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Sample records for levonorgestrel intrauterine device

  1. Continuation of copper and levonorgestrel intrauterine devices: a retrospective cohort study.

    Science.gov (United States)

    Phillips, Sharon J; Hofler, Lisa G; Modest, Anna M; Harvey, Lara F B; Wu, Lily H; Hacker, Michele R

    2017-07-01

    Studies conflict on whether the duration of use of the copper intrauterine device is longer than that of the levonorgestrel intrauterine device, and whether women who continue using intrauterine devices differ from those who discontinue. We sought to assess continuation rates and performance of levonorgestrel intrauterine devices compared with copper intrauterine devices over a 5-year period. We performed a retrospective cohort study of 1164 individuals who underwent intrauterine device placement at an urban academic medical center. The analysis focused on a comparison of continuation rates between those using levonorgestrel intrauterine device and copper intrauterine device, factors associated with discontinuation, and intrauterine device performance. We assessed the differences in continuation at discrete time points, pregnancy, and expulsion rates using χ(2) tests and calculated hazard ratios using a multivariable Cox model. Of 1164 women who underwent contraceptive intrauterine device insertion, 956 had follow-up data available. At 2 years, 64.9% of levonorgestrel intrauterine device users continued their device, compared with 57.7% of copper intrauterine device users (P = .11). At 4 years, continuation rates were 45.1% for levonorgestrel intrauterine device and 32.6% for copper intrauterine device (P 4 years was 0.71 (95% confidence interval, 0.55-0.93) and >5 years was 0.82 (95% confidence interval, 0.64-1.05) after adjusting for race, age, parity, and education. Copper intrauterine device users were more likely to experience expulsion (10.2% copper intrauterine device vs 4.9% levonorgestrel intrauterine device, P < .01) over the study period and to become pregnant in the first year of use (1.6% copper intrauterine device vs 0.1% levonorgestrel intrauterine device, P < .01). We found a difference in continuation rates between levonorgestrel and copper intrauterine device users at 4 years but not at 5 years. Copper intrauterine device users were more likely

  2. Removal of an intraabdominal levonorgestrel-releasing intrauterine device during pregnancy.

    Science.gov (United States)

    Peleg, David; Latta, Richard

    2013-06-01

    A woman with a viable intrauterine 12-week pregnancy and an intraabdominal levonorgestrel-releasing intrauterine device had the device successfully removed under local anesthesia. The pregnancy continued without complication. The decision to remove an intraabdominal levonorgestrel-releasing intrauterine device during pregnancy remains controversial.

  3. Levonorgestrel Intrauterine System

    Science.gov (United States)

    Levonorgestrel intrauterine system (Mirena, Skyla) is used to prevent pregnancy. The manufacturer states that Mirena brand intrauterine ... to use an intrauterine system to prevent pregnancy. Levonorgestrel is in a class of medications called hormonal ...

  4. Cornual pregnancy as a complicaton of the use of a levonorgestrel intrauterine device: a case report

    Science.gov (United States)

    2009-01-01

    Introduction Complications of copper load intrauterine devices, including ectopic pregnancies are well reported. Rates of ectopic pregnancy are 0.6 to 1.1% per year. However, the levonorgestrel intrauterine device has been described as more protective against ectopic pregnancies due to the addition of the hormone levonorgestrel. The hormone released from the intrauterine device causes some systemic effects, but local effects such as glandular atrophy and stromal decidualization, in addition to foreign body reaction, are dominant. Few case reports have described ampullary ectopic pregnancies. However, we report, for the first time, a major complication of levonorgestrel intrauterine device: a cornual pregnancy. Case presentation A 36-year-old Caucasian nulliparous woman presented with complaints of progressive nausea, abdominal pain and irregular vaginal bleeding for 2 months. For 3 years, she had been using a levonorgestrel intrauterine device. A two-dimensional transvaginal sonogram noted a sac situated external to the endometrial cavity in the right cornua of the uterus with an empty uterus. She was successfully treated with chemotherapy. Conclusion Many complications have been described, including ectopic pregnancies, using copper intrauterine devices. The levonorgestrel-releasing intrauterine system is a particularly good choice for adolescents because of associated non-contraceptive benefits such as decreased menstrual bleeding, dysmenorrhea and pain associated with endometriosis [1]. Yet a cornual pregnancy following the use of a levonorgestrel intrauterine device is a complication which, to our knowledge, has not been described before. Physicians prescribing this type of intrauterine device should be aware of this rare event. PMID:19830226

  5. Cornual pregnancy as a complicaton of the use of a levonorgestrel intrauterine device: a case report

    Directory of Open Access Journals (Sweden)

    Beltman JJ

    2009-07-01

    Full Text Available Abstract Introduction Complications of copper load intrauterine devices, including ectopic pregnancies are well reported. Rates of ectopic pregnancy are 0.6 to 1.1% per year. However, the levonorgestrel intrauterine device has been described as more protective against ectopic pregnancies due to the addition of the hormone levonorgestrel. The hormone released from the intrauterine device causes some systemic effects, but local effects such as glandular atrophy and stromal decidualization, in addition to foreign body reaction, are dominant. Few case reports have described ampullary ectopic pregnancies. However, we report, for the first time, a major complication of levonorgestrel intrauterine device: a cornual pregnancy. Case presentation A 36-year-old Caucasian nulliparous woman presented with complaints of progressive nausea, abdominal pain and irregular vaginal bleeding for 2 months. For 3 years, she had been using a levonorgestrel intrauterine device. A two-dimensional transvaginal sonogram noted a sac situated external to the endometrial cavity in the right cornua of the uterus with an empty uterus. She was successfully treated with chemotherapy. Conclusion Many complications have been described, including ectopic pregnancies, using copper intrauterine devices. The levonorgestrel-releasing intrauterine system is a particularly good choice for adolescents because of associated non-contraceptive benefits such as decreased menstrual bleeding, dysmenorrhea and pain associated with endometriosis 1. Yet a cornual pregnancy following the use of a levonorgestrel intrauterine device is a complication which, to our knowledge, has not been described before. Physicians prescribing this type of intrauterine device should be aware of this rare event.

  6. The levonorgestrel-releasing intrauterine device potentiates stress reactivity.

    Science.gov (United States)

    Aleknaviciute, Jurate; Tulen, Joke H M; De Rijke, Yolanda B; Bouwkamp, Christian G; van der Kroeg, Mark; Timmermans, Mirjam; Wester, Vincent L; Bergink, Veerle; Hoogendijk, Witte J G; Tiemeier, Henning; van Rossum, Elisabeth F C; Kooiman, Cornelis G; Kushner, Steven A

    2017-06-01

    The levonorgestrel-releasing intrauterine device (LNG-IUD) is currently recommended as a first-line contraceptive with an exclusively local intrauterine influence. However, recent clinical trials have identified side effects of LNG-IUD that appear to be systemically mediated, including depressed mood and emotional lability. We performed two experimental studies and a cross-sectional study. For each study, women were included from three groups: LNG-IUD (0.02mg/24h), oral ethinylestradiol/levonorgestrel (0.03mg/0.15mg; EE30/LNG) and natural cycling (NC). Study 1-Salivary cortisol was measured at baseline and at defined intervals following the Trier Social Stress Test (TSST). Heart rate was monitored continuously throughout the TSST. Study 2-Salivary cortisol and serum total cortisol were evaluated relative to low-dose (1μg) adrenocorticotropic hormone (ACTH) administration. Study 3-Hair cortisol was measured as a naturalistic index of long-term cortisol exposure. Women using LNG-IUD had an exaggerated salivary cortisol response to the TSST (24.95±13.45 nmol/L, 95% CI 17.49-32.40), compared to EE30/LNG (3.27±2.83 nmol/L, 95% CI 1.71-4.84) and NC (10.85±11.03nmol/L, 95% CI 6.30-15.40) (P<0.0001). Heart rate was significantly potentiated during the TSST in women using LNG-IUD (P=0.047). In response to ACTH challenge, women using LNG-IUD and EE30/LNG had a blunted salivary cortisol response, compared to NC (P<0.0001). Women using LNG-IUD had significantly elevated levels of hair cortisol compared to EE30/LNG or NC (P<0.0001). Our findings suggest that LNG-IUD contraception induces a centrally-mediated sensitization of both autonomic and hypothalamic-pituitary-adrenal (HPA) axis responsivity. LNG-IUD sensitization of HPA axis responsivity was observed acutely under standardized laboratory conditions, as well as chronically under naturalistic conditions. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. [Abdominal migration of a levonorgestrel-releasing intrauterine device. Case report and review of the literature].

    Science.gov (United States)

    Pont, M; Lantheaume, S

    2009-04-01

    We report the case of a 27-year-old woman in amenorrhea after the installation of a levonorgestrel releasing intra-uterine device, 3 years previously. In front of pelvic continuing pains, paraclinic explorations diagnosed the DIU-LNG in intra-abdominal situation. An exploratory laparoscopy was realized and allowed its ablation. The authors discuss the systemic distribution of the levonorgestrel and the impact of the DIU-LNG in intra-abdominal situation by a review of the literature.

  8. Immediate postpartum levonorgestrel intrauterine device insertion and breast-feeding outcomes: a noninferiority randomized controlled trial.

    Science.gov (United States)

    Turok, David K; Leeman, Lawrence; Sanders, Jessica N; Thaxton, Lauren; Eggebroten, Jennifer L; Yonke, Nicole; Bullock, Holly; Singh, Rameet; Gawron, Lori M; Espey, Eve

    2017-08-23

    Immediate postpartum levonorgestrel intrauterine device insertion is increasing in frequency in the United States, but few studies have investigated the effect of early placement on breast-feeding outcomes. This study examined the effect of immediate vs delayed postpartum levonorgestrel intrauterine device insertion on breast-feeding outcomes. We conducted this noninferiority randomized controlled trial at the University of Utah and the University of New Mexico Health Sciences Centers from February 2014 through March 2016. Eligible women were pregnant and planned to breast-feed, spoke English or Spanish, were aged 18-40 years, and desired a levonorgestrel intrauterine device. Enrolled women were randomized 1:1 to immediate postpartum insertion or delayed insertion at 4-12 weeks' postpartum. Prespecified exclusion criteria included delivery <37.0 weeks' gestational age, chorioamnionitis, postpartum hemorrhage, contraindications to levonorgestrel intrauterine device insertion, and medical complications of pregnancy that could affect breast-feeding. We conducted per-protocol analysis as the primary approach, as it is considered the standard for noninferiority studies; we also report the alternative intent-to-treat analysis. We powered the study for the primary outcome, breast-feeding continuation at 8 weeks, to detect a 15% noninferiority margin between groups, requiring 132 participants in each arm. The secondary study outcome, time to lactogenesis, used a validated measure, and was analyzed by survival analysis and log rank test. We followed up participants for ongoing data collection for 6 months. Only the data analysis team was blinded to the intervention. We met the enrollment target with 319 participants, but lost 34 prior to randomization and excluded an additional 26 for medical complications prior to delivery. The final analytic sample included 132 in the immediate group and 127 in the delayed group. Report of any breast-feeding at 8 weeks in the immediate

  9. Uterine Perforation with the Levonorgestrel-Releasing Intrauterine Device Analysis of Reports from Four National Pharmacovigilance Centres

    NARCIS (Netherlands)

    van Grootheest, Kees; Sachs, Bernhardt; Harrison-Woolrych, Mira; Caduff-Janosa, Pia; van Puijenbroek, Eugene

    2011-01-01

    Background: Levonorgestrel-releasing intrauterine devices (LNG-IUD) are commonly used for contraception and other indications in many countries. National pharmacovigilance centres have been receiving reports from healthcare professionals and patients of uterine perforation associated with the use of

  10. Uterine Perforation with the Levonorgestrel-Releasing Intrauterine Device Analysis of Reports from Four National Pharmacovigilance Centres

    NARCIS (Netherlands)

    van Grootheest, Kees; Sachs, Bernhardt; Harrison-Woolrych, Mira; Caduff-Janosa, Pia; van Puijenbroek, Eugene

    2011-01-01

    Background: Levonorgestrel-releasing intrauterine devices (LNG-IUD) are commonly used for contraception and other indications in many countries. National pharmacovigilance centres have been receiving reports from healthcare professionals and patients of uterine perforation associated with the use of

  11. Endometrial cancer treated with levonorgestrel-releasing intrauterine device for almost three years in an elderly woman with comorbidity

    DEFF Research Database (Denmark)

    Andreasen, Lisbeth Anita; Antonsen, Sofie Leisby; Settnes, Annette

    2016-01-01

    In this case report we describe the treatment of a 95-year-old woman with endometrioid adenocarcinoma. She suffered from cardiovascular comorbidity and did not want surgical treatment. Instead a levonorgestrel-releasing intrauterine device (Mirena) was inserted. She had progression of the tumor...... but with a minimum of symptoms and side effects. At the final examination there were no signs of extra uterine disease. The levonorgestrel-releasing intrauterine device may be an acceptable alternative to surgery in severely comorbid patients, or if the patient refuses surgical treatment. © 2016, Springer...

  12. Continuation of a Levonorgestrel Intrauterine Device During Hematopoietic Stem Cell Transplant: A Case Report.

    Science.gov (United States)

    Brady, Paula C; Soiffer, Robert J; Ginsburg, Elizabeth S

    2017-04-01

    During treatment of hematologic malignancies in premenopausal women, both menstrual suppression and contraception are crucial. Continuation of hormonal intrauterine devices (IUDs) - widely used and highly effective contraceptives that also decrease menstrual flow - is controversial during hematopoietic stem cell transplants (SCTs) due to infectious and vaginal bleeding concerns. A 23-year-old nulligravid female was diagnosed with acute myeloid leukemia (AML, positive for FLT3-ITD, DNMT3A and RUNX1, with normal cytogenetics). She elected to retain her existing levonorgestrel-containing IUD during chemotherapy and SCT. During and following treatment, she remained amenorrheic without infection, despite severe neutropenia and thrombocytopenia. Eight months later, she remains in remission without IUD-related complications. This is the first report of levonorgestrel IUD retention during hematopoietic SCT. Despite severe neutropenia and thrombocytopenia, the patient developed neither pelvic infection by retaining her IUD nor significant vaginal bleeding. Future studies are needed to confirm the safety of levonorgestrel IUDs in women undergoing SCT. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  13. Osteoporosis in a young woman after 6 years of levonorgestrel administration from intrauterine devices?

