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PubMed2006

Intravesical migration of an intrauterine contraceptive device complicated by bladder stone: a report of six cases.

Intrauterine contraceptive device is the most popular method of reversible contraception in developing countries due to its efficiency and low cost. However, this device is often inserted by paramedics of variable skills, and follow-up evaluations are irregular or absent which can be the source of major complications. The authors report six cases of intravesical migration of intrauterine contraceptive devices complicated by bladder stones. All the six cases were managed endoscopically with excellent outcome. The authors demonstrate that this major complication can be managed endoscopically with decreased morbidity for the patient.

Adult↗
PubMed1983

[Fragmentation of intra-uterine contraceptive devices during their extraction].

Three cases are reported in which the lateral arm of the intra-uterine contraceptive device had broken off. The fragmentation of the intrauterine contraceptive device was observed during spontaneous expulsion and during extraction. The broken off portions of the intra-uterine devices were not located by sonography, radiography or computer tomography. In two of three cases the diagnosis was not made by hysteroscopy. In one case the remaining parts of the intra-uterine device were removed by curettage. The problems from partial perforation and embedding of the fragments are discussed and the management described. A hysteroscopic diagnosis and extraction the fragments is recommended.

Adult↗
PubMed1983

[Analysis of surface deposits on intrauterine contraceptive devices].

The surface deposits on stainless steel contraceptive devices removed from the uterus after various periods of insertion were examined and analyzed by means of scanning electron microscopy, X-ray energy dispersive analysis, Augar electron spectroscopy, X-ray photoelectron spectroscopy, transmission electron microscopy and atomic absorption spectrophotometer for microquantitative analysis. The data obtained were compared with those of copper-bearing IUDs (TCu 200) obtained by the same methods. The wire coils of stainless steel IUDs which had been in situ for 5 years showed on evident changes but the copper wire coils of the same duration showed varying degrees of erosion. The analysis clearly showed that the wire coils of both types of IUDs were encrusted with deposit. Deposition began on copper-bearing IUDs earlier than on stainless steel IUDs (27 days and 3 months after insertion, respectively). This process began earlier than was reported in other literature. The amount of deposits increased with the time of insertion, but there were great individual variations. Through the above mentioned microanalysis, it was found that the principal composition of the deposition both types of IUDs was calcium and existed in the crystal form of calcium carbonate. The substance attaching to the crystals were very likely nitrogenous organic compounds. Regarding the mechanism of the deposit formation, the authors suggest that it may be similar to that of calculus. The influence of the deposits on the complications of IUD insertion, such as uterine bleeding and unwanted pregnancy, is discussed briefly in this article should be studied for further details.

Calcium↗
PubMed1989

A prospective New Zealand study of fertility after removal of copper intrauterine contraceptive devices for conception and because of complications: a four-year study.

A prospective New Zealand study was started in 1982 to determine fertility rates and pregnancy outcomes after removal of copper intrauterine contraceptive devices to allow conception or because of complications. In a combined 4-year study, there were 887 removals to allow conception and 164 due to complications. Participants were 375 (35.7%) nulligravid and 676 (64.3%) gravid women. Within 48 months, 91.5% of the nulligravid and 95.7% of the gravid women had conceived. A 2-year combined study, with regard to longer use of intrauterine contraceptive devices (greater than 2 years), did not show any significant reduction in fertility or increase in ectopic gestation within 24 months. However, in gravid women of similar age distribution, there was a significant increase in the miscarriage rate, compared with use of intrauterine contraceptive devices for less than 2 years or compared with nulligravid women. In a 1-year study, removals because of complications did not cause a significant reduction in fertility or an increase in ectopic gestation, miscarriage, or preterm delivery rates within 12 months, compared with removals to allow conception.

Abortion, Spontaneous↗
PubMed1983

Relationship of oral contraceptives and the intrauterine contraceptive devices to the regression of concentrations of the beta subunit of human chorionic gonadotropin and invasive complications after molar pregnancy.

