Patient: I am a family member of a patient in Taiyuan, Shanxi. The doctor did some tests and said that the ring should be taken out, but they failed to take it out twice in the operating room, and made my mother have stomach pain for several days. I heard from someone that your hospital has a hysteroscope. I wonder if I can remove the ring and help my mother with her pain. Answer: In your letter, you mentioned that your mother’s IUD (commonly known as the ring) has been in place for 30 years, and she has been menopausal for 11 years, and has failed to remove the ring twice. cannot be removed. This is not uncommon in menopausal women, and it can even happen in some women who are not menopausal. This is because 30 years ago when your mother had the ring placed, she was still in her childbearing years and the size of the uterine cavity was normal, but when a woman goes through menopause, the size of the uterus and the uterine cavity will shrink significantly, and the endocervical opening will also shrink significantly and become tight, while the size of the ring will remain the same. Some rings do not “grow” into the uterine wall, but they cannot be removed by conventional methods because of the narrow inner cervical opening. In addition, due to some doctors’ mistakes, the ring is not placed in the correct position in the uterine cavity when the ring is placed, or the ring itself may “wander” and change its position, which may also cause the failure to remove the ring. It can also cause abdominal pain, irregular vaginal bleeding and other gynecological problems such as pelvic infection, so it should be treated promptly. This problem can be solved by using hysteroscopic techniques! Because the hysteroscope has access to the uterine cavity, the doctor can directly observe the situation inside the uterine cavity through the monitor to find out if the ring has become embedded and in what position, and to evaluate the condition of the uterine cavity and the cervical canal to decide if the ring can be removed by conventional methods. Also, we can perform these operations under ultrasound supervision, so that the operation is done in an almost three-dimensional environment, which greatly improves the safety of the procedure. For patients who have failed to remove the ring because of the cervical canal, we can remove the ring directly under ultrasound supervision with an IUD hook after administering some medication to soften the cervix; for shallowly embedded IUDs, we can pull out the ring under direct vision with a special “IUD mirror”, which can We can use the special “IUD removal mirror” to pull out the ring under direct vision to avoid the blind operation when using only the hook to remove the ring; for the deeper embedded intrauterine ring, we can use the special “surgical mirror” to sever the dense union between the ring and the uterine wall tissue before removing the ring. In addition, for some hospitals, the same method can be applied to remove the broken ring! Even for rings that have “wandered” into the abdominal cavity, we can remove them laparoscopically. In short, hysteroscopy is the best treatment for removing rings that cannot be removed by conventional means, so I am confident in treating your mother’s condition and hope that she will come to our hospital as soon as possible. Finally, I need to remind that women who have an intrauterine ring placed should have regular checkups at the hospital to know the position of the ring, and for those comrades who experience discomfort after the ring is placed, they should consult a doctor as soon as possible in order to clarify the cause. Those who have had the IUD for more than 10-15 years should have it replaced in time to prevent the occurrence of intussusception.