    Science.gov (United States)

    Greiner, Christine Ursula; Brune, Kay; Haen, Ekkehard

    2009-01-01

    This report describes a young woman who developed dysmenorrhoea at the age of 12. She received a levonorgestrel (LNg)-releasing intrauterine device at the age of 21, and this was replaced twice within 8 years. At the age of 28, she started to have multiple bone and joint pain (predominantly low back pain), which, after intensive diagnostic of blood parameters and bone CT, turned out to result – from a manifest (mild) osteoporosis. Since the woman developed very low (postmenopausal) oestradiol levels during the presence of the gestagen-releasing device and encountered normalisation of oestradiol production after removal, suppression of the hypophysial–ovarian axis is proposed as the cause of both lack of oestradiol and osteoporosis. This poses the question of whether long-term use of such devices in young women may result in reduced bone density in the early phases of life, paving the way to serious osteoporosis at menopause. PMID:21686786

  14. Levonorgestrel Intrauterine Device Placement in a Premenopausal Breast Cancer Patient with a Bicornuate Uterus.

    Science.gov (United States)

    Eskew, Ashley M; Crane, Erin K

    2016-01-01

    Young women with breast cancer face contraceptive challenges. Data are limited and conflicting on the use of the levonorgestrel intrauterine device (LNG-IUD) in this patient population. A 32-year-old nulligravid woman with a history of breast cancer on tamoxifen presented with new-onset vaginal bleeding. Further workup revealed a previously undiagnosed bicornuate uterus. She underwent hysteroscopy, dilation and curettage, and LNG-IUD placement in each uterine horn. Postoperative follow-up confirmed retention and proper placement of both IUDs. Pathology from the dilation and curettage was benign, and the abnormal uterine bleeding abated. LNG-IUD placement in a young patient with a personal history of breast cancer on tamoxifen and a bicornuate uterus is a safe and feasible alternative for contraception.

  15. Evaluation of levonorgestrel intrauterine system upon presumed nonintact removal.

    Science.gov (United States)

    Bukowski, Josh; Rogers, Anna; Cansino, Catherine

    2014-12-01

    A 51 year old woman presented for removal of her expired levonorgestrel intrauterine device (IUD). The IUD arms appeared absent upon IUD removal. Further examination of the device revealed that the arms were concealed inside the hormonal cylinder. Recognizing abnormal presentations of the levonorgestrel IUD upon removal can avoid unnecessary procedures.

  16. Comparison of human papillomavirus infection and cervical cytology in women using copper-containing and levonorgestrel-containing intrauterine devices.

    Science.gov (United States)

    Lekovich, Jovana P; Amrane, Selma; Pangasa, Misha; Pereira, Nigel; Frey, Melissa K; Varrey, Aneesha; Holcomb, Kevin

    2015-05-01

    To investigate whether there is a difference in cervical cytology and high-risk human papillomavirus (HPV) infection clearance between levonorgestrel- and copper-containing intrauterine device (IUD) users. The electronic medical record system was searched by the appropriate procedural code for IUD insertion for all patients undergoing IUD placement during the study period (January 31, 2005 to January 31, 2012). Patients who received treatment for cervical dysplasia, had their IUDs removed, or conceived during the study period were excluded. High-risk HPV and cervical cytology results immediately preceding and after IUD placement were obtained. One hundred fifty patients had a copper-containing and 152 patients a levonorgestrel-containing IUD placed. The groups were comparable in terms of age, body mass index, duration of follow-up, and percentage of smokers. Sixty-six patients were high-risk HPV-positive before IUD insertion (30 in copper compared with 36 in the levonorgestrel IUD group, P=.4), and the groups had similar follow-up times (364.1±26.3 compared with 357.2±29.7 days, respectively, between the IUD placement and a repeat Pap test with high-risk HPV cotesting, P=.2). Of those, 21 (70%; 95% confidence interval [CI] 53.6-86.4%) cleared the infection after copper-containing IUD placement compared with 15 (42%; 95% CI 25.6-57.8%) in the levonorgestrel group (P=.04). There were only two (1.7%) new high-risk HPV infections in the copper compared with eight (6.9%) in the levonorgestrel group (P=.056). Our data suggest that levonorgestrel-containing IUD could be associated with decreased high-risk HPV infection clearance and possibly increased acquisition compared with the copper-containing IUD. II.

  17. Chronic vulvovaginal candidiasis in patients using a levonorgestrel-containing intrauterine device.

    Science.gov (United States)

    Nguyen, Yvonne; Fischer, Gayle

    2016-12-13

    Chronic vulvovaginal candidiasis is usually responsive to therapy with oral antifungals. We present a case series of 13 patients with this condition who were also using a levonorgestrel intrauterine system (LNG-IUS). All cases responded to ongoing oral fluconazole therapy while the LNG-IUS was in situ. The LNG-IUS was removed in six patients and of these, two experienced clinical improvement with lower fluconazole dosage requirements and three experienced complete resolution of symptoms. One remains on fluconazole 100 mg daily. © 2016 The Australasian College of Dermatologists.

  18. Non-contraceptive applications of the levonorgestrel intrauterine system

    Directory of Open Access Journals (Sweden)

    Maria Isabel Rodriguez

    2010-04-01

    Full Text Available Maria Isabel Rodriguez, Philip D DarneyDepartment of Obstetrics, Gynecology, and Reproductive Sciences, San Francisco General Hospital and Bixby Center for Global Reproductive Health, University of California, San Francisco, CA, USAAbstract: Intrauterine progestins have many important current and potential gynecologic applications. This article describes the evidence for use of intrauterine progestin for common gynecologic conditions beyond its important role in contraception. The pharmacology of and selection criteria for use of the levonorgestrel intrauterine device is discussed, and the evidence for use of intrauterine progestin delivery for menorrhagia, endometriosis management, uterine fibroids, adenomyosis and endometrial hyperplasia is reviewed.Keywords: intrauterine progestin, levonorgestrel, contraceptive

  19. Levonorgestrel Intrauterine Device as an Endometrial Cancer Prevention Strategy in Obese Women: A Cost-Effectiveness Analysis.

    Science.gov (United States)

    Dottino, Joseph A; Hasselblad, Vic; Secord, Angeles Alvarez; Myers, Evan R; Chino, Junzo; Havrilesky, Laura J

    2016-10-01

    To estimate the cost-effectiveness of the levonorgestrel intrauterine device (IUD) as an endometrial cancer prevention strategy in obese women. A modified Markov model was used to compare IUD placement at age 50 with usual care among women with a body mass index (BMI, kg/m) 40 or greater or BMI 30 or greater. The effects of obesity on incidence and survival were incorporated. The IUD was assumed to confer a 50% reduction in cancer incidence over 5 years. Costs of IUD and cancer care were included. Clinical outcomes were cancer diagnosis and deaths from cancer. Incremental cost-effectiveness ratios were calculated in 2015 U.S. dollars per year of life saved. One-way and two-way sensitivity analyses and Monte Carlo probabilistic analyses were performed. For a 50 year old with BMI 40 or greater, the IUD strategy is costlier and more effective than usual care with an incremental cost-effectiveness ratio of $74,707 per year of life saved. If the protective effect of the levonorgestrel IUD is assumed to be 10 years, the incremental cost-effectiveness ratio decreases to $37,858 per year of life saved. In sensitivity analysis, a levonorgestrel IUD that reduces cancer incidence by at least 68% in women with BMIs of 40 or greater or costs less than $500 is potentially cost-effective. For BMI 30 or greater, the incremental cost-effectiveness ratio of IUD strategy is $137,223 per year of life saved compared with usual care. In Monte Carlo analysis, IUD placement for BMI 40 or greater is cost-effective in 50% of simulations at a willingness-to-pay threshold of $100,000 per year of life saved. The levonorgestrel IUD is a potentially cost-effective strategy for prevention of deaths from endometrial cancer in obese women.

  20. Nonoperative management of atypical endometrial hyperplasia and grade 1 endometrial cancer with the levonorgestrel intrauterine device in medically ill post-menopausal women.

    Science.gov (United States)

    Baker, William D; Pierce, Stuart R; Mills, Anne M; Gehrig, Paola A; Duska, Linda R

    2017-07-01

    To assess the endometrial response rates to treatment with the levonorgestrel intrauterine device in post-menopausal women with atypical hyperplasia/endometrial intraepithelial neoplasia and grade 1 endometrioid (AH/EC) endometrial carcinoma who are not surgical candidates. Chart review was undertaken of patients with AH/EC who underwent levonorgestrel intrauterine device insertion by a gynecologic oncologist within two academic health systems between 2002 and 2013. When available, tissue blocks were evaluated with immunohistochemical staining for progesterone receptor expression. A total of 41 patients received treatment for AH/EC with the levonorgestrel intrauterine device. Follow up sufficient to assess response occurred in 36 women (88%). Complete response was documented in 18 of 36 women (50%), no response in 8 patients (22%), partial response in 3 women (8%) and progression of disease in 7 patients (19%). Four of 18 patients with complete response (22%) later experienced relapse of hyperplasia or cancer. Four patients (10%) died during the study period: none had evidence of metastatic disease and 1 of the 4 woman died of perioperative complications following hysterectomy for stage I disease. Patients responding to treatment had significantly lower progesterone receptor expression on post-treatment biopsies. Intrauterine levonorgestrel is a viable treatment option for post-menopausal women with AH/EC who are poor candidates for standard surgical management. The response rate in this series is similar to published reports in premenopausal patients and includes cases of disease recurrence following conversion to benign endometrium. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. PREPARATION AND RELEASE RATE OF A LEVONORGESTREL-RELEASING INTRAUTERINE DEVICE

    Institute of Scientific and Technical Information of China (English)

    LINWu; JINGZhao-Ying; ZHUGeng-Geng

    1989-01-01

    A key-shaped lcvonorgcstrcl-rclcasing intrauterine device ( LNG-IUD ) was designed and fabricated. The IUD with a hollow vcrtlcal arm was made of modified ethylene-vinyl acetate copolymcr ( EVA ). The LNG paste was cncapsulcd in the vertical arm to

  2. Conservative management in ureteric hydronephrosis due to deep endometriosis: Could the levonorgestrel-intrauterine device be an option?

    Science.gov (United States)

    Simón, Elisa; Tejerizo, Álvaro; Muñoz, José Luis; Álvarez, Carmen; Marqueta, Laura; Jiménez, Jesús S

    2017-07-01

    Endometriosis can affect up to 10% of women of reproductive age, in a wide range of clinical presentations that vary from mild to severe or deep endometriosis. Deep endometriosis can affect the urinary tract in 1-5% to 15-25% cases. Even though deep endometriosis' surgeries are usually complex with higher rate of complications, conservative management is not always considered as an option because of its high failure rates. This paper describes two cases of deep endometriosis with ureteric involvement (hydronephrosis) treated conservatively with a double-pigtail stent plus a Levonorgestrel intrauterine device, after conservative surgery, who remained symptom free with no evidence of recurrence at 3 years follow-up, avoiding radical high-risk surgery. Impact statement Several treatments have been described for endometriosis. From a symptomatic perspective, conservative medical management has been proposed with a variable response. Concerning deep endometriosis (affecting the urinary or digestive tract), the definitive treatment has always been thought to be radical surgery. However, this can lead to several complications. To illustrate a possible more conservative approach this paper describes two cases of deep infiltrating endometriosis affecting the ureter, treated conservatively with a temporary pigtail ureter stent plus a Levonorgestrel intrauterine device. The management demonstrates that, in a selected population, conservative treatment solves the urinary disease avoiding the surgical complications and, what is more, improving patients' symptoms in a permanent way. Further prospective studies are needed to confirm whether the introduction of this management in clinical practice would reduce the need for surgery thereby, avoiding high-risk surgery and improving the success rate of conservative management.

  3. The incidence of actinomyces-like organisms in Papanicolaou-stained smears of copper- and levonorgestrel-releasing intrauterine devices.

    Science.gov (United States)

    Merki-Feld, G S; Lebeda, E; Hogg, B; Keller, P J

    2000-06-01

    Actinomyces-like organisms (ALOs) are a common finding in Papanicolaou-stained cervico-vaginal smears (PAP smears) of women using an intrauterine device (IUD). The incidence of ALOs positive PAP smears depends on the type of IUD. Pelvic actinomycosis is a severe disease that may require hysterectomy and salpingo-oophorectomy. In a retrospective study we compared the incidence of ALOs positive PAP smears in users of the new levonorgestrel-releasing intrauterine device (LNG-IUD) (n = 52) with the incidence in Multiload Copper IUD (ML375) users (n = 104). All IUDs had been inserted from 1996-1998. Women with a follow-up period of more than 9 months were included into the final analysis (LNG-IUD: n = 34; ML375: n = 65). The incidence of ALOs in LNG-IUD users (2.9%) was significantly lower than in ML375 users (20%). Clinical consequences of ALOs positive PAP smears are discussed controversially. The low incidence in the LNG-IUD users probably leads to less IUD-removals, reinsertions and less pelvic-inflammatory-diseases.

  4. Immunologic evaluation of the endometrium with a levonorgestrel intrauterine device in solid organ transplant women and healthy controls.