One hundred ninety-four patients with pathologically confirmed molar pregnancy and intact uteri were studied prospectively. Group A included 177 patients in whom the beta subunit of human chorionic gonadotropin (hCG-beta) declined to normal (less than 5 mlU/ml) without chemotherapy, whereas group B included 17 patients with invasive complications in the postmolar phase which necessitated the use of chemotherapy. Only women with intact uteri were included in the study. In group A, there were no significant differences in the human chorionic gonadotropin (hCG) positive interval between women who used intrauterine contraceptive devices, barrier and other methods, and those who used oral contraceptives. Differences in the proportions of women in groups A and B who used the oral contraceptives and intrauterine contraceptive devices were not observed. However, the mean dosage of estrogen and the proportion of women who ingested more than 50 micrograms of estrogen were higher in group B. These data suggest that (1) the oral contraceptives with less than 50 micrograms of estrogen and the intrauterine contraceptive devices do not prolong the hCG-beta positive interval nor increase the risk of invasive complications in the postmolar phase which requires the use of chemotherapy; and (2) the dose of estrogen (in formulations that contain more than 50 micrograms) rather than the oral contraceptives per se may influence the risk of these postmolar complications.

Choriocarcinoma↗
PubMed1975

Clinical study of a progesterone-releasing intrauterine contraceptive device.

A double-blind clinical study was performed to determine whether the release of progesterone from an intrauterine contraceptive device (IUD) had any effect on IUD event rates. A total of 101 women received intrauterine contraceptive devices containing progesterone, resulting in the accumulation of 877 women-months experience; 100 women received IUD's without steroid, resulting in the accumulation of 780 women-months. The only significant difference was a higher incidence of pregnancy in those patients using devices which did not contain progesterone.

Adult↗
PubMed2003

Extrauterine translocated contraceptive device: a presentation of five cases and revisit of the enigmatic issues of iatrogenic perforation and migration.

Translocation of an intrauterine contraceptive device to an extrauterine site in the peritoneal cavity is an uncommon complication. In cases reported in literature, the timing of extrauterine presentation and the distant sites of translocation often raise the issue of whether iatrogenic uterine perforation or migration of the device was responsible. We present and discuss five referred cases of the extrauterine device inserted in centres outside the University of Port Harcourt Teaching Hospital. The indication for insertion of the intrauterine contraceptive device in the patients (mean age 25.6 years) was contraception in four patients and adhesiolysis for Asherman's syndrome in the fifth. The most common presenting symptom was inability to feel the device's string (in three patients). Four of the patients presented within one month of the insertion. Three of the five translocated intraperitoneal devices were recovered by laparotomy and the forth by laparoscopy. The fifth patient, pregnant, defaulted with the device still retained. We are of the opinion that primary iatrogenic uterine perforation occurs occasionally. Other possible translocatory mechanisms include spontaneous uterine contractions, urinary bladder contractions, gut peristalsis and movement of peritoneal fluid.

Adult↗
PubMed1983

Vaginal mechanical contraceptive devices.

The alleged adverse effects of oral contraceptives and intrauterine devices have led to increased consumer and physician demand for vaginal contraceptive devices. The efficacy and the advantages and disadvantages of vaginal sponges, cervical caps and diaphragms are discussed and compared in this article.

Contraceptive Agents, Female↗
PubMed1978

[Ultra sonography for the localization of intra-uterine contraceptive devices (i.u.d.'s) (author's transl)].

The localization of uterine devices by ultra-sound techniques was investigated. Seven different types of intra-uterine contraceptive devices were checked under immersion in water and in the uterus of 585 wearers of I.U.D.'s. The quality of the ultra-sound pictures is mostly determined by the type of intra-uterine device. Under optimal conditions the investigated types of I.U.D.'s produced standard ultra-sound pictures which permitted their identification. The evaluation of the localization of the intra-uterine contraceptive devices in the uterus was reasonably accurate. At first the classification of normal localization, lower segment localization and cervical localization was used, and this was later enlarged by the measurement of the distance between the uterine fundus and the end of the device closest to the fundus. It was possible to estimate the contraceptive efficiency with these measurements. In 486 cases (83%) the intra-uterine device was found in normal position. In 24 (4.1%) of the cases removal and repeat insertion of the device was suggested. In 18 (3.1%) cases the device was not localized despite normal intra-uterine localization.

