, effectively avoiding laparotomy.

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