Medical Q&As

Hysterectomy - perforated uterus?

My doctor recommended that I have a D and C for heavy periods and also at the same time to have a Mirena coil fitted. During the fitting of the coil my gynaecologist ruptured my womb, leaving me with heavier bleeding. He suggested that he would try and fit the coil again for me but he could not guarantee that he would be successful. The only option for me then would be a hysterectomy. I panicked because of the distress the heavy bleeding was causing me and six weeks later opted for the hysterectomy. I am forty years of age, have three children, and I am in great form now after the operation. I cannot help but wonder did I make the right choice at the time. I also wondered how many women this happens to. I never realised that fitting a coil could go wrong. I would appreciate you views on this, and also perhaps it would console me, as I feel my gynaecologist did not give the time to explain everything to me.

Perforation of the womb is one of the listed complications following insertion of an intrauterine device. The perforation usually happens as a result of a gynaecological instrument piercing the fundus or top of the womb. Sometimes the coil itself may partially perforate the wall of the womb. In many cases the woman does not experience any ill effects from this and the perforation can heal without any further gynaecological intervention. Perforation of the womb occurs in approximately 1 in a 1,000 cases of insertion of an intrauterine device. I can understand your decision to opt for the hysterectomy rather than undergoing a further attempt at inserting the coil. Clearly you were greatly distressed by the heavier vaginal bleeding that occurred after the first attempt to insert the coil was abandoned. As your gynaecologist indicated to you it was not possible to guarantee that the procedure would be successful the second time around. Perforation of the womb could have occurred had the procedure been re-attempted. Also, given the fact that you have three children the wall of your womb may have been thin, which would again increase the risk of perforation. I think you made the correct decision considering all the circumstances.