Anthropometry↗
PubMed1975

A Review of Commonly Used Intrauterine Contraceptive Devices.

The radiographic appearances of the most commonly used intrauterine contraceptives devices are reviewed, and methods are suggested to determine the extrauterine location of these devices. Complications resulting from the use of these devices are also discussed.

Foreign Bodies↗
PubMed1986

Vesicouterine fistula with menouria: a complication from an intrauterine contraceptive device.

We report a case of a vesicouterine fistula with menouria (vesical menstruation) secondary to an intrauterine contraceptive device. Of the 23 cases of menouria reported previously 21 occurred after cesarean section, 1 was secondary to a traumatic forceps delivery and 1 was owing to infection. In our case the fistula did not close after removal of the perforated intrauterine contraceptive device and 2 months of catheter drainage. Closure was achieved by excision of the fistula and hysterectomy.

Adult↗
PubMed1981

Ultrastructural alterations in human endometrium caused by intrauterine contraceptive devices.

Biopsies of endometrium from women using intrauterine contraceptive devices (IUDs) were examined by electron microscopy to elucidate the possible cause of IUD-associated uterine hemorrhage. The findings reveal the presence of degenerated, shrunken cells in the endometrial glands of IUD users. These cells, termed pyknotic or apoptotic, are more prevalent in tissue from women with complaints of excessive bleeding than in cases without such complaints. The pyknotic cells often show discontinuities of the plasma membrane at their luminal pole, from which cell contents stream into the lumen. Sometimes erythrocytes are also observed in the lumen. A second alteration in the ultrastructure of the endometrium is an abnormal increase in microfilaments in the epithelial cells. These two changes, a large number of pyknotic cells on the one hand and increase in microfilaments on the other, are correlated with excessive bleeding but they do not explain in simple terms of outflow of erythrocytes. Probably some inflammatory mechanism is involved. The increased number of microfilaments might be helping the movement of fluid from healthy to pyknotic cells.

Adult↗
PubMed1989

Laparoscopic removal of translocated intrauterine contraceptive devices.

Data is presented regarding 20 translocated intrauterine contraceptive devices (IUCD). Successful laparoscopic removal was made in 13 (65%) cases though all these devices were Copper 'T' 200 model which tend to produce dense adhesions. Only when the IUCD was suspected to be partially or fully in the gut lumen or thick adhesions were present, or the device was not visualised, was laparotomy performed. Hence it is advocated that laparoscopy should be performed as a routine in patients with suspected translocated IUCD, as it obviates the need for laparotomy and thus decreases the duration of the hospital stay as well as preventing morbidity associated with laparotomy.

Adult↗
PubMed1979

Pelvic actinomycosis in women using intrauterine contraceptive devices.

Several recent reports have indicated the possible association between pelvic infection caused by Actinomyces and the use of intrauterine contraceptive devices. Seven cases of infection or colonization of the female genital tract have been detected among women using intrauterine contraceptive devices (IUD's) at Grady Memorial Hospital, Atlanta, Georgia, from March, 1975, until May, 1977. No single IUD type has been incriminated. The shortest duration of consecutive IUD use before the diagnosis was two and a half years. Six of these cases were detected incidentally at the time of endometrial or endocervical biopsy. The diagnosis in each case was made histologically. One patient presented with severe pelvic inflammatory disease and had Actinomyces identified. This is the first reported death associated with pelvic actinomycosis in a woman using an IUD. This organism must be considered as a possible pathogen whenever a patient with an IUD develops pelvic inflammatory disease.

Actinomycosis↗