First, let’s introduce the basics: the copper-containing, stentless IUD, also known as the Ginny IUD, was invented by Dr. Uildemeersch, a Belgian women’s specialist. It is composed of 6 copper sleeves strung on 1 nylon wire with a surface area of 330 mm2, and the nylon wire has a small knot at 25px from the upper copper sleeve, called the Ginny knot. Each copper sleeve is 5 mm long and about 2.2 mm in diameter, composed, when placed with a special needle to insert the nylon wire knot into the myometrium at the bottom of the uterus 25 px. it has 3 characteristics: no stent, fixed or variable. The stentless and bendable nature of the Ginny Ring allows the Ginny Ring to change with the position of the uterus in the uterus, reducing the damage to the endometrium from the IUD and making the side effects of bleeding and pain less severe. The Gini IUD is a long-acting IUD with a clinical expiration date of 10 years and a theoretical duration of 29 years (each copper sleeve weighs 70mg and has an intrauterine dissolution rate of 2.4mg/year) in the manual. In the 7th edition of the textbook the duration of use of the Gini ring was 5-8 years, and in the 8th edition it was changed to 10 years. The average pulling force for removal of the Gini ring is 6.0 Newton, which is significantly higher than the force required to remove the T-ring (1.0 to 1.7 Newton). Because it is fixed at the bottom of the uterus, it is not easily dislodged and is suitable for women with different uterine cavity sizes and is suitable for a wide range of people, especially for women of childbearing age who have a loose uterine orifice or after abortion. The first one can be seen at the opening of the cervix, but it breaks when pulled. The other doctor came up, explored the uterine cavity and then used a spatula to scrape out the ring intact. Later, I asked for advice and was told to use the teeth on the head of the scraper to find the gap between the copper sleeve at the top and the bottom of the uterus, change direction slightly, press it against the uterine wall to prevent it from slipping out, and then remove it with slow, even pressure downward. This is suitable for patients who have a broken tail wire but the wires connecting each copper sleeve are intact. In the second patient, who had undergone a diagnostic scraping and IUD removal, the tail wire was also visible at the cervical os, but it was still broken when pulled with little force. In the second patient, the tail wire was also visible at the cervical os, but it was still broken when pulled with little force. After I got on the stage, I considered that the ring should be hanging at the bottom of the uterus and the end might be hanging down in the cervical canal, so I used a vascular clamp to hold it, but I did not get it. After dilation of the uterus to the 6th size, a retrieval forceps was used, which should be used during laparoscopic surgery, with two semi-circular cylinders forming the two lobes of the forceps with a gap in them. After entering the uterine cavity and slightly separating and rotating it, four small copper sleeves were seen, and another copper sleeve was found in the accumulated blood scraped out. The cavity could not be removed by re-entering the uterus. The bedside ultrasound showed obvious uterine lines, but no ring shadow was seen due to air entering the uterine cavity after the operation, which was also strongly echogenic. It is possible that there is another copper sleeve mixed with blood that has been removed, or it may still be in the uterine cavity, but there is a high chance that such a small copper sleeve can be removed through the uterine cavity, unless it is embedded in the myometrium. It is recommended to take a pelvic film or review ultrasound after the next menstrual cleansing. The best way to get the ring is to clarify the type of ring, ask the patient (some doctors call it a Ginny ring, some doctors call it a fixed ring, all the same, do not be confused), or refer to the ultrasound pictures. 2, take the Ginny ring, pull the two tail wires with even force, such as the tail wire is broken or the cervical opening is not visible tail wire, any uterine cavity exploration may push the residual tail wire in the cervical canal into the uterine cavity, you can first use the vascular forceps cervical canal clamping, no Then explore the uterine cavity, such as the uterine body and cervical angle, curvature is small, the estimated clamp can directly enter, but also the uterine cavity and then carefully clamp to see, not then scraped out with a scraper spoon close to the uterine wall. The company’s main business is to provide a wide range of products and services to the public. The consequences of residual are generally not serious, such as shedding in the uterine cavity is easy to discharge on their own, the cervical opening is more relaxed, so you can also wait for the post-menstrual review, there may be endometrial shedding with menstrual blood discharge. There is another problem that is confusing, why is the tail wire of the ring easily broken? This is also the case with the “T” ring. After checking, most of the information says that the ring is fixed by nylon thread (Baidu’s encyclopedia says that polypropylene non-biological suture is used.) . The nylon is made of amine and acid or lactam polymerization, which can absorb water under certain conditions and undergo degradation reactions. But for the general PH within the vital organs are not very small and not very dangerous, except for stomach acid. Under physiological conditions, the pH of uterine cavity and fallopian tube fluid is weakly alkaline, and nylon degradation in the uterine cavity should be relatively small. However, the vagina has an acidic environment, which may be the reason for the increased degradation and reduced strength of nylon. Clinically, tail filament breakage also occurs mostly at the junction between the cervical opening and the vagina, perhaps the nylon threads in the two places have different strengths! Vaginal pH: under physiological conditions, estrogen thickens the vaginal epithelium and increases the intracellular glycogen content. The vaginal epithelium breaks down glycogen into monosaccharides, and Lactobacillus vaginalis converts the monosaccharides into lactic acid, maintaining a normal acidic environment in the vagina (pH ≤ 4.5, mostly 3.8 to 4.4). Additional note: I found the instructions or training material for the Ginny ring in the section today and the two sections of wire are really different. The wire that strings the copper sleeve is a 00 gauge polypropylene surgical wire, and the lower end of the surgical wire is connected to a 0.19mm diameter polyethylene surgical wire left as a tail wire in the vagina. The 8th edition of the textbook says that nylon wire is used, which may be easy to understand, but is not very accurate. The method of removal is described in the instruction manual: the image under ultrasound, in the form of a string of 6 beads, can be referred to when the patient cannot remember what ring.