[Uterine perforation caused by 2 types of copper IUD].
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Occurrence of actinomyces infection, following IUD insertion, was observed by the authors in two cases. A pathogenetic role has been positively ascribed to the IUD. In one case, actinomycosis was histologically confirmed on a surgically removed and accompanied by severe tuberculoid tissue reaction. In the second case, actinomyces colonies were recorded and identified from the IUD which had been removed for adnexitis. Good success was obtained by early medication. Prevention and early detection will be possible by vaginal smears prior to insertion of an IUD and with the latter in place, after some time, as well as by testing the IUD proper for actinomycosis, after its removal.
We describe pelvic and rectal actinomycosis in a patient with an intrauterine contraceptive device. The presentation was that of an indolent, noninfectious process which mimicked a pelvic malignancy. As in many cases of pelvic actinomycosis, the diagnosis was not suspected preoperatively. Moreover, suppurative disease progressed despite removal of the intrauterine device. In patients who have intrauterine contraceptive devices or who have had them removed recently, abdominal pain, recurrent vaginal bleeding or adnexal masses should prompt a diligent search for potentially pathogenic actinomyces in the genital tract.
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A less common complication of intra-uterine device contraception is the lost string. Since the intra-uterine devices are more used the problem of the search for lost string intra-uterine devices has increased. An intra-uterine device forceps with a diameter of 2.5 mm. is presented. The instrument can easily be used in office practice. Removal of the device under general anaesthesia after dilation of the cervix with a large instrument can best be avoided.
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