Hysteroscopic removal of foreign bodies and its method of monitoring

Objective To evaluate transcervical removal of foreign bodies(TCRF)and to estimate the effectiveness of its monitoring methods.Methods One hundred and thirteen women were identified as having residual intrauterine devices(IUD),residual pregnancy products,unabsorbed strings and broken hooks,which were not removed during routine curettage of IUD removal.All patients were monitored using B ultrasonography while TCRF was performed.Four cases were monitored by laparoscopy simultaneously.One case was monitored by laparoscopic ultrasonography.Results Foreign bodies of one hundred and nine patients were taken out by TCRF.Uterine bleeding, amenorrhoea,discharge,abdominal pain,mlcturition and hematuria disappeared postoperatively.Fetal bones embedded into intramural uterin in four cases were not removed completely.Of these four,one became pregnant 4 months later after TCR and term delivered.One case encountered uterine perforation that was sutured by laparoscopy.Conclusions TCRF is safe and efficient.Sufficient cervical canal distension,selection of equipment and methods to be used is important for successful TCRF.As a non-invasive and effective monitoring method,B ultrasonography is the first choice to monitor for TCRF.For patients with high risk factors for uterine perforation,laparoscopic monitoring should be done simultaneously.Laparoscopic ultrasonography monitoring has both the advantages of B ultrasonography and laparoscopy monitoring,but is invasive and expensive.