    Science.gov (United States)

    Kim, Caron R; Martinez-Maza, Otoniel; Magpantay, Larry; Magyar, Clara; Gornbein, Jeffrey; Rible, Radhika; Sullivan, Peggy

    2016-11-01

    The objective was to describe the endometrial milieu of stable transplant patients and healthy women before and after levonorgestrel intrauterine system (LNG-IUS) insertion. Women between 18 and 45 years of age desiring LNG-IUS insertion were enrolled with a 2:1 ratio of healthy to stable solid organ transplant patients. The first visit entailed a blood draw, uterine lavage and endometrial biopsy followed by LNG-IUS insertion. Follow-up visit involved a repeat serum draw, uterine lavage and endometrial biopsy. Cytokine levels were measured in the uterine lavage and serum by quantifying inflammatory biomarkers. Immunohistochemistry staining was performed on the endometrial tissue to measure macrophage levels. Statistical analysis included a nonparametric analysis that compared medians of the marker levels before and after intrauterine device (IUD) insertion within the group and between the two groups. Sixteen participants completed the study: 5 solid organ transplant patients and 11 healthy patients. For the serum, there were no marked changes in the cytokines or soluble receptor levels in either group after IUD insertion. However, in the uterine lavage, there was an increase in cytokine levels post-IUD insertion for both healthy and transplant women. For the endometrial tissue, there was evidence of macrophage activity in both groups after device insertion. This pilot study investigated the uterine environment of the transplant patient population. Findings have pointed to the strong local inflammatory response following LNG-IUS insertion for the transplant recipients. In addition, these preliminary findings will help power a larger study that can investigate the safety and effectiveness of the IUD in this patient population. Findings from this pilot study suggest that the IUD is inducing a local inflammatory reaction in the uterus of the transplant patient as in the healthy control. A larger study can build on these preliminary results to pursue the efficacy and

  5. Treatment of Women With an Endometrial Polyp and Heavy Menstrual Bleeding: A Levonorgestrel-Releasing Intrauterine Device or Hysteroscopic Polypectomy?

    Science.gov (United States)

    van Dijk, Myrthe M; van Hanegem, Nehalennia; de Lange, Maria E; Timmermans, Anne

    2015-01-01

    We performed a literature review of reports comparing a levonorgestrel-releasing intrauterine device (LNG-IUD) with transcervical polyp resection (TCRP) as a treatment for heavy menstrual bleeding (HMB). Our second objective was to investigate the effectiveness of LNG-IUD and TCRP in reducing menstrual bleeding and the patient satisfaction with each technique. No previously reported studies have compared TCRP and LNG-IUD as treatment for HMB in premenopausal women with an endometrial polyp. Likewise, no studies are available on LNG-IUD as a treatment for HMB in the presence of an endometrial polyp. Several studies have found the LNG-IUD to be an effective treatment option for HMB, with high patient satisfaction rates. Evidence of the effectiveness of TCRP as treatment of HMB is scarce. Patient satisfaction is reported relatively good, although persistent or recurrent symptoms appear to be frequent. We conclude that no evidence is available on LNG-IUD as treatment for HMB in women with an endometrial polyp. We hypothesize that LNG-IUD could be a good alternative to TCRP for treating HMB in premenopausal women with a polyp; however, further evidence is needed, and a randomized controlled trial should be performed.

  6. [Levonorgestrel-releasing intrauterine device (Mirena) and breast cancer: what do we learn from literature for clinical practice?].

    Science.gov (United States)

    Boutet, G

    2006-11-01

    Annual occurrence of breast cancer is constantly increasing in France. In 2000, the number of breast cancer cases for women of 30-49 years was estimated at 9,918, which represents 23.7% of all breast cancer cases diagnosed that year. The levonorgestrel-releasing intrauterine device (IUD LNG) is one of the most frequently used coils in France. Because contraception is an important matter for women whose ovarian function survived cancer treatments, the question of whether to use such device on a woman with breast cancer has become a frequent and controversial gynaecological issue. With the review of available literature as a basis, we have tried to answer the following questions. First, whether the use of IUD LNG increases the risk of breast cancer: there is at the moment no "A" level answer available. According to the only study published, which may be considered "C" level, there is no such increase. Second, whether the use of IUD LNG counterbalances the endometrial effects of Tamoxifene: based on a limited level of evidence via a single randomised controlled trial on a small number of patients for one year only, this device appears to be able to prevent benign endometrial modifications. However, there is no conclusive study regarding its effectiveness on the prevention of endometrium adenocarcinoma caused by Tamoxifene. In addition, there are numerous uncertainties as to whether levonorgestrel presence in the plasma would have a systemic prejudicial impact. Third, whether a woman with a personal antecedent of breast cancer can safely use DIU LNG: it is necessary to remove it promptly upon suspicion or diagnosis, to dissuade its use in case of current cancer, and, in the event of cancer remission for more than 5 years, to generally avoid this contraceptive method except on a case by case basis and with a regular medical follow-up. In the latter situation, the use of IUD LNG can be considered only after a multidisciplinary collective formal decision and after the

  7. One-year continuation of copper or levonorgestrel intrauterine devices initiated at the time of emergency contraception.

    Science.gov (United States)

    Sanders, J N; Turok, D K; Royer, P A; Thompson, I S; Gawron, L M; Storck, K E

    2017-08-01

    This study compares 1-year intrauterine device (IUD) continuation among women presenting for emergency contraception (EC) and initiating the copper (Cu T380A) IUD or the levonorgestrel (LNG) 52 mg IUD plus 1.5 mg oral LNG. This cohort study enrolled 188 women who presented at a single family planning clinic in Utah between June 2013 and September 2014 and selected either the Cu T380A IUD or LNG 52 mg IUD plus oral LNG for EC. Trained personnel followed participants by phone, text or e-mail for 12 months or until discontinuation occurred. We assessed reasons for discontinuation and used Cox proportional hazard models, Kaplan-Meier estimates and log-rank tests to assess differences in continuation rates between IUDs. One hundred seventy-six women received IUDs; 66 (37%) chose the Cu T380A IUD and 110 (63%) chose the LNG 52 mg IUD plus oral LNG. At 1 year, we accounted for 147 (84%) participants, 33 (22%) had requested removals, 13 (9%) had an expulsion and declined reinsertion, 3 (2%) had a pregnancy with their IUD in place and 98 (67%) were still using their device. Continuation rates did not differ by IUD type; 60% of Cu T380A IUD users and 70% of LNG 52 mg IUD plus oral LNG users were still using their device at 12 months (adjusted hazard ratio 0.72, 95% confidence interval 0.40-1.3). Two-thirds of women who chose IUD placement at the EC clinical encounter continued use at 1 year. Women initiating Cu T380A IUD and LNG 52 mg IUD had similar 1-year continuation rates. These findings support same-day insertion of IUDs for women who are seeking EC and would like to use a highly effective reversible method going forward. Providing IUD options for EC users presents an opportunity to increase availability of highly effective contraception. Copyright © 2017. Published by Elsevier Inc.

  8. Weight variation in users of depot-medroxyprogesterone acetate, the levonorgestrel-releasing intrauterine system and a copper intrauterine device for up to ten years of use.

    Science.gov (United States)

    Modesto, Waleska; de Nazaré Silva dos Santos, Priscila; Correia, Vinicius Machado; Borges, Luiza; Bahamondes, Luis

    2015-02-01

    Data on record regarding weight variation in depot-medroxyprogesterone acetate (DMPA) and levonorgestrel-releasing intrauterine system (LNG-IUS) users are controversial. To date, no studies have yet evaluated weight variation in DMPA and LNG-IUS users in up to ten years of use compared to non-hormonal contraceptive users. A retrospective study analysed weight variations in 2138 women using uninterruptedly DMPA (150 mg intramuscularly, three-monthly; n = 714), the LNG-IUS (n = 701) or a copper-intrauterine device (Cu-IUD; n = 723). At the end of the first year of use, there was a mean weight increase of 1.3 kg, 0.7 kg and 0.2 kg among the DMPA-, LNG-IUS- and Cu-IUD users, respectively, compared to weight at baseline (p < 0.0001). After ten years of use, the mean weight had risen by 6.6 kg, 4.0 and 4.9 kg among the DMPA-, LNG-IUS- and Cu-IUD users, respectively. DMPA-users had gained more weight than LNG-IUS- (p = 0.0197) and than Cu-IUD users (p = 0.0294), with the latter two groups not differing significantly from each other in this respect (p = 0.5532). Users of hormonal and non-hormonal contraceptive methods gained a significant amount of weight over the years. DMPA users gained more weight over the treatment period of up to ten years than women fitted with either a LNG-IUS or a Cu-IUD.

  9. Prolonged use of the etonogestrel implant and levonorgestrel intrauterine device: 2 years beyond Food and Drug Administration-approved duration.

    Science.gov (United States)

    McNicholas, Colleen; Swor, Erin; Wan, Leping; Peipert, Jeffrey F

    2017-06-01

    The subdermal contraceptive implant and the 52-mg levonorgestrel intrauterine device are currently Food and Drug Administration approved for 3 and 5 years of use, respectively. Limited available data suggested both of these methods are effective beyond that time. Demonstration of prolonged effectiveness will improve the cost-effectiveness of the device, and potentially patient continuation and satisfaction. We sought to evaluate the effectiveness of the contraceptive implant and the 52-mg hormonal intrauterine device in women using the method for 2 years beyond the current Food and Drug Administration-approved duration. We initiated this ongoing prospective cohort study in January 2012. We are enrolling women using the contraceptive implant or 52-mg levonorgestrel intrauterine device for a minimum of 3 and 5 years, respectively (started intrauterine device in ≥2007 or implant in ≥2009). Demographic and reproductive health histories, as well as objective body mass index, were collected. Implant users were offered periodic venipuncture for analysis of serum etonogestrel levels. The primary outcome, unintended pregnancy rate, was calculated per 100 woman-years. We analyzed baseline demographic characteristics using χ(2) test and Fisher exact test, and compared serum etonogestrel levels stratified by body mass index using the Kruskal-Wallis test. Implant users (n = 291) have contributed 444.0 woman-years of follow-up. There have been no documented pregnancies in implant users during the 2 years of postexpiration follow-up. Calculated failure rates in the fourth and fifth years for the implant are calculated as 0 (1-sided 97.5% confidence interval, 0-1.48) per 100 woman-years at 4 years and 0 (1-sided 97.5% confidence interval, 0-2.65) per 100 woman-years at 5 years. Among 496 levonorgestrel intrauterine device users, 696.9 woman-years of follow-up have been completed. Two pregnancies have been reported. The failure rate in the sixth year of use of the

  10. An evaluation of the simultaneous use of the levonorgestrel-releasing intrauterine device (LNG-IUS, Mirena®) combined with endometrial ablation in the management of menorrhagia.

    LENUS (Irish Health Repository)

    Vaughan, D

    2012-05-01

    The objective of our study was to document the efficacy and possible complications in women who were treated for menorrhagia with the simultaneous use of endometrial ablation and the levonorgestrel-releasing intrauterine device. Women were offered this combined treatment if they complained of menorrhagia and needed contraception. A structured questionnaire was mailed to 150 women who had undergone this combined treatment; 105 (70%) returned a completed questionnaire. The mean duration of follow-up was 25 months (range 6-54 months). Following treatment, 53 women (50.5%) described their periods as being lighter than normal and 49 (46%) had become amenorrhoeic. Overall, 101 (96%) stated that they were satisfied with the treatment. Of the women, 95 (90.5%) said that the treatment had been a \\'complete success\\'; eight (7.6%) \\'partly successful\\' and two women (1.9%) said the treatment had been a \\'failure\\'. One woman subsequently required a hysterectomy. This observational study supports the hypothesis that combined endometrial ablation and insertion of a levonorgestrel-releasing intrauterine device is an effective treatment for menorrhagia and has some advantages when compared with the individual use of these treatments.

  11. Levonorgestrel-Releasing Intrauterine Device Use in Female Adolescents with Heavy Menstrual Bleeding and Bleeding Disorders: Single Institution Review.

    Science.gov (United States)

    Adeyemi-Fowode, Oluyemisi A; Santos, Xiomara M; Dietrich, Jennifer E; Srivaths, Lakshmi

    2017-08-01

    To identify complications and efficacy of the levonorgestrel-releasing intrauterine device (LNgIUD) in adolescents with heavy menstrual bleeding (HMB) and bleeding disorders (BD). A retrospective chart review of 13 postmenarchal adolescent girls with HMB/BD who underwent placement of an LNgIUD. Placement of an LNgIUD. Primary outcome was to identify complications from placement of an LNgIUD. Secondary outcome was to evaluate the efficacy of the LNgIUD in adolescents with BD. Thirteen patients met study criteria. The mean age of diagnosis of HMB was 14.08 ± 1.75 years. BD or bleeding risk factor diagnoses included low von Willebrand (VW) activity in 5, type I VW disease in 5, type IIM VW disease in 1, low VW activity and factor 7 deficiency in 1, and acquired VW disease and factor 7 deficiency in 1. Before LNgIUD placement, other hormonal therapy (n = 13) and hemostatic therapy (antifibrinolytic agents, desmopressin acetate; n = 8) yielded poor control of HMB. The LNgIUD was placed using anesthesia with periprocedure hemostatic therapy with no complications. All patients reported significant improvement in HMB after LNgIUD placement and 60% achieved amenorrhea, with mean time to improvement of 94 ± 69 days. Mean hemoglobin and ferritin levels increased after LNgIUD placement compared with before LNgIUD placement values (P = .02, P = .0085, respectively). Use of supplemental hormonal and hemostatic agents decreased (n = 4) after LNgIUD placement. None required LNgIUD removal; 1 spontaneously expelled the LNgIUD with subsequent replacement. Study results indicated the LNgIUD is an effective therapeutic option in postmenarchal adolescents with HMB due to BD/bleeding risk factor with minimal complications, high compliance rate, improvement in HMB and anemia, and no periprocedural bleeding with hemostatic management. Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  12. Choice of the levonorgestrel intrauterine device, etonogestrel implant or depot medroxyprogesterone acetate for contraception after aspiration abortion.

