Reproductive Endocrinology

SUN-114 - The Grave Sequelae of the Prolonged IUD Use.

Sunday, June 14, 2026

9:00 AM - 4:00 PM CT

Location: ENDOExpo; Poster Floor

Senior Author/Primary Investigator(s)

AD

Alberto Dominguez-bali, MD, PhD, MPH

Miami Center for Obstetrics, Gynecology, and Human Sexuality, Miami, Florida, USA
Hialeah, Florida, United States

Submitting author(s)

Margaret Parker, MS4

Medical Student
University College Cork
Bedminster, NJ, United States

Abstract Poster Presenter(s)

Margaret Parker, MS4

Medical Student
University College Cork
Bedminster, NJ, United States

Co-Author(s)

CD

Catherine Dominguez-Bali, PhD, MSN

Registered Nurse
Miami Center of Obstetrics, Gynecology, and Human Sexuality, Miami, Florida, United States
Hialeah, Florida, United States

Disclosure(s):

Margaret Parker, MS4: No financial relationships to disclose

Introduction:
IUDs are one of the most common birth control methods used worldwide. In addition to the
complications of insertion and removal [pelvic pain, abnormal uterine bleeding (menorrhea, metrorrhagia or both), dyspareunia, endometritis, and pelvic inflammatory disease (PID)], the use of IUDs beyond expiration date, the use of banned IUDs, or domestically manufactured can also lead to negative consequences.

Objective:
1. Call the attention of the highly frequent findings in our socio-geographical area of the
serious consequences in women who have had an IUD over the time of expiration (more
than 5 years to 52 years).
2. Present a non- described syndrome (The Cuban IUD syndrome) characterized by the
prolonged use of IUD (5 – 52 years) with the development of severe medical consequences: endometritis, pyometra, tubo-ovarian abscess (TOA), peritonitis, sepsis, and permanent infertility.

Methods:
Between 2005 - 2025, 119 patients (26- 75 years old), 112 Cuban, were admitted to the emergency department with one or more of the following diagnosis chronic pelvic pain or severe acute abdominal pain (98%), UTI symptoms, dyspareunia, purulent vaginal secretions, ovarian cysts and mass, pelvic simple or complex mass (23%), TOA (78%), salpingitis, and PID. High white blood count was found in 78% and fever in 13%. In every case, the initial ultrasound or later explorations (with open uterus after hysterectomy) an IUD was found, especially Multiload (72), fishline (22), or Dalkon Shield (11), Lippes Loop (10), and unable to identify 4 cases. More than 25% of the patients did not know they had an IUD, and 5% had no radiological or ultrasound findings.

Results:
Of 119 patients, 21 did not have any medical consequences and the IUD (8- 25 years) were
removed by hysteroscopy. 98 patients had surgical treatment plus antibiotics: 51 Exploratory
laparotomy (Elap) and 26 interventional radiology. 21 had medical treatment with IV antibiotics and IUD removal with 5 of them finishing in surgical treatment: Elap plus antibiotics. There was readmission for IV antibiotics in 11 and readmission for surgical treatment for Elap in 4. The findings included TOA simple or multiple in 92 patients with 34 in the ICU, endometritis in 96, salpingitis (unilateral or bilateral) in 90, peritonitis 6 with sepsis 2 in the ICU, PID 98, large pyometra with sepsis in 1 case that went to the ICU.

Conclusions:
The lack of continued medical care and the increased frequency in the placement of IUDs in patients with low medical literacy, discontinuous care, the lack of emphasis of healthcare providers in the need to remove this device once they reach expiration date, the misconception that extended use of an IUD is not dangerous, and production of makeshift IUDs with fishline and other objects that prevent pregnancies in impoverished countries have increased the number of women with the inappropriate prolonged use of an IUD and negative health outcomes.

*Unless otherwise noted, all abstracts presented at ENDO must not be released to the press or the public until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.*