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[An atraumatic instrument for the removal of the lost string intra-uterine device (author's transl)].

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.

Female↗

Management of the patient with an intrauterine device and a unilateral adnexal mass.

Patients wearing the intrauterine contraceptive device (IUD) and presenting with an unilateral adnexal mass may have a pelvic abscess in the absence of the typical dramatic stigmata that usually accompany an acute pelvic infection. Three such patients are presented, each receiving a different surgical management. An elevated erythrocyte sedimentation rate helps make the diagnosis in these relatively asymptomatic patients. IUD removal and prompt hospitalization for intravenous antibiotics are the appropriate management.

Adult↗

Complications associated with IUD use in a family practice setting.

This study compares the complication rate of intrauterine contraceptive devices (IUD) with other contraceptive measures in a residency practice. The study population included 220 randomly selected women who had IUDs inserted by residents over a five-year period. One hundred similarly selected women started on birth control pills (BCP) were used as a control group. Of the IUD patients, 8.6 percent developed pelvic inflammatory disease vs 2 percent of the BCP patients. The incidence of gonorrhea was not significantly different between the two groups: 8.2 percent for the IUD groups vs 7 percent for the BCP group. Discontinuation of IUDs for reasons other than desiring pregnancy was significantly higher than discontinuation of BCPs: 41 percent vs 12 percent. Of the total IUD insertions, there were 21 expulsions (10 percent) and one uterine perforation (0.4 percent). Five pregnancies occurred in the IUD group, yielding a pregnancy rate of 1.7 per 100 women-years. There was a four percent rate of gynecologic hospitalizations in the IUD group as contrasted with one percent rate in BCP group. IUD use in the family practice setting under study is associated with comparatively poor long-term acceptance and a relatively high rate of complications.

Adolescent↗

[The problem of the lost intrauterine contraceptive device (author's transl)].

Report on 18 patients who were treated in hospital during the last 4 years because of a lost intrauterine contraceptive device. Carbon dioxide hysteroscopy was found to be a more advantageous diagnostic procedure in the search than radiography. In 14 cases, the intrauterine contraceptive device was grasped and removed under hysteroscopic control. In 4 cases the uterine cavity was empty on hysteroscopy. The device had perforated into the uterine muscle or into the peritoneal cavity. These 4 cases are reported in detail.

Abdomen↗

Altered surface character of stretched condom latex.

A new type of imperfection in condom latex, present during moderate stretching, was observed by low magnification scanning electron microscopy. The normally smooth surface of relaxed natural latex was transformed into an accordion-like arrangement of ripples in addition to tears. A corollary experiment with Alcian blue dye placed into both stretched and unstretched condoms leaked no dye. These surface features are consistent with latex acting as a molecular barrier. The tears may represent areas of lowered mechanical resistance and raise questions concerning quality control.

Contraceptive Devices, Male↗