    Science.gov (United States)

    Steinauer, Jody E; Upadhyay, Ushma D; Sokoloff, Abby; Harper, Cynthia C; Diedrich, Justin T; Drey, Eleanor A

    2015-12-01

    Women who have abortions are at high risk of contraception discontinuation and subsequent unintended pregnancy. The objective of this analysis was to identify factors associated with choice of highly effective, long-acting, progestin-only contraceptive methods after abortion. Women presenting for surgical abortion who selected the levonorgestrel intrauterine device (IUD), the progestin implant or the progestin injection (depot medroxyprogesterone acetate or DMPA) as their postabortion contraceptives were recruited to participate in a 1-year prospective cohort study. We used multivariable multinomial logistic regression to identify factors associated with choosing long-acting reversible contraceptives (IUD or implant) compared to DMPA. A total of 260 women, aged 18-45 years, enrolled in the study, 100 of whom chose the IUD, 63 the implant and 97 the DMPA. The women were 24.9 years old on average; 36% were black, and 29% were Latina. Fifty-nine percent had had a previous abortion, 66% a prior birth, and 55% were undergoing a second-trimester abortion. In multivariable analyses, compared with DMPA users, women who chose the IUD or the implant were less likely to be currently experiencing intimate partner violence (IPV); reported higher stress levels; weighed more; and were more likely to have finished high school, to have used the pill before and to report that counselors or doctors were helpful in making the decision (all significant at p<.05, see text for relative risk ratios and confidence intervals.) In addition, women who chose the IUD were less likely to be black (p<.01), and women who chose the implant were more likely to report that they would be unhappy to become pregnant within 6 months (p<.05) than DMPA users. A variety of factors including race/ethnicity, past contraceptive use, feelings towards pregnancy, stress and weight were different between LARC and DMPA users. Notably, current IPV was associated with choice of DMPA over the IUD or implant, implying

  13. Ultrasound Location of Misplaced Levonorgestrel Releasing Intrauterine System (LNG-IUS) – is it easy?

    Science.gov (United States)

    Gowri, Vaidyanathan; Mathew, Mariam

    2009-01-01

    The Levonorgestrel intrauterine device (LNG-IUD) is a hormone-containing device licensed for treatment of menorrhagia and contraception. Though complications such as perforation have been reported similar to other non-hormonal intrauterine devices, the diagnosis of such complications is difficult with this device because the LNG-IUD has a different ultrasound appearance compared to copper devices and these case reports are intended to emphasize this point. PMID:22303513

  14. Ultrasound Location of Misplaced Levonorgestrel Releasing Intrauterine System (LNG-IUS) - is it easy?

    Science.gov (United States)

    Gowri, Vaidyanathan; Mathew, Mariam

    2009-01-01

    The Levonorgestrel intrauterine device (LNG-IUD) is a hormone-containing device licensed for treatment of menorrhagia and contraception. Though complications such as perforation have been reported similar to other non-hormonal intrauterine devices, the diagnosis of such complications is difficult with this device because the LNG-IUD has a different ultrasound appearance compared to copper devices and these case reports are intended to emphasize this point.

  15. Review of the safety, efficacy and patient acceptability of the levonorgestrel-releasing intrauterine system

    Directory of Open Access Journals (Sweden)

    Chandra Kailasam

    2008-10-01

    Full Text Available Chandra Kailasam1, David Cahill21Bristol Centre for Reproductive Medicine, Southmead Hospital, Bristol, UK; 2Dept of Obstetrics and Gynaecology, University of Bristol, St Michael’s Hospital, Bristol, UKAbstract: The levonorgestrel-containing intrauterine system is an extremely effective, reversible and safe form of long-term yet reversible birth control. In view of its efficacy, it is a safer alternative to permanent contraceptive methods such as sterilization. It is especially useful in situations where use of estrogen-containing contraceptives is contraindicated. While menstrual disturbances are a common side effect, proper counseling improves compliance. In addition to its contraceptive effect, the levonorgestrel intrauterine system offers potential therapeutic benefits in other clinical contexts, including menorrhagia, symptomatic fibroids, endometriosis, and endometrial protection.Keywords: intrauterine device, levonorgestrel intrauterine device, contraception

  16. Role of the levonorgestrel intrauterine system in effective contraception

    Directory of Open Access Journals (Sweden)

    Attia AM

    2013-08-01

    Full Text Available Abdelhamid M Attia,1 Magdy M Ibrahim,1 Ahmed M Abou-Setta21Department of Obstetrics and Gynecology, Cairo University, Cairo, Egypt; 2George and Fay Yee Centre for Healthcare Innovation, University of Manitoba/Winnipeg Regional Health Authority, Winnipeg, MB, CanadaAbstract: Norgestrel, a synthetic progestin chemically derived from 19-nortestosterone, is six times more potent than progesterone, with variable binding affinity to various steroid receptors. The levonorgestrel-releasing intrauterine system (LNG IUS provides a long-acting, highly effective, and reversible form of contraception, with a pearl index of 0.18 per 100 women-years. The locally released hormone leads to endometrial concentrations that are 200–800 times those found after daily oral use and a plasma level that is lower than that with other forms of levonorgestrel-containing contraception. The contraceptive effect of the LNG IUS is achieved mainly through its local suppressive effect on the endometrium, leading to endometrial thinning, glandular atrophy, and stromal decidualization without affecting ovulation. The LNG IUS is generally well tolerated. The main side effects are related to its androgenic activity, which is usually mild and transient, resolving after the first few months. Menstrual abnormalities are also common but well tolerated, and even become desirable (eg, amenorrhea, hypomenorrhea, and oligomenorrhea with proper counseling of the patient during the choice of the method of contraception. The satisfaction rates after 3 years of insertion are high, reaching between 77% and 94%. The local effect of the LNG IUS on the endometrium and low rates of systemic adverse effects have led to its use in other conditions rather than contraception, as for the treatment of endometrial hyperplasia, benign menorrhagia, endometriosis, adenomyosis, and uterine fibroids.Keywords: levonorgestrel, intrauterine device, contraception, family planning, Mirena, Skyla

  17. The levonorgestrel-releasing intrauterine system: Safety, efficacy, and patient acceptability

    Directory of Open Access Journals (Sweden)

    Megan N Beatty

    2009-07-01

    Full Text Available Megan N Beatty, Paul D BlumenthalDepartment of Obstetrics and Gynecology, Stanford University, Stanford, CA, USAAbstract: The levonorgestrel-releasing intrauterine system (LNG-IUS is a safe, effective and acceptable form of contraception used by over 150 million women worldwide. It also has a variety of noncontraceptive benefits including treatment for menorrhagia, endometriosis, and endometrial hyperplasia. The LNG-IUS has also been used in combination with estrogen for hormone replacement therapy and as an alternative to hysterectomy. Overall, the system is very well tolerated and patient satisfaction is quite high when proper education regarding possible side effects is provided. However, despite all of the obvious benefits of the LNG-IUS, utilization rates remain quite low in the developed countries, especially in the United States. This is thought to be largely secondary to the persistent negative impressions from the Dalkon Shield intrauterine experience in the 1970s. This history continues to negatively influence the opinions of both patients and health care providers with regards to intrauterine devices. Providers should resolve to educate themselves and their patients on the current indications and uses for this device, as it, and intrauterine contraception in general, remains a largely underutilized approach to a variety of women’s health issues.Keywords: Mirena®, levonorgestrel-releasing, intrauterine system, intrauterine contraceptive device

  18. Levonorgestrel-releasing intrauterine system use in premenopausal women with symptomatic uterine leiomyoma: a systematic review.

    Science.gov (United States)

    Jiang, Wenxiao; Shen, Qi; Chen, Miaomiao; Wang, Ying; Zhou, Qingfeng; Zhu, Xuejie; Zhu, Xueqiong

    2014-08-01

    A systematic review is done to determine the efficacy and safety of levonorgestrel-releasing intrauterine systems as a treatment using in premenopausal women with symptomatic uterine leiomyoma. We searched the Medline, Central and ICTRP databases for all articles published from inception through July 2013 that examined the following outcomes: uterine volume, uterine leiomyoma volume, endometrial thickness, then menstrual blood loss, blood haemoglobin, ferritin and hematocrit levels, treatment failure rate, device expulsion rate, hysterectomy rate and side effects. From 645 studies, a total of 11 studies met our inclusion criteria with sample sizes ranging from 10 to 104. Evidence suggested that levonorgestrel-releasing intrauterine systems could decrease uterine volume and endometrial thickness, significantly reduce menstrual blood loss, and increase blood haemoglobin, ferritin and hematocrit levels. There was no evidence for decreasing uterine leiomyoma volume. There were no adverse effects on the ovarian function except for ovarian cysts. Device expulsion rates were low, which associated with leiomyoma size (larger than 3cm) but not with leiomyoma location. Irregular bleeding/spotting was observed at the beginning of the follow-up period and then decreased progressively. Results of this systematic review indicate that levonorgestrel-releasing intrauterine systems may be effective and safe treatment for symptomatic uterine leiomyoma in premenopausal women.

  19. Use of the levonorgestrel 52-mg intrauterine system in adolescent and young adult solid organ transplant recipients: a case series.

    Science.gov (United States)

    Huguelet, P S; Sheehan, C; Spitzer, R F; Scott, S

    2017-04-01

    This case series reports on the safety and efficacy of the levonorgestrel 52-mg intrauterine system in adolescent and young adult solid organ transplant recipients. All patients used the device for contraception, with no documented cases of disseminated pelvic infection or unplanned pregnancy. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. 左炔诺孕酮宫内缓释系统治疗子宫腺肌病疗效观察%Curative effect and observation of adenomyosis treated with levonorgestrel-releasing intrauterine device

    Institute of Scientific and Technical Information of China (English)

    杨丽晔; 崔友红; 张梅; 费华

    2011-01-01

    Objective To investigate the clinical effection of levonorgestrel-releasing intrauterine device (LNG IUS) in the treatment of adenomyosis.Methods Before LNG-IUS insertion and after 3, 6, 12, 18 months, 74 cases were asked to complete a visual analog scale ( VAS) form regarding pelvic pain, pictorial blood loss assessment chart (PBAC) form regarding menstrual blood volume and volume of uterus.Results After the 18-month visit, VAS score,PBAC score and volume of uterus were 0.74, 42.7, 206.5cm3, respectively.There were decreased significantly before LNG-IUS insertion(P<0.05).Conclusion Levonorgestrel intrauterine device is a preferable effective method in the treatment of adenomyosis.%目的 观察子宫腺肌病患者放置左炔诺孕酮宫内缓释系统(LNG-IUS;商品名:曼月乐)后的临床效果.方法 观察74例子宫腺肌病患者放置LNG-IUS前,放置后3、6、12、18个月痛经评分(VAS)、PBAC法月经量评分、子宫体积的变化.结果 痛经评分、经量评分和子宫体积大小在放置后18个月分别为0.74、42.7和206.5 cm3,与放置前相比差异有统计学意义(P<0.05).结论 曼月乐是治疗子宫腺肌病的一种较为有效且安全的方法.

  1. A 3-year multicentre randomized controlled trial of etonogestrel- and levonorgestrel-releasing contraceptive implants, with non-randomized matched copper-intrauterine device controls.

    Science.gov (United States)

    Bahamondes, Luis; Brache, Vivian; Meirik, Olav; Ali, Moazzam; Habib, Ndema; Landoulsi, Sihem

    2015-11-01

    Is there any difference in the clinical performance of the 3-year one-rod etonogestrel (ENG)- and the 5-year two-rod levonorgestrel (LNG)-releasing contraceptive implants during 3 years of insertion, and between implant and intrauterine device (IUD) contraception, in particular complaints possibly related to hormonal contraceptives? The cumulative contraceptive effectiveness after 3 years and method continuation through 2.5 years were not significantly different between ENG and LNG implants, but both outcomes were significantly worse in the non-randomized age-matched group of IUD users than in the combined implant group. ENG- and LNG-releasing implants are safe and highly efficacious contraceptives with pregnancy rates reported to be 0.0-0.5 per 100 women-years (W-Y). No head-to-head comparative study of the two implants has been undertaken, and little information is available on comparisons of complaints of side effects of implant and copper IUD users. This was an open parallel group RCT with 1:1 allocation ratio of the ENG and the LNG implants with non-randomized control group of women choosing TCu380A IUD to address lack of reliable data on common side effects typically attributed to the use of progestogen-only contraceptives. After device(s) placement, follow-ups were at 2 weeks, 3 and 6 months, and semi-annually thereafter for 3 years or until pregnancy, removal or expulsion of the implant/IUD occurred. The study took place in family planning clinics in Brazil, Chile, Dominican Republic, Hungary, Thailand, Turkey and Zimbabwe. Women seeking long-term contraception were enlisted after an eligibility check and informed consent, and 2982 women were enrolled: 1003, 1005 and 974 in the ENG-implant, LNG-implant and IUD groups, respectively; 995, 997 and 971, respectively, were included in the per protocol analysis reported here. ENG and LNG implants each had the same 3-year cumulative pregnancy rate of 0.4 per 100 W-Y [95% confidence interval (CI) 0.1-1.4]. A weight

  2. Non-contraceptive benefits of intrauterine levonorgestrel administration: why not?

    Science.gov (United States)

    Sabbioni, Lorenzo; Petraglia, Felice; Luisi, Stefano

    2017-06-06

    Levonorgestrel intrauterine systems (LNG-IUS) represent a modern therapy for an array of preexisting gynecological conditions, though they were first marketed in Finland in 1990. However, there are countries in which their use is extremely limited by social and cultural factors. This manuscript describes the possible reasons for this misuse, taking in consideration the clinical noncontraceptive benefits of intrauterine levonorgestrel in routinary practice. Medical diseases in which LNG-IUS represent a treatment include abnormal uterine bleeding, iron-deficiency anemia, endometrial hyperplasia, uterine fibroids, adenomyosis, endometriosis, and coagulopathies. The advantage of reducing the need for more radical treatments such as surgery or hysterectomy is well demonstrated, with remarkable benefits for patients. However, in many countries, surgery is still used as a first-line treatment and there is a need to define who could benefit from a less invasive option. It seems clear that such a reduced use of LNG-IUS depends on factors that imply both patients and practitioners, and that the role of counseling is becoming a key component in the decision-making process to reach the ultimate goal of compliance.

