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[Actinomycosis of the minor pelvis associated with prolonged use of intrauterine contraceptive devices (IUD)].

Pelvic actinomycosis is a rare disorder caused by Gram-positive anaerobic bacteria Actinomyces Israeli, and it is commonly associated with the prolonged use of IUD. The authors present two cases of pelvic actinomycosis in patients who used IUD for prolonged periods of time (eight and fourteen years). The diagnostic procedure in both cases lasted long and the definite diagnosis was made only after the pathohistological examination of the material taken during the surgical treatment. Actinomyces Israeli should be considered as one of the causes of the diagnosed pelvic inflammation especially when it is associated with the prolonged use of IUD.

Actinomycosis↗

Ovarian abscess associated with incomplete abortion and intrauterine contraceptive device.

A 28-yera-old woman with an intrauterine device (IUD) was admitted to hospital with signs of incomplete abortion. The IUD was removed and curettage revealed necrotic infected decidua with no trophoblastic cells or chorionic villi. The patient subsequently developed multiple abscesses in the right ovary. The mechanism of development of ovarian abscesses in patients with IUD or with infected incomplete abortion is discussed.

Abortion, Incomplete↗

Rare case of the utero-vesical fistula caused by intrauterine contraceptive device.

The vesico-uterine fistula is a very rare disease. There have only been 150-200 causes. We are reporting on a case in which the chronic fistula was caused by an IUD having been placed 4 years ago and it "wandered" through the bladder. A 30 year-old patient in 1992 and IUD was inserted. She had gynecological controls twice, in 1993 last time. She has problem of urination very often. A cyclical bladder bleeding drew the attention to the disease. In ambulanterely performed cystoscopy we found an IUD perforating towards the interior of bladder in the borderline of its bottom and back wall and was situated in the bladder with its 3/4. We have removed it with forceps. After six weeks of expectation and strict observation did we want to manage the fistula after having consolidated the symptoms of the inflamed surroundings. During the operation we have noticed a wallment size mass of scar between the uterus and the bladder expanding to the height of the orifice of the uterus. The scarily fixed bladder has been separated from the cervix and the scarry wall of the fistula has been cut out. We have brained the cervix towards the vagina and then we've sutured the cervix and the bladder with Dexon 'O' treat, as well. We have interposed a surgical net between the cervix and the bladder followed by blood-clotting and peritonisation. We should take the follows into consideration: careful separation, fine operative technique, and strong well absorbing thread as well as trying to keep the organ. In our opinion the bioplast--interpositum used on our case maker the efficiency of the operation higher.

Adult↗

Detection of human chorionic gonadotropin in blood of regularly bleeding women using copper intrauterine contraceptive devices.

Highly sensitive and specific radioreceptorassay and radioimmunoassay of human chorionic gonadtropin (hCG) have been used in the detection of hCG in random serum samples during the luteal phase of the menstrual cycles of 200 women and in daily serum samples obtained a few days prior to expected ovulation through the luteal phase in 3 women with regular bleeding patterns and using a copper intrauterine device (IUD). Twelve to nineteen per cent of IUD users showed hCG in serum during the luteal phase, indicating that the presence of the IUD, while permitting fertilization, probably causes interference through degeneration of the blastocyst and consequent lack of implantation.

Chorionic Gonadotropin↗