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PubMed1981

[The 'lost' intra-uterine contraceptive device (author's transl)].

The authors report five cases of lost intra-uterine devices, which means that the threads were not visible at the external os of the cervix. This gives them an opportunity to review the literature and to conclude the following: 1. Ultra-sound is the treatment of choice to find the position of the IUD that has been lost, whether is is intra- or extra-uterine. 2. In doubtful cases an antero-posterior and a lateral hysterogram makes it possible to determine the relative position of the IUD to the uterine cavity. Laparoscopy gives useful complementary information. 3. If the IUD is intra-uterine, either totally so or partially, the treatment of choice is to remove it under hysteroscopic control. 4. Where perforation has occurred and the IUD has only entered incompletely into the pelvis, it is possible to pull it out under hysteroscopic control through the vagina if laparoscopy has demonstrated that there are no local adhesions attaching it to neighbouring organs. 5. Where perforation has been complete, laparotomy is preferable to laparoscopy as a technique to recover the lost IUD, in particular when this is a copper one. 6. Perforations occur particularly when the IUDs are inserted post-partum.

Adult↗
PubMedDate not supplied

The endometrial bacterial flora following insertion of intrauterine contraceptive device.

Bacteriological cultures of material were collected from the endometrium and cervix of 150 women using the IUD, 75 control women and transfundally from 20 uteri of women who had undergone abdominal hysterectomy. The results show that the IUD does not alter the endometrial flora unless it is left in situ for a period exceeding two years. The transfundal cultures yielded the lowest positive cultures. The relationship of positive culture to the cycle and the period of insertion of IUD is discussed.

Cervix Uteri↗
PubMed1981

The multiload intra-uterine contraceptive device. Comparison of 4 different models.

A study of conducted in the Outpatients' Gynaecological Department of St Elisabeth's of Groote Gasthuis, Haarlem, The Netherlands, to compare the performance of 14 IUCDs, namely the Multiload (ML) Cu 250-standard, the ML Cu 250-short (which has a shortened vertical stem), the ML Cu 250-mini and the ML Cu 375 (which has an increased copper area of 375 mm2). Sound length was the sole method governing insertion: greater than or equal to 7 cm with the ML Cu 250-standard and ML Cu 375, 5-7 cm with the ML Cu 250-short and less than 5 cm with the ML Cu 250-mini. All the ML Cu 250-minis and 10% of the ML Cu 250-shorts were inserted in nulliparous women. Data were recorded and evaluated over a period of 36 months according to the table method Tietze. Performance of the ML Cu 250-standard and the ML Cu 250-short were nearly similar after 3 years of use with a continuation rate of 70,6 and 70,3 and a cumulative pregnancy rate of 1,3 and 1,7 respectively. Results with the ML Cu 250-mini were less successful. The continuation rate after 3 years of use was 60,1 with a cumulative pregnancy rate of 3,1. The expulsion and removal rates because of medical reasons were twice those with the standard model. At 12 months the ML Cu 375 proved to be superior in the prevention of pregnancy compared with the ML Cu 250-standard.

Adolescent↗
PubMedDate not supplied

[An analysis of complications and bacteriological and histological studies following extraction of an intrauterine contraceptive device (Beospir) which was inserted several years ago].

Ninety-nine women with the average IUCD (Beospir type) insertion length of 45.2 months were investigated. Pathological changes were clinically evidenced in 9 women (9.09%). Causes of the IUCD removal were bleeding in 4 women (4.04%) and pregnancy during the IUCD use in situ in 3 women (3.03%). The IUCD and endometrium were bacteriologically and the endometrium also histologically analysed. In 58 women (58.58%) the endometrium and in 29 women (29.29%) the IUCD remained sterile. The dominant findings were facultatively pathogenic bacteria commonly present in the cervix. The infection, i.e. when the same kind of bacteria was found in the whole material, was evidenced in 6 women (6.06%), and this was also histologically confirmed. The same kind of bacteria were found in the IUCD and the endometrium. The histological analysis has shown that at the moment of the IUCD removal the endometrium was in physiological phases in 86 women (86.86%). There was glandular hyperplasia in 4 (4,04%) women whose bacteriological vaginal flora was positive. By the Papanicolau test all the women belonged to group II. The IUCD produces no pathologic effect most probably because there is a cyclic renewal (regeneration) of the endometrium.

Adult↗