  3. Application analysis of levonorgestrel intrauterine device in treatment of young and middle-aged people with adenomyosis%左炔诺孕酮宫内节育器在中青年子宫腺肌症治疗中的应用分析

    Institute of Scientific and Technical Information of China (English)

    涂小娥; 刘强

    2014-01-01

    目的:探析左炔诺孕酮宫内节育系统在中青年子宫腺肌症治疗中的临床效果。方法选取我院就诊治疗子宫肌腺患者28例子宫腺肌患者,观察在放置左炔诺孕酮宫内节育器前后痛经、月经量、子宫体积、子宫内膜厚度、血清CA125、血清性激素水平的变化情况,比较治疗前后患者临床症状、激素水平的变化及不良反应。结果左炔诺孕酮宫内节育器放置12个月后,患者的痛经程度降低,子宫体积和子宫内膜厚度明显减小,CA125水平明显减低,与放置前相比差异有统计学意义(P<0.05)。结论利用左炔诺孕酮宫内节育器可明显改善子宫腺肌症中痛经、月经量等临床症状,值得临床进一步研究进而推广。%Objective To explore the clinical effects of levonorgestrel intrauterine device in the treatment of young and middle-aged people with adenomyosis.Methods Twenty-eight patients with adenomyosis treated in our hospital were selected.Changes of the patients'dysmenorrhea,menstrual blood volume,uterine volume, endometrial thickness,serum CA125 and serum sex hormone levels after placing the levonorgestrel intrauterine device were observed.The clinical symptoms,hormone level changes and adverse reactions of the patients before and after the placement of levonorgestrel intrauterine device were compared.Results After placing the levonorgestrel intrauterine device for 12 months, the patients'dysmenorrhea degree decreased,uterine volume and endometrial thickness significantly reduced, and CA125 level significantly lowered,with significant differences to those before placing (P<0.05).Conclusion The application of levonorgestrel intrauterine device can significantly improve the clinical symptoms such as dysmenorrhea and menstrual blood volume in adenomyosis,thereby worthy of further clinical study and subsequent promotion.

  4. The clinical efficacy of levonorgestrel intrauterine device on endometriosis patients after surgery%子宫内膜异位症术后置左炔诺孕酮宫内节育器的临床疗效

    Institute of Scientific and Technical Information of China (English)

    李瑞珠

    2013-01-01

    目的 观察子宫内膜异位症术后置左炔诺孕酮宫内节育器的临床疗效.方法 选择经手术和病理确诊的子宫内膜异位症患者84例,均行腹腔镜手术,按随机数字表法分为对照组和治疗组,每组42例.对照组术后仅予短期药物治疗,治疗组在对照组治疗的基础上术后放置左炔诺孕酮宫内节育器.术后随访1年,比较两组疗效. 结果 治疗组随访1年时的疼痛评分为0分,低于对照组的(1.5±0.2)分,差异有统计学意义(P<0.05);治疗组术后术后月经量占术前的比例及癌抗原125水平明显低于对照组[(1l±3)%比(45±6)%、(7.01±2.97) U/L比(38.79±31.43) U/L],差异有统计学意义(P<0.05);治疗组术后病灶复发率为2.38%(1/42),低于对照组的28.57%(12/42),差异有统计学意义(P<0.05).结论 子宫内膜异位症术后置左炔诺孕酮宫内节育器能明显缓解患者术后疼痛,减少月经量,降低病灶复发率,临床疗效显著.%Objective To observe the clinical efficacy of levonorgestrel intrauterine device (IUD) on endometriosis patients after surgery.Methods Eighty-four endometriosis patients diagnosed by pathological and surgery were divided into control group and treatment group by random digits table with 42 cases each group.The control group was accepted only short-term drug treatment,while the treatment group was placed levonorgestrel intrauterine device on the basis of control group,then comparing the efficacy after followed up for one year.Results The mean pain score of treatment group was 0,control group was (1.5 ±0.2) points,the difference was statistically significant (P< 0.05).The menstrual blood volume and CA125 levels in treatment group were significantly lower than those in control group [(11 ± 3)% vs.(45 ± 6)%,(7.01 ±2.97) U/L vs.(38.79 ±31.43) U/L] (P <0.05).The recurrence rate in treatment group was significantly lower than that in control group [2.38% (1/42) vs.28.57% (12/42),P

  5. The missing intrauterine device

    Directory of Open Access Journals (Sweden)

    Rajesh Devassy

    2016-10-01

    Full Text Available The Intrauterine Contraceptive Device (IUD is an acceptable and common form of contraception worldwide. The objective of this study was to report the case of an asymptomatic missing intrauterine contraceptive (IUD inserted to prevent intrauterine adhesions after synechiolysis. A patient presented with missing IUD threads. Ultrasound of the pelvis showed an empty uterine cavity with the missing IUD probably anterior to the uterus. We present a stepwise approach in the management of the and ldquo;lost IUD and rdquo;, where the strings of the device are not visible at the time of speculum examination. We suggest first determining sonographically whether the IUD is within the cavity. If it is in situ, options for retrieval are including hysteroscopic retrieval. If the IUD is not within the cavity, X-rays are recommended. The device will not be present on X-ray if expulsion has occurred. If the device is present on the X-ray, cystoscopic or laparoscopic retrieval is required. IUD-providers should not only screen potential users and insert IUD correctly, but also ensure adequate follow-up with localization. [Int J Reprod Contracept Obstet Gynecol 2016; 5(10.000: 3587-3589

  6. Aplicação de dispositivo intra-uterino liberador de levonorgestrel, previamente a ciclos de fertilização in vitro, nas portadoras de adenomiose Application of a levonorgestrel-releasing intrauterine device prior to in vitro fertilization cycles in women with adenomyosis

    Directory of Open Access Journals (Sweden)

    Nilson Donadio

    2006-08-01

    Full Text Available OBJETIVO: verificar os efeitos do dispositivo intra-uterino (DIU de levonorgestrel em portadoras de adenomiose, com falhas de implantação em ciclos de fertilização in vitro (FIV. MÉTODOS: foram selecionadas 80 mulheres inférteis, com até 38 anos, com diagnóstico de adenomiose pela ultra-sonografia e ressonância magnética pélvica. Todas apresentavam tentativas anteriores de FIV sem sucesso. No grupo Diu, de 40 mulheres, foi colocado DIU liberador de 20 µg de levonorgestrel/dia por seis meses, previamente a um novo ciclo de FIV. No grupo Fiv, de 40 mulheres, estas foram submetidas diretamente a novo ciclo, sem o prévio tratamento. No Grupo Diu, avaliaram-se o volume uterino, a espessura e os focos de hipersinal da zona juncional, pré e pós-tratamento, assim como as taxas de gravidez em novo ciclo de FIV comparadas com as obtidas no grupo Fiv. As análises estatísticas foram realizadas adotando-se o nível de significância de 5% (pPURPOSE: to verify the effects of intrauterine levonorgestrel device (IUD in women with adenomyosis, with implantation failure in previous in vitro fertilization (IVF cycles. METHODS: eighty infertile women with ages up to 38 years, who had adenomyosis diagnosed by ultrasonography and MRI were selected. All the women presented antecedents of one or more tormer IVF attempts without success due to implantation failure. The women were subdivided into IUD Group, composed of 40 women with an IUD that released 20 µg of levonorgestrel/day during six months, preceding a new IVF cycle, and IVF Group, also composed of 40 women, who were directly submitted to a new IVF cycle without previous adenomyosis treatment. In the IUD Group the uterine volume, thickness and hypersignal foci of the junctional zone were assessed before and after treatment, as well as the pregnancy rates in the new IVF cycle, compared to the data obtained with the IVF Group. Statistical analyses were performed adopting the significance level of

  7. Review of the safety, efficacy and patient acceptability of the levonorgestrel-releasing intrauterine system

    Science.gov (United States)

    Kailasam, Chandra; Cahill, David

    2008-01-01

    The levonorgestrel-containing intrauterine system is an extremely effective, reversible and safe form of long-term yet reversible birth control. In view of its efficacy, it is a safer alternative to permanent contraceptive methods such as sterilization. It is especially useful in situations where use of estrogen-containing contraceptives is contraindicated. While menstrual disturbances are a common side effect, proper counseling improves compliance. In addition to its contraceptive effect, the levonorgestrel intrauterine system offers potential therapeutic benefits in other clinical contexts, including menorrhagia, symptomatic fibroids, endometriosis, and endometrial protection. PMID:19920976

  8. Timing of insertion of levonorgestrel-releasing intrauterine system : a randomised controlled trial

    NARCIS (Netherlands)

    van der Heijden, Pahh; Geomini, Pmaj; Herman, M C; Veersema, S; Bongers, M Y

    OBJECTIVE: The objective was to assess whether patient-perceived pain during the insertion of the levonorgestrel-releasing intrauterine system (LNG-IUS) depends on the timing during the menstrual cycle. DESIGN: A stratified two-armed non-inferiority randomised controlled trial. SETTING: Large

  9. Pregnant with a perforated levonorgestrel intrauterine system and visible threads at the cervical os.

    Science.gov (United States)

    Howard, David L; Beasley, Lauren M

    2017-05-22

    We present a case in which a patient presented with a pregnancy of unknown location and normally rising human chorionic gonadotropin (hCG) levels but with a levonorgestrel intrauterine device (LNG-IUD) present. The LNG-IUD had been placed 4.5 years ago. Although unintended, this pregnancy was desired. Strings were clearly visible and initial 2D ultrasound suggested intrauterine location of the LNG-IUD. The LNG-IUD could not be removed however. The patient was managed expectantly with close follow-up, serial beta-hCGs and serial ultrasounds until definitive diagnosis of the location of the pregnancy. The patient was diagnosed with an ectopic pregnancy and during laparoscopy the body of the IUD was noted in the posterior cul-de-sac. When patients present with multiple competing clinical problems it is important to look at the patient as a whole, taking into account their desires, in order to construct a cohesive management plan. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  10. Milestones in intrauterine device development.

    Science.gov (United States)

    Tatum, H J

    1983-02-01

    Levonorgestrel T, both of which effect a reduction in menstrual blood loss. While major advances have been made in the field of intrauterine contraception, more innovations and improvements can be expected in the future.

  11. Hysteroscopic sterilization of patient with intrauterine device Mirena®.

    Science.gov (United States)

    Depes, Daniella De Batista; Pereira, Ana Maria Gomes; Yatabe, Salete; Lopes, Reginaldo Guedes Coelho

    2013-01-01

    Tubal sterilization is the definitive procedure most often used worldwide to control fecundity. Laparoscopic ligature is safe, but invasive and with possible surgical and anesthetic risks. The hysteroscopic approach enables tubal occlusion at outpatient's setting without the need of incisions or anesthesia. A microdevice (Essure®) is inserted directly into the tubes and its polyethelene fibers cause obstruction of tubes in about three months. During this period, it is recommended that patients continue the use of a temporary birth control method. Several women use the levonorgestrel-releasing intrauterine system, which is called in the market as Mirena®. This report evaluated the possibility of inserting Essure® without remove the intrauterine device; patient tolerance to the procedure was also assessed. The tubal device was successfully placed in the patient without the need to remove Mirena®. After three months the intrauterine device was removed with no intercurrent events.

  12. The effects of the levonorgestrel intrauterine system (Mirena coil) on endometrial morphology

    Science.gov (United States)

    Phillips, V; Graham, C T; Manek, S; McCluggage, W G

    2003-01-01

    Aims: The Mirena coil is a levonorgestrel releasing intrauterine device that is in widespread use. This study aims to document the endometrial morphology associated with this device. Methods: Endometrial specimens from 75 women with the Mirena coil were reviewed and the histological features detailed. Results: Morphological features found in most of the endometria were decidualisation of stroma (72 of 75 cases), atrophy of endometrial glands (65 of 75 cases), a surface papillary pattern (38 of 75 cases), and a stromal inflammatory cell infiltrate (59 of 75 cases). Additional common histological features were the presence of foci of stromal myxoid change (29 of 75 cases) and stromal haemosiderin pigment (24 of 75 cases). Reactive atypia of surface glands, glandular metaplastic changes, stromal necrosis, and stromal calcifications were found in small numbers of cases. Conclusion: The endometrial features are characteristic and relatively constant and are in keeping with the effects of both a progestogenic compound and a mechanical device. Pathologists should be aware of these histological features because the Mirena coil is in widespread use. PMID:12663645

  13. Levonorgestrel-releasing intrauterine system (LNG-IUS 12) for prevention of pregnancy for up to five years.

    Science.gov (United States)

    Nelson, Anita L

    2017-08-01

    A new five-year low dose, smaller-framed, levonorgestrel-releasing intrauterine contraceptive system (LNG-IUS 12) has been introduced to complement the currently available systems. Areas Covered: This article will provide an overview of this new intrauterine system - its composition and its mechanisms of action as well as the results of the Phase II and III clinical trials of its efficacy, safety and tolerability. Expert Commentary: This new LNG-IUS 12 provides five-year contraceptive protection a pregnancy rate (less than 1%) in first year of use, which puts it into the top tier with the existing LNG-IUS 20 products; however, the LNG-IUS 12 does not have the high rates of amenorrhea often seen with the higher dose devices. On the other hand, this new IUD shares the smaller frame and narrower insertion tube with the lower dose LNG-IUS 8, but offers longer effective life.

