ABSTRACT
This procedure can usually be completed by gentle, steady traction exerted on the string (see Chapter 19).
The likelihood of expulsion of the LNG-IUS is minimized by careful patient selection and correct insertion technique. However, up to 5 per cent of LNG-IUS fitted may be spontaneously expelled when used for treating menorrhagia. This is more likely within the first 3 months, especially if there is heavy menstrual loss or uterine cavity fibroids. Women should be given a patient information booklet and be aware of the appearance of the LNGIUS so it will be recognized if expelled. The woman should be advised how to check the threads, especially if the LNG-IUS is being used for contraceptive purposes (see Chapter 19). Later partial or complete expulsion may be suspected if menorrhagia or pain returns.
