58300 Insertion of intrauterine device (IUD)

Name of the Procedure:

Insertion of Intrauterine Device (IUD) Common Name(s): IUD Insertion
Medical Term: Intrauterine Device Placement

Summary

An intrauterine device (IUD) insertion is a procedure where a small, T-shaped device is placed into the uterus to prevent pregnancy. It is a long-term form of contraception that can last several years depending on the type.

Purpose

IUD insertion is used to provide long-term contraception. The goal is to prevent pregnancy either by releasing hormones that thicken cervical mucus and thin the uterine lining (hormonal IUDs) or by releasing copper, which is toxic to sperm (copper IUDs).

Indications

• Desire for long-term contraception.
• Preference for a non-daily birth control method.
• Contraindication to or intolerance of hormonal contraceptives (for copper IUD).
• Reduced chance of compliance with daily pills or other short-term methods.

Preparation

• Patients may be asked to avoid sexual intercourse, douching, or using tampons for 24 hours before the procedure.
• Over-the-counter pain relievers like ibuprofen may be recommended 30-60 minutes prior.
• A pelvic exam and possibly an STI screening may be conducted beforehand.

Procedure Description

1. The patient will lie on an examination table with feet positioned in stirrups.
2. A speculum is inserted into the vagina to hold it open.
3. The cervix is cleaned with an antiseptic solution.
4. A tenaculum might be used to stabilize the cervix.
5. The IUD is loaded into an applicator tube and carefully inserted through the cervical canal into the uterus.
6. Once in place, the IUD is released from the applicator, and the strings are trimmed to the appropriate length.
7. The speculum is removed.

Tools: Speculum, tenaculum, antiseptic solution, IUD applicator.

Anesthesia: Local anesthesia or numbing agent may be used, but often not required.

Duration

Typically, the procedure takes around 5-10 minutes.

Setting

The procedure is usually performed in an outpatient clinic or a healthcare provider's office.

Personnel

• Primary Healthcare Provider (e.g. OB/GYN, Family Medicine Doctor)
• Nurse or Medical Assistant

Risks and Complications

Common risks:

• Cramping or discomfort
• Spotting or irregular periods initially

Rare risks:

• Perforation of the uterine wall
• Expulsion of the IUD
• Infection

Complications are usually managed by removing the IUD or through medication.

Benefits

• Long-term, reliable contraception (3-12 years depending on type).
• Reduced menstrual cramps and bleeding with hormonal IUDs.
• Non-hormonal option available (copper IUD).

Benefits are typically realized immediately for copper IUDs and within 7 days for hormonal IUDs.

Recovery

Post-procedure care:

• Mild cramping or spotting may occur for a few days.
• Over-the-counter pain relievers can be used for discomfort.
• Avoiding tampons or sexual intercourse for 24-48 hours.

Recovery time:

• Immediate normal activities can usually be resumed.
• Follow-up appointment in 4-6 weeks to check IUD placement.

Alternatives

• Oral contraceptive pills
• Contraceptive implants
• Contraceptive patches or vaginal rings
• Permanent methods like tubal ligation
• Pros and cons vary based on duration, compliance needed, and hormonal side effects.

Patient Experience

During the procedure:

• A sensation of pressure or cramping as the IUD is placed.
• Brief, sharp pain when the IUD passes through the cervix.

After the procedure:

• Mild to moderate cramping for a few days.
• Spotting or irregular periods initially.

Pain management:

• Over-the-counter pain relievers.
• Heating pads or warm compresses for cramping relief.