  14. Levonorgestrel-releasing intrauterine systems for long-acting contraception: current perspectives, safety, and patient counseling

    Directory of Open Access Journals (Sweden)

    Costescu DJ

    2016-10-01

    Full Text Available Dustin J Costescu Department of Obstetrics and Gynaecology, McMaster University, Hamilton, ON, Canada Abstract: Unintended pregnancy is a significant global problem. In 2008, there were over 100 million unplanned pregnancies worldwide, representing approximately 41% of global conceptions. Family planning strategies in many countries are shifting from increasing the uptake of contraception among nonusers to increasing the uptake of the most effective methods among users of less effective methods. One of the most effective and acceptable methods of contraception is the levonorgestrel-releasing intrauterine system (LNG IUS; however, its uptake varies widely by country. This article reviews the currently available LNG IUSs, the rationale for increasing uptake of these methods, and evidence regarding safety, and discusses counseling strategies to best inform women about this option for contraception. Keywords: LNG IUS, long-acting contraception, intrauterine contraception, levonorgestrel, contraception, family planning

  15. The Effectiveness of Levonorgestrel-Releasing Intrauterine System in the Treatment of Heavy Menstrual Bleeding.

    Science.gov (United States)

    Eralil, Georgy Joy

    2016-10-01

    Levonorgestrel-releasing intrauterine system (LNG-IUS) has been shown to be an effective treatment for patients with abnormal uterine bleeding (AUB) in many Western studies. The purpose of study was to examine the effectiveness of LNG-IUS in the treatment of Indian women with AUB. We conducted a retrospective observational study of 70 women diagnosed with AUB and treated with LNG-IUS insertion between February 2010 and 2014 at the Department of Gynecology of Sree Narayana Institute of Medical Sciences. Baseline endometrial biopsies were done before insertion of LNG-IUS, and outpatient follow-up with symptom diary was undertaken at 3-month intervals after insertion of LNG-IUS. Primary outcome in the two treatment groups was significantly greater among women assigned to levonorgestrel-IUS than among those assigned to usual treatment (mean difference in scores over the course of 1 year 13.4 points; 95 % confidence interval [CI] 9.9-16.9; P < 0.001). All six domains of the MMAS favored the levonorgestrel-IUS at every time point (P < 0.001) with the use of a test for trend. In conclusion, our study showed that both the levonorgestrel-IUS and usual medical treatments reduced the adverse effect of menorrhagia on women's lives over the course of 2 years, but the levonorgestrel-IUS was the more effective first choice, as assessed by the impact of bleeding on the women's quality of life.

  16. Application analysis of levonorgestrel-releasing intrauterine device in the treatment of young and middle-aged patients with adenomyosis%左炔诺孕酮宫内节育器在中青年子宫腺肌症治疗中的应用分析

    Institute of Scientific and Technical Information of China (English)

    徐红云

    2015-01-01

    目的 探讨临床上使用左炔诺孕酮宫内节育器治疗中青年子宫腺肌症的疗效. 方法 选取2013年1月至2014年9月鄢陵县人民医院收治的24例子宫腺症患者为研究对象,于宫内置左炔诺孕酮宫内节育器,随访1年,观察记录节育器放置前和放置后4、8、12 个月时患者的月经量、痛经程度、子宫大小、子宫内膜厚度、血清CA125及性激素变化情况. 结果 连续放置1年后患者月经量显著减少、痛经程度明显减轻、子宫大小和子宫内膜厚度显著降低、CA125水平显著降低,与放置前比较差异有统计学意义( P0.05). 结论 左炔诺孕酮宫内节育可显著改善中青年子宫腺肌症患者的月经量并缓解痛经,是一种较好的治疗中青年子宫腺肌症的保守治疗手段.%Objective To investigate the clinical effect of levonorgestrel-releasing intrauterine device on young and middle-aged patients with adenomyosis .Methods Twenty-four patients with adeno-myosis from January 2013 to September 2014 were selected and treated by levonorgestrel-releasing intrau-terine device .The menstrual capacity , dysmenorrhea of the degree , uterine size , endometrial thickness , serum CA125 and serum sex hormone levels were detected before and 4 , 8 , 12 months after treatment . Results After treatment for 12 months, the menstrual capacity , dysmenorrhea of the degree , uterine size, endometrial thickness, serum CA125 were changed significantly (P0.05).Conclusions The application of levonorgestrel-releasing intrauterine device is good to im-prove the clinical symptoms such as menstrual capacity and dysmenorrhea of the degree in adenomyosis , which can be a good conservative treatment method for the treatment of young and middle-aged patients with adenomyosis .

  17. Intrauterine levonorgestrel delivery with frameless fibrous delivery system: review of clinical experience.

    Science.gov (United States)

    Wildemeersch, Dirk; Andrade, Amaury; Goldstuck, Norman D; Hasskamp, Thomas; Jackers, Geert

    2017-01-01

    The concept of using a frameless intrauterine device (IUD) instead of the conventional plastic framed IUD is not new. Frameless copper IUDs have been available since the late 1990s. They rely on an anchoring system to retain in the uterine cavity. The clinical experience with these IUDs suggests that frameless IUDs fit better as they are thin and, therefore, do not disturb or irritate the uterus. High tolerance and continuation rates have been achieved as complaints of pain are virtually nonexistent and the impact on menstrual blood loss is minimal. Conventional levonorgestrel-releasing intrauterine systems (LNG-IUSs) are very popular as they significantly reduce menstrual bleeding and provide highly effective contraception. However, continuation of use remains problematic, particularly in young users. Total or partial expulsion and displacement of the LNG-IUS also occur too often due to spatial incompatibility within a small uterine cavity, as strong uterine contractions originate, attempting to get rid of the bothersome IUD/IUS. If not expelled, embedment ensues, often leading to chronic pain and early removal of the IUD/IUS. Several studies conducted recently have requested attention to the relationship between the LNG-IUS and the endometrial cavity. Some authors have proposed to measure the cavity width prior to inserting an IUD, as many uterine cavities are much smaller than the currently existing LNG-IUSs. A frameless fibrous drug delivery system fits, in principle, in all uterine cavities and may therefore be preferable to framed drug delivery systems. This review examines the clinical performance, acceptability, and potential of the frameless LNG-IUS (FibroPlant(®)) when used for contraception, treatment of heavy menstrual bleeding, dysmenorrhea, and endometrial suppression in women using estrogen replacement therapy, endometrial hyperplasia, and other gynecological conditions. The review concludes that FibroPlant LNG-IUS offers unique advantages in

  18. Intrauterine levonorgestrel delivery with frameless fibrous delivery system: review of clinical experience

    Science.gov (United States)

    Wildemeersch, Dirk; Andrade, Amaury; Goldstuck, Norman D; Hasskamp, Thomas; Jackers, Geert

    2017-01-01

    The concept of using a frameless intrauterine device (IUD) instead of the conventional plastic framed IUD is not new. Frameless copper IUDs have been available since the late 1990s. They rely on an anchoring system to retain in the uterine cavity. The clinical experience with these IUDs suggests that frameless IUDs fit better as they are thin and, therefore, do not disturb or irritate the uterus. High tolerance and continuation rates have been achieved as complaints of pain are virtually nonexistent and the impact on menstrual blood loss is minimal. Conventional levonorgestrel-releasing intrauterine systems (LNG-IUSs) are very popular as they significantly reduce menstrual bleeding and provide highly effective contraception. However, continuation of use remains problematic, particularly in young users. Total or partial expulsion and displacement of the LNG-IUS also occur too often due to spatial incompatibility within a small uterine cavity, as strong uterine contractions originate, attempting to get rid of the bothersome IUD/IUS. If not expelled, embedment ensues, often leading to chronic pain and early removal of the IUD/IUS. Several studies conducted recently have requested attention to the relationship between the LNG-IUS and the endometrial cavity. Some authors have proposed to measure the cavity width prior to inserting an IUD, as many uterine cavities are much smaller than the currently existing LNG-IUSs. A frameless fibrous drug delivery system fits, in principle, in all uterine cavities and may therefore be preferable to framed drug delivery systems. This review examines the clinical performance, acceptability, and potential of the frameless LNG-IUS (FibroPlant®) when used for contraception, treatment of heavy menstrual bleeding, dysmenorrhea, and endometrial suppression in women using estrogen replacement therapy, endometrial hyperplasia, and other gynecological conditions. The review concludes that FibroPlant LNG-IUS offers unique advantages in reducing

  19. The intrauterine device and the intrauterine system.

    Science.gov (United States)

    Stephen Searle, E

    2014-08-01

    Intrauterine contraception is used by about 100 million women worldwide, making it the most popular form of fertility regulation. In UK community contraception clinics, however, long-acting reversible contraception has increased to 28% of users, and intrauterine contraception accounts for only 8% of methods used by women accessing these services. Potential exists to increase uptake of these more effective methods. In this chapter, we review the clinical advantages, disadvantages and cost-effectiveness of intrauterine contraception. We discuss the management of complications along with advice for trainers, and briefly consider issues in developing countries.

  20. [Levonorgestrel-releasing intrauterine system Mirena® (Bayer) for the prevention and treatment of endometrial adenocarcinoma and the incidence of other malignancies in women].

    Science.gov (United States)

    Jóźwik, Maciej; Jóźwik, Marcin; Modzelewska, Beata; Niewińska, Marta; Jóźwik, Michał

    2015-04-01

    The use of hormone-releasing intrauterine devices has been on the increase for the last three decades. To date, evidence of their long-term efficiency is available. The aim of the present paper was to briefly review beneficial prophylactic effects of the levonorgestrel-releasing intrauterine system on the incidence of a variety of malignancies in women. Such an influence is of a particular importance in the light of the currently observed increased prevalence of endometrial and cervical adenocarcinomas. Low-dose releasing intrauterine systems are also available, but the hard evidence-based medical data have been derived primarily for Mirena® (Bayer) device, which topically releases from 20 to 14 pg of levonorgestrel daily. Consequently the risk of developing endometrial carcinoma in Mirena® users is lowered by as much as 50% compared with the general population risk To a lesser extent, the intrauterine system decreases the risk for cervical adenocarcinoma and squamous cell carcinoma, as well as ovarian, pancreas, and lung carcinomas. In one population-based study Mirena® increased the risk for breast carcinoma by approximately 20%, whereas a number of other studies failed to demonstrate such a hazard. In the recent decades of the increased predominance of insulin resistance and obesity and an occurrence of hormone-dependent carcinomas at earlier age, a broad application of levonorgestrel-releasing intrauterine systems may become a particularly important component of primary prevention of malignancies in women. Both obese and overweight patients seem perfect candidates for such a hormonal intervention.

  1. Relationship between user satisfaction with the levonorgestrel-releasing intrauterine system and bleeding patterns.

    Science.gov (United States)

    Carvalho, Nelsilene M; Chou, Victoria; Modesto, Waleska; Margatho, Deborah; Garcia, Elaine A L; Bahamondes, Luis

    2017-08-17

    Satisfaction with a contraceptive method constitutes an important factor in its acceptance and long-term use. The objective of this study was to assess the relationship between user satisfaction with the 20-μg/day levonorgestrel-releasing intrauterine system (LNG-IUS) and the bleeding patterns reported at two different time-points during follow-up. A total of 251 LNG-IUS users aged 18-45 years were invited to answer a questionnaire on their return to the clinic for a routine follow-up visit and again 1 year later. Data were collected face-to-face. Twenty women discontinued prematurely; therefore, the analysis was performed on 231 women. Most users were either highly satisfied (66.6% and 66.2% at the first and second interviews, respectively) or satisfied (26.4% and 26.4% at the first and second interviews, respectively) with the LNG-IUS. Satisfaction was related to amenorrhea (P < 0.001) and duration of use (P < 0.001). Prolonged bleeding and spotting were the main causes of dissatisfaction with the device. Most LNG-IUS users in this sample were satisfied with the device. The only two factors associated with satisfaction were amenorrhea and duration of use, while prolonged bleeding and spotting were the main causes of dissatisfaction. These findings could be useful for health-care professionals and policy-makers when developing information material for women. The study provides insight into the profile of satisfied LNG-IUS users; however, this information is not suitable for counseling women who are considering using an LNG-IUS. © 2017 Japan Society of Obstetrics and Gynecology.

  2. Intrauterine devices containing progesterone.

    Science.gov (United States)

    Murad, F

    1977-05-01

    Characteristics of progesterone-releasing IUDs are reported. At present, the only progesterone-containing IUD on the market is Progestasert, a T-shaped ethylene vinyl acetate copolymer device containing 38 mg progesterone in silicone. The device releases approximately 65 mcg/day into the uterine cavity over the course of 1-year. The device does not alter pituitary function or ovulation, nor does it depend on a local mechanical effect. Rather, it may exert its effect by inhibiting sperm capacitation or survival, or it may prevent nidation by alterning the endometrium. The reported pregnancy rate for Progestasert is 1.9% in parous women and 2.5% in nulliparous women. This efficacy rate is similar to that for other IUDs and low-dose progestin-only oral contraceptives. Breakthrough bleeding is the most common side effect, and perhaps 10-15% of the acceptors will have the device removed for either bleeding, pain, or infection. The rate of spontaneous expulsion of the device is about 3-8%. It is recommended that the device be inserted during or shortly after the menstrual period.

  3. Levonorgestrel-releasing intrauterine systems for long-acting contraception: current perspectives, safety, and patient counseling.

    Science.gov (United States)

    Costescu, Dustin J

    2016-01-01

    Unintended pregnancy is a significant global problem. In 2008, there were over 100 million unplanned pregnancies worldwide, representing approximately 41% of global conceptions. Family planning strategies in many countries are shifting from increasing the uptake of contraception among nonusers to increasing the uptake of the most effective methods among users of less effective methods. One of the most effective and acceptable methods of contraception is the levonorgestrel-releasing intrauterine system (LNG IUS); however, its uptake varies widely by country. This article reviews the currently available LNG IUSs, the rationale for increasing uptake of these methods, and evidence regarding safety, and discusses counseling strategies to best inform women about this option for contraception.

