Copper bearing IUCD -The relevance of its string (so caled thread)

 

Remarks on the string of IUD:

As mentioned earlier the only commitment of the client after the IUD is fitted is to cheek the presence in the upper part of vagina at monthly intervals. Thus it is worthy to know few relevant points pertaining to the string attached to IUD.

Both copper medicated and hormone containing IUDs have one or two ‘filaments’ or ‘strings’ – that is threaded through a hole in the bottom of the vertical arm of the device which is shaped as T (sig. Fig.-3). The strings are tied in the device with a knot and strings hang through the lower opening of the cervix into the upper birth canal. The string is monofilament i.e. a single strand of strong plastic. Contrary to popular belief, this thread which hangs in the birth canal does not absorb fluid from birth canal neither transmits bacteria up into the womb. The partner do not feel the thread during lovemaking process neither the male organ is hurt by the thread.

The string has two purposes. It is primarily meant for easy removal of the device with the help of an instrument called ‘artery forceps’. The string also gives an opportunity to the woman clinician to know if the IUD is still in the correct position i.e. inside the womb. As said earlier, the women or her husband should periodically check (once a month is sufficient) its presence by touching the string. It is best palpated in squatting position or else woman can put one foot on a low tool and then insert her index and middle fingers in the birth canal. It should be searched more in backwards than upward direction. Usually, the thread is readily palpable. If not, then one can put her fingers up in the birth canals. When she will be able to feel cervix which feel like tip of nose with a small hole i.e. depression at centre. Some amount of mucus is easily felt at this part and it is in this portion the string should be searched.

If the string seems to shorten or lengthen, the IUD it may mean that have moved up inside then womb or has come down. This mandates an ultrasonography (imaging  the womb) to verify correct location of IUD in relation to longitudinal axis of womb (uterus).

If the string can’t be located at all it may mean that IUD has expelled spontaneously possibly without the knowledge of the acceptor. On very rare occasion device may have perforated the womb and travelled to tummy (abdomen). In summary the purpose of putting a sting in IUD is as follows –

a)        It satisfies the client that the IUD has not fallen off the body.

b)       It helps in easy removal of IUD.

c)         If there is there is lengthening or shortening of thread then it implies that IUD has either come down from womb or has coiled up in the womb.