Mathieu IUD Removal Forceps — Lost-Threads Retrieval

Mathieu IUD Removal Forceps — Lost-Threads Retrieval

The Mathieu IUD removal forceps is the specific Mathieu pattern variant for intrauterine-device retrieval when the device’s strings are not visible at the external cervical os — the “lost-strings” or “lost-IUD” scenario that occurs in approximately 5-10% of long-term IUD users. The Mathieu forceps’s specific jaw geometry engages the IUD body once visualised in the uterine cavity through hysteroscopy or under ultrasound guidance.

The lost-strings management algorithm

When IUD strings are not visible at the cervical os, the algorithm proceeds: (1) gentle exploration with a cytology brush at the cervical canal — strings often retracted into the canal can be retrieved; (2) ultrasound confirmation of IUD position within the uterine cavity; (3) hysteroscopic retrieval with the Mathieu IUD forceps under direct vision. The Mathieu forceps grasps the IUD body for retrieval through the cervical canal.

The uterine-perforation differential

If ultrasound shows no IUD in the uterus, the differential includes expulsion (most common) or uterine perforation with intraperitoneal migration (rare but requires laparoscopic retrieval). The Mathieu IUD forceps serves the in-uterus retrieval; perforated IUDs require laparoscopic removal with different instrumentation.