  4. Intrauterine device developments.

    Science.gov (United States)

    1984-01-01

    Results of recent IUD research are presented. The largest study of postpartum IUD insertion to date, a multicenter comparative trail involving 3791 women at 15 sites in 13 countries, has shown that the practice is safe and effective if the IUD is correctly placed. Modifications in design of the device are unnecessary to reduce expulsions. In 1977, Family Health International (FHI) began developing IUDs that would have clinically acceptable expulsion rates following postpartum insertion. By adding chromic catgut suture material to the upper arms of the TCu andLippes Loop, FHI developed the Delta T and Delta Loop. Many of the centers involved in studies of postpartum IUD insertion were large urban maternity hospitals in developing countries with heavy caseloads of 10,000-30,000 deliveries/year. Results of the trials and of a 19-center evaluation of the timing of postpartum insertion support several conclusions: 1) insertion should take place within 10 minutes of placental expulsion; 2) if insertion is done within 10 minutes of delivery, there is no increased risk of infection or uterine perforation; 3) the type of device inserted is less important than the method of insertion; expulsion rates at different clinics ranged from 6-37/1000 women at 6 monts, and the fundal placement of the device is crucial; and 4) expulsions are higher for postpartum than interval insertions but not so high as to make the offer of an IUD immediately postpartum unacceptable. Since the incidence of pain or bleeding associated with IUD use is related to their size, attempts to decrease the side effects have centered on development of smaller copper devices. 1 such device, the copper i, consists of a straight stem with small crossarms in an 'x' configuration disigned to anchor the IUD in place. A copper wire around the stem of the device exposes 200 sq millimeters of cooper. A study of 98 women who used the Copper i showed an accidental pregnancy rate of 3.2 at 6 months and 9.0 at 12 months

  5. Intrauterine levonorgestrel delivery with frameless fibrous delivery system: review of clinical experience

    Directory of Open Access Journals (Sweden)

    Wildemeersch D

    2017-01-01

    Full Text Available Dirk Wildemeersch,1 Amaury Andrade,2 Norman D Goldstuck,3 Thomas Hasskamp,4 Geert Jackers5 1Gynecological Outpatient Clinic and IUD Training Center, Ghent, Belgium; 2Centro de Biologia da Reprodução, Universidade Federal Juiz de Fora, Juiz de Fora, Brazil; 3Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Western Cape, South Africa; 4Klinik für Operativen Gynäkologie, GynMünster, Münster, Germany; 5Applied Controlled Release, Technology Park, Ghent (Zwijnaarde, Belgium Abstract: The concept of using a frameless intrauterine device (IUD instead of the conventional plastic framed IUD is not new. Frameless copper IUDs have been available since the late 1990s. They rely on an anchoring system to retain in the uterine cavity. The clinical experience with these IUDs suggests that frameless IUDs fit better as they are thin and, therefore, do not disturb or irritate the uterus. High tolerance and continuation rates have been achieved as complaints of pain are virtually nonexistent and the impact on menstrual blood loss is minimal. Conventional levonorgestrel-releasing intrauterine systems (LNG-IUSs are very popular as they significantly reduce menstrual bleeding and provide highly effective contraception. However, continuation of use remains problematic, particularly in young users. Total or partial expulsion and displacement of the LNG-IUS also occur too often due to spatial incompatibility within a small uterine cavity, as strong uterine contractions originate, attempting to get rid of the bothersome IUD/IUS. If not expelled, embedment ensues, often leading to chronic pain and early removal of the IUD/IUS. Several studies conducted recently have requested attention to the relationship between the LNG-IUS and the endometrial cavity. Some authors have proposed to measure the cavity width prior to inserting an IUD, as many uterine cavities are much smaller than the

  6. Is antibiotic prophylaxis mandatory after the insertion of levonorgestrel-releasing intrauterine systemin order to decrease the risk of pelvic inflammatory disease?

    Science.gov (United States)

    Munteanu, O; Radulescu, L; Bodean, O; Cirstoiu, C; Secara, D; Cirstoiu, M

    2013-01-01

    This study was undertaken in order to determine if antibiotic prophylaxis is mandatory, after the insertion of levonorgestrel-releasing intrauterine system in order to decrease the risk of pelvic inflammatory disease. We prospectively evaluated 44 patients, admitted in the Bucharest Emergency Hospital between the 1ⁱ of February 2012 and the 1ⁱ of October 2012, in whom the levonorgestrel-releasing intrauterine system was inserted. The patients enrolled were divided into two groups. In group A, a number of 22 patients, received, after the insertion of levonorgestrel-releasing intrauterine system, 875mg Amoxicillin Trihydrate + 125 mg Potassium Clavulanate, a dose every 12 hours for 5 days. Group B was represented by the other 22 patients who did not receive antibiotic prophylaxis. All patients were reevaluated at 4 and 12 weeks after the insertion of levonorgestrel-releasing intrauterine system. During the first 4 weeks after the insertion of levonorgestrel-releasing intrauterine system only two patients, one from group A and one from group B were diagnosed with pelvic inflammatory disease. At a second follow up visit - 12 weeks after the insertion of levonorgestrel-releasing intrauterine system, no other patient was diagnosed with pelvic inflammatory disease. Antibiotic prophylaxis is not mandatory, after the insertion of levonorgestrel-releasing intrauterine system in order to decrease the risk of pelvic inflammatory disease.

  7. Levonorgestrel releasing intrauterine system (Mirena) versus endometrial ablation (Novasure) in women with heavy menstrual bleeding : a multicentre randomised controlled trial

    NARCIS (Netherlands)

    Herman, Malou C.; van den Brink, Marian; Geomini, Peggy M.; van Meurs, Hannah S.; Huirne, Judith A.; Eising, Heleen P.; Timmermans, Anne; Pijnenborg, Johanna M. A.; Klinkert, Ellen R.; Coppus, Sjors F.; Nieboer, Theodoor E.; Catshoek, Ruby; van der Voet, Lucet F.; van Eijndhoven, Hugo W. F.; Graziosi, Giuseppe C. M.; Veersema, Sebastiaan; van Kesteren, Paul J.; Langenveld, Josje; Smeets, Nicol A. C.; van Vliet, Huib A. A. M.; van der Steeg, Jan Willem; Lisman-van Leeuwen, Yvonne; Dekker, Janny H.; Mol, Ben W.; Berger, Marjolein Y.; Bongers, Marlies Y.

    2013-01-01

    Background: Heavy menstrual bleeding is an important health problem. Two frequently used therapies are the levonorgestrel intra-uterine system (LNG-IUS) and endometrial ablation. The LNG-IUS can be applied easily by the general practitioner, which saves costs, but has considerable failure rates. As

  8. Levonorgestrel releasing intrauterine system (Mirena) versus endometrial ablation (Novasure) in women with heavy menstrual bleeding: a multicentre randomised controlled trial

    NARCIS (Netherlands)

    Herman, M.C.; Brink, M.J. van den; Geomini, P.M.; Meurs, H.S. van; Huirne, J.A.; Eising, H.P.; Timmermans, A.; Pijnenborg, J.; Klinkert, E.R.; Coppus, S.F.P.J.; Nieboer, T.; Catshoek, R.; Voet, L.F. van der; Eijndhoven, H.W. van; Graziosi, G.; Veersema, B.S.; Kesteren, P.J.M. van; Langenveld, J.; Smeets, Nathalie; Vliet, H.A. Van; Steeg, J.W. van der; Leeuwen, Y.L.; Dekker, J.H.; Mol, B.W.; Berger, M.Y.; Bongers, M.Y.

    2013-01-01

    BACKGROUND: Heavy menstrual bleeding is an important health problem. Two frequently used therapies are the levonorgestrel intra-uterine system (LNG-IUS) and endometrial ablation. The LNG-IUS can be applied easily by the general practitioner, which saves costs, but has considerable failure rates. As

  9. Levonorgestrel releasing intrauterine system (Mirena) versus endometrial ablation (Novasure) in women with heavy menstrual bleeding : a multicentre randomised controlled trial

    NARCIS (Netherlands)

    Herman, Malou C.; van den Brink, Marian; Geomini, Peggy M.; van Meurs, Hannah S.; Huirne, Judith A.; Eising, Heleen P.; Timmermans, Anne; Pijnenborg, Johanna M. A.; Klinkert, Ellen R.; Coppus, Sjors F.; Nieboer, Theodoor E.; Catshoek, Ruby; van der Voet, Lucet F.; van Eijndhoven, Hugo W. F.; Graziosi, Giuseppe C. M.; Veersema, Sebastiaan; van Kesteren, Paul J.; Langenveld, Josje; Smeets, Nicol A. C.; van Vliet, Huib A. A. M.; van der Steeg, Jan Willem; Lisman-van Leeuwen, Yvonne; Dekker, Janny H.; Mol, Ben W.; Berger, Marjolein Y.; Bongers, Marlies Y.

    2013-01-01

    Background: Heavy menstrual bleeding is an important health problem. Two frequently used therapies are the levonorgestrel intra-uterine system (LNG-IUS) and endometrial ablation. The LNG-IUS can be applied easily by the general practitioner, which saves costs, but has considerable failure rates. As

  10. Levonorgestrel releasing intrauterine system (Mirena) versus endometrial ablation (Novasure) in women with heavy menstrual bleeding: a multicentre randomised controlled trial

    NARCIS (Netherlands)

    Herman, M.C.; Brink, M.J. van den; Geomini, P.M.; Meurs, H.S. van; Huirne, J.A.; Eising, H.P.; Timmermans, A.; Pijnenborg, J.; Klinkert, E.R.; Coppus, S.F.P.J.; Nieboer, T.; Catshoek, R.; Voet, L.F. van der; Eijndhoven, H.W. van; Graziosi, G.; Veersema, B.S.; Kesteren, P.J.M. van; Langenveld, J.; Smeets, Nathalie; Vliet, H.A. Van; Steeg, J.W. van der; Leeuwen, Y.L.; Dekker, J.H.; Mol, B.W.; Berger, M.Y.; Bongers, M.Y.

    2013-01-01

    BACKGROUND: Heavy menstrual bleeding is an important health problem. Two frequently used therapies are the levonorgestrel intra-uterine system (LNG-IUS) and endometrial ablation. The LNG-IUS can be applied easily by the general practitioner, which saves costs, but has considerable failure rates. As

  11. Infection risk and intrauterine devices.

    Science.gov (United States)

    Martínez, Francisca; López-Arregui, Eduardo

    2009-01-01

    For most women, intrauterine contraceptive devices (IUCD) are a safe option. Upper genital tract infections (pelvic inflammatory disease, PID) occur when pathogenic microorganisms ascend from the cervix and invade the endometrium and the fallopian tubes, causing an inflammatory reaction. Evidence-based recommendations regarding intrauterine contraception and risk of infection were presented at the Congress of the European Society of Contraception, in Prague, 2008: A clinical history (including sexual history) should be taken as part of the routine assessment for intrauterine contraception to identify women at high risk of sexually transmitted infections (STI); if appropriate a test should be offered; if symptoms or signs are present, appropriate diagnostic tests should be done, results awaited, necessary treatment completed, and IUCD insertion postponed until resolution. Prophylactic antibiotics are not recommended (evidence level II-3). STI screening is not routinely recommended. PID among IUCD users is most strongly related to the insertion process and to the background risk of STI (evidence level II-2). Conditions which represent an unacceptable health risk if an IUCD is inserted (WHO Medical Eligibility Criteria, MEC, Categories 3-4) are current PID, current purulent cervicitis, chlamydial or gonorrheal infection. For continuation as well as initiation, WHO MEC categories 3-4 are allotted to women with known pelvic tuberculosis, puerperal sepsis and septic abortion.

  12. Experience and levels of satisfaction with the levonorgestrel-releasing intrauterine system in China: a prospective multicenter survey

    Directory of Open Access Journals (Sweden)

    Zhao S

    2014-10-01

    considering Mirena. Continuation rates for Mirena were 99% at 3–6 months and 93% at 12 months after insertion, and most women (92% and 93%, respectively had less bleeding at these times. The percentage of women who rated Mirena as better than their previous contraceptive method was 63%. Overall, around 90% of respondents were very satisfied or rather satisfied with Mirena, and 64% stated that they would recommend it to their friends. Conclusion: These data suggest that continuation and satisfaction rates with Mirena were very high, and that the device is well accepted by Chinese women. Keywords: levonorgestrel-releasing intrauterine system, intrauterine device, contraception, user satisfaction

  13. Intra-uterine contraceptive devices.

    Science.gov (United States)

    Elias, J

    1985-05-01

    Among the advantages of IUDs are the device's high continuation rate, the lack of systemic side effects, and the absence of a need for continual motivation to practice contraception. The effectiveness of plastic IUDs is directly proportional to their surface area, but the degree of excessive bleeding experienced is inversely related to device size. Thus, devices represent a compromise between large size for effectiveness and small size for acceptability. The optimum time to fit an IUD is during the 1st hald of the menstrual cycle. Absolute contraindications to IUD use include the presence of active pelvic inflammatory disease, undiagnosed irregular bleeding, a history of ectopic pregnancy or tubal surgery, and a distorted uteine cavity. Failure rates associated with IUD use range from 2-3% in the 1st year and then decrease. Since the main mechanism of action appears to be production of a sterile inflammatory reaction in the uterine cavity, the IUD prevents intrauterine pregnancy more effectively than ectopic pregnancy. Nonetheless, there is little evidence to suggest that IUD use actually increases the incidence of ectopic pregnancy. Resumption of fertility after IUD removal is not delayed. There is not need to change inert plastic IUDs in women who remain symptom free. The copper devices should be changed every 3-4 years. A search is under way for antifertility agents that can be incorporated into the device to reduce side effects. In general, the IUD is most suitable for older, parous women.

  14. Abnormal uterine bleeding in midlife: The role of levonorgestrel intrauterine system

    Directory of Open Access Journals (Sweden)

    Osama Shawki

    2013-01-01

    Full Text Available Abnormal uterine bleeding is a common gynecological complaint affecting 10-30% of women in midlife and constitute about one-third of all outpatient gynecological visits. It adversely affects the quality of woman′s life and can lead to psychological, social, medical, and sexual problems and thus necessitating appropriate and adequate management. Different treatment modalities for such problems are available, yet the levonorgestrel intrauterine system (LNG-IUS has recently provided a good treatment option effective in treating such complaints and at the same time, having a reliable contraceptive effect which is desired by such age group. For women in their reproductive years, the LNG-IUS has become one of the most acceptable medical treatments for menorrhagia, reducing referrals to specialists, and decreasing the recourse to operative treatments. It is easy to insert, has a sustained effect, cost-effective, and well tolerated besides providing reliable contraception.

