7 responses to “Use of Endometrial Aspirators as a Uterine Sound for IUD Insertion”

  1. Is it possible to resterilize this sound? I am concerned about using plastics and single use items for the environment

  2. “However, an IUD device can be quite costly financially to many patients, upwards of $400, and thus when practicing patient-centred medicine, this must be considered.”

    I agree it’s important to only open the IUD once you are reasonably confident it can be inserted, however I have on occasion been able to sound with the pipelle only to then be unsuccessful passing the IUD insertion device through the cervix (I suspect because the inserter is wider than the pipelle). I keep in mind for these situations however – at least for the Mirena device – the company provides a replacement device free-of-charge if you open the package and are unable to insert the device due to contamination or other inability to insert the device. Similarly, if the IUD is expelled post-procedure, they will provide a replacement. In this way, it takes some of the pressure off of this being another cost for the patient if the procedure is unsuccessful despite our best efforts.

  3. Where do you buy endometrial aspirators?

  4. Many copper IUDs come with a single-use flexible plastic sound (example: The Liberté & Mona Lisa series). I save these if If they are not req’d: my practice has been to use the metal sound first, which our office sterilizes in a single IUD pack that has all the gear. If this is not successful, then I switch to the flexi-sounds. The use of the endometrial biopsy pipelle seems like a clever McGyver move, but they are a little pricey and cannot be re-resterilized.

  5. I think it would be worth actually doing a study on this rather than just “assuming” it is better. Many things that have seemed like a good idea in the end have not proven to be any better.

  6. I used to use endometrial samplers, but then found I could purchase a box of flexible plastic endometrial sounds for much less money. Saves my worry about perforation with metal sounds, nice easily visible cm markings. Down side, as mentioned above, is waste. Maybe a company will make a biodegradable version!

  7. Another useful strategy for getting through a tricky internal cervical os are (reusable) os finders. These are malleable plastic rods of three different tapering diameters. Frequently, when the internal os seems elusive, using an os finder brings success. They can be curved to accommodate any angle between the cervix and the endometrial canal.
    They will also facilitate gentle dilation up to the presenting diameter of the IUD inserter. It’s not so much the measurement of the endometrial canal depth, but getting through the os that determines the effectiveness of IUD insertion. Once the os has been navigated, and you know the exact path you will be following with the IUD, gently curving the loaded IUD insertion tube by using the IUD wrapper can help, as the angle between the cervix and the endometrial canal can be more acute in some women. (Mona Lisa and the Liberte silver-copper UT 380 IUDs have the most user friendly malleable insertion tubes.)

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