  15. Levonorgestrel intrauterine system: Current role in management of heavy menstrual bleeding

    Directory of Open Access Journals (Sweden)

    Navneet Magon

    2013-01-01

    Full Text Available A review of literature was conducted to report on the effectiveness of levonorgestrel intrauterine system (LNG-IUS in women with heavy menstrual bleeding (HMB. The relevant data were obtained by computerized searches of PubMed up to December 2012 and other references available with the authors. Information was obtained from references listed. Studies and case reports were excluded if they did not specifically provide information about LNG-IUS usage in women with HMB. After perusal, each relevant publication was summarized and appraised in terms of whether it contained information relevant to the stated objective. Available data shows that LNG-IUS therapy is effective and safe, providing significant reduction of menstrual bleeding in patients with HMB. LNG-IUS is a good strategy to reduce the number of hysterectomies in women with HMB.

  16. Levonorgestrel-releasing intrauterine systems for long-acting contraception: current perspectives, safety, and patient counseling

    Science.gov (United States)

    Costescu, Dustin J

    2016-01-01

    Unintended pregnancy is a significant global problem. In 2008, there were over 100 million unplanned pregnancies worldwide, representing approximately 41% of global conceptions. Family planning strategies in many countries are shifting from increasing the uptake of contraception among nonusers to increasing the uptake of the most effective methods among users of less effective methods. One of the most effective and acceptable methods of contraception is the levonorgestrel-releasing intrauterine system (LNG IUS); however, its uptake varies widely by country. This article reviews the currently available LNG IUSs, the rationale for increasing uptake of these methods, and evidence regarding safety, and discusses counseling strategies to best inform women about this option for contraception. PMID:27785107

  17. A prospective assessment of pelvic infection risk following same-day sexually transmitted infection testing and levonorgestrel intrauterine system placement.

    Science.gov (United States)

    Turok, David K; Eisenberg, David L; Teal, Stephanie B; Keder, Lisa M; Creinin, Mitchell D

    2016-11-01

    Misperceptions persist that intrauterine device placement is related to pelvic infections and Chlamydia and gonorrhea testing results are needed prior to placement. We sought to evaluate the relationship of Chlamydia and gonorrhea screening to pelvic infection for up to 2 years following placement of the levonorgestrel 52-mg intrauterine system. A total of 1751 nulliparous and multiparous females 16 to 45 years old enrolled in a multicenter trial designed to evaluate the efficacy and safety of a new levonorgestrel intrauterine system for up to 7 years. Participants had Chlamydia screening at study entry and yearly if they were age ≤25 years. Women also had baseline gonorrhea screening if testing had not been performed since starting their current sexual relationship. Those who changed sexual partners during the trial had repeated Chlamydia and gonorrhea testing. Intrauterine system insertion could occur on the same day as screening. Participants did not receive prophylactic antibiotics for intrauterine system placement. Investigators performed pelvic examinations after 12 and 24 months and when clinically indicated during visits at 3, 6, and 18 months after placement and unscheduled visits. Pelvic infection included any clinical diagnosis of pelvic inflammatory disease or endometritis. Most participants (n = 1364, 79.6%) did not have sexually transmitted infection test results available prior to intrauterine system placement. In all, 29 (1.7%) participants had positive baseline testing for a sexually transmitted infection (Chlamydia, n = 25; gonorrhea, n = 3; both, n = 1); 6 of these participants had known results (all with Chlamydia infection) prior to intrauterine system placement and received treatment before enrollment. The 23 participants whose results were not known at the time of intrauterine system placement received treatment without intrauterine system removal and none developed pelvic infection. The incidence of positive Chlamydia testing was

  18. Management of Intrauterine Device-Associated Actinomycosis

    OpenAIRE

    1993-01-01

    Objective: To assess various methods of management of actinomyces-like organisms associated with intrauterine devices. Methods: A retrospective chart review of 173 patients with intrauterine device-associated actinomyces- like organisms detected on Pap smear was performed. The patients were managed by IUD removal with or without antibiotic therapy, antibiotic therapy alone, or no treatment at all. Results: The success rate as reflected in negative follow-up smear was 100% for IUD removal comb...

  19. Intrauterine devices: an effective alternative to oral hormonal contraception.

    Science.gov (United States)

    2009-06-01

    (1) Intrauterine devices (IUDs) are placed in the uterine cavity with the objective of providing long-term contraception, mainly by preventing fertilisation. The best-known IUDs contain copper, but there is also an IUD delivering levonorgestrel, a progestin; (2) How effective are these devices, and what are their adverse effects? To answer these questions, we analysed the literature using the standard Prescrire methodology; (3) T-shaped copper IUDs, with a copper surface area of 380 mm2 on 3 arms, and the levonorgestrel-releasing device, have similar contraceptive efficacy as combined oral contraceptives that are used correctly. In contrast, IUDs are more effective than oral contraception used incorrectly; (4) Among IUD users, there are on average about 6 pregnancies per 1000 woman-years. There is less experience with the levonorgestrel IUD which seems to be at least as effective as copper IUDs; (5) The rare intrauterine pregnancies that occur in women using an IUD generally end in miscarriage. About 25% of these pregnancies end in a live birth if the device is left in place, compared to about 90% if the device is removed; (6) Ectopic pregnancies are rarer in IUD users than in women who do not use contraception. However, about one in 20 pregnancies that occur in women using an IUD is ectopic; (7) The IUD is expelled in about 5% to 10% of cases within 5 years, and expulsion recurs in about 30% of these women; (8) Problems such as difficult insertion, pain, bleeding and syncope are reported in less than 1.5% of cases overall; (9) Uterine perforation during insertion is rare, occurring in 0.6 to 16 cases per 1000 insertions, regardless of the type of IUD. The risk of perforation is higher when the IUD is inserted less than 4 to 6 weeks after delivery or elective abortion; (10) During the first 3 months after insertion, the risk of pelvic infection is slightly higher than in the general population, especially in women with pre-existing asymptomatic Chlamydia

  20. LEVONORGESTREL-RELEASING INTRAUTERINE SYSTEM AS AN ALTERNATIVE THERAPY IN ABNORMAL UTERINE BLEEDING

    Directory of Open Access Journals (Sweden)

    Kunjamma Roy

    2017-05-01

    Full Text Available BACKGROUND Abnormal uterine bleeding is one of the most frequent reasons for gynaecological consultation, occurring in approximately 30% of women of reproductive age. Menorrhagia by definition implies a menstrual blood loss equal to or greater than 80 mL. Many women seek consultation for bleeding episodes of less than this amount because of the stress associated with it. Most frequently used medications are combinations of prostaglandin synthetase inhibitors and antifibrinolytic drugs, nonsteroidal antiinflammatory drugs, oral progesterone like Norethisterone or medroxyprogesterone acetate and combined oral contraceptives. The usual treatment for women with menorrhagia not desiring further pregnancies and those not responding to medical managements is either hysterectomy or endometrial ablation. Endometrial ablation less commonly performed due to low success rate. Levonorgestrel intrauterine system (LNG-IUS is a new modality in the treatment of AUB. The objective of this study is to evaluate the use of Levonorgestrel intrauterine system as a treatment for women with menorrhagia. MATERIALS AND METHODS This is a prospective interventional comparative study conducted on women with abnormal uterine bleeding. The duration of study was from March 2012 to October 2013. The respondents include those outpatients attending Gynaecology Department of Government Medical College, Kottayam with menorrhagia. The samples size was 50 of which 25 were in experimental groups and remaining 25 in control group. Experimental group were given LNG IUS for menorrhagia and the remaining 25 patients were given oral progestins for heavy menstrual bleeding. In order to make a comparison of the impact of the two different kinds of interventions, the Hb level as well as the amount of blood loss were systematically estimated at frequent intervals. Accordingly, these measurements were carried for the said both groups at the commencement of research study and thereafter at an

  1. Controlling levonorgestrel binding and release in a multi-purpose prevention technology vaginal ring device.

    Science.gov (United States)

    Murphy, Diarmaid J; Boyd, Peter; McCoy, Clare F; Kumar, Sandeep; Holt, Jonathon D S; Blanda, Wendy; Brimer, Andrew N; Malcolm, R Karl

    2016-03-28

    Despite a long history of incorporating steroids into silicone elastomers for drug delivery applications, little is presently known about the propensity for irreversible drug binding in these systems. In this study, the ability of the contraceptive progestin levonorgestrel to bind chemically with hydrosilane groups in addition-cure silicone elastomers has been thoroughly investigated. Cure time, cure temperature, levonorgestrel particle size, initial levonorgestrel loading and silicone elastomer type were demonstrated to be key parameters impacting the extent of levonorgestrel binding, each through their influence on the solubility of levonorgestrel in the silicone elastomer. Understanding and overcoming this levonorgestrel binding phenomenon is critical for the ongoing development of a number of drug delivery products, including a multi-purpose technology vaginal ring device offering simultaneous release of levonorgestrel and dapivirine - a lead candidate antiretroviral microbicide - for combination HIV prevention and hormonal contraception.

  2. Management Of Misplaced Intrauterine Device And Complications

    Directory of Open Access Journals (Sweden)

    Harun TOY, Mehmet VURAL, Hakan CAMUZCUOĞLU, Halef AYDIN

    2010-11-01

    Full Text Available Uterin perforation is the one of the most important complication of intra-uterine deviceapplication. We aimed to discuss management and complications of lost intrauterine device inthe case series of 10 patients who are operationally treated with this diagnosis, betweenSeptember 2007 and June 2009 in our clinic. In the algoritm we described ultrasonography keepit’s importance and there is usually no need for other radiologic techniques.

  3. Evaluating the Efficacy of Levonorgestrel Intrauterine System and Danazol for Relief of Postoperative Pain in Endometriosis.

    Science.gov (United States)

    Taneja, Ashima; Kaur, Satinder; Soni, R K; Bhanupriya; Kaur, Jaspreet; Singla, Laveen

    2017-07-01

    Endometriosis is an oestrogen-dependent disorder, manifests during reproductive years and is associated with pain and infertility. There is considerable debate about the effectiveness of various interventions for pain relief. To evaluate the efficacy of Levonorgestrel Intrauterine System (LNG-IUS) and Danazol in postoperative pain relief for patients with endometriosis. Hundred patients with diagnosis of endometriosis, who were treated laparoscopically, entered the study to receive either danazol (600 mg once daily) or LNG-IUS (inserted during immediate post operative period) postsurgery, for pain relief. Patients were analysed for pain relief according to VAS score and recurrence of disease using ultrasonography at third and sixth months of follow up. There were 50% patients in stage IV of endometriosis. Majority of them presented with complaint of infertility (49%) and pelvic pain (43%). It was observed that LNG-IUS was significantly more effective in relieving pain compared to danazol (65.2% vs 38.0%, p<0.05). Recurrence rate was significantly lower in LNG-IUS users compared to other group. LNG-IUS was found to be more effective in relieving pain compared to danazol.

  4. Use of levonorgestrel-releasing intrauterine system in the prevention and treatment of endometrial hyperplasia.

    Science.gov (United States)

    Ewies, Ayman A A; Alfhaily, Fadi

    2012-11-01

    Endometrial hyperplasia is a commonly seen gynecological condition that affects women of all age groups. Whereas hysterectomy is the most preferred treatment option for complex endometrial hyperplasia with atypia, there is no consensus regarding the first-line management of women with hyperplasia without cytological atypia. Oral progestogen therapy was used with some success. Nonetheless, it may be plausible to argue that women with endometrial hyperplasia need continuous treatment and high level of compliance to ensure complete regression, which may not be guaranteed with oral therapy. Observational studies suggested that levonorgestrel-releasing intrauterine system (LNG-IUS) has been successfully used to treat endometrial hyperplasia without cytological atypia and selected cases of atypical endometrial hyperplasia. Furthermore, there is strong evidence from randomized controlled trials that LNG-IUS prevents the development of endometrial hyperplasia in exogenous estrogen users; however, its protective role and safety in tamoxifen-treated breast cancer survivors remain uncertain. This article evaluates the current evidence for the use of LNG-IUS, releasing 20 μg of LNG per day, in the prevention and treatment of endometrial hyperplasia.

  5. Emerging indications for the levonorgestrel-releasing intrauterine system (LNG-IUS).

    Science.gov (United States)

    Heikinheimo, Oskari; Gemzell-Danielsson, Kristina

    2012-01-01

    The levonorgestrel intrauterine system (LNG-IUS), originally designed for long-term contraceptive use, has been on the Scandinavian market for approximately 20 years. Novel clinical indications for the LNG-IUS, derived mainly from investigator-initiated studies, are emerging. These include heavy menstrual bleeding associated with uterine fibroids, endometriosis, adenomyosis, as well as endometrial hyperplasia. In both cohort and randomized studies, the LNG-IUS is effective in decreasing heavy menstrual bleeding, also in women diagnosed with uterine fibroids. In randomized studies the LNG-IUS has shown comparable clinical efficacy to GnRH analogues or progestins for the symptomatic treatment of endometriosis. Experience with LNG-IUS in adenomyosis is based on prospective cohort studies. Dysmenorrhea has been reported to decrease in all women, and uterine volume was seen to diminish in some of these studies. In the treatment of endometrial hyperplasias, including atypical hyperplasia, the LNG-IUS is equal or superior to treatment with systemic progestins. Further studies are needed to examine the full potential of the LNG-IUS in such common clinical situations.

  6. The levonorgestrel-releasing intrauterine system for endometrial protection during estrogen replacement therapy: a clinical review.

    Science.gov (United States)

    Depypere, H; Inki, P

    2015-01-01

    Estrogen replacement therapy (ERT) is a well-established method of managing climacteric symptoms in women approaching the menopause, but it is associated with a significant risk of endometrial hyperplasia if unopposed by concomitant progestogen administration. The levonorgestrel-releasing intrauterine system (LNG-IUS) offers a highly effective method of minimizing this risk and has additional benefits beyond endometrial protection. The LNG-IUS provides excellent contraception, which may still be necessary in perimenopausal women, and is suitable for women with underlying conditions that may preclude their use of estrogen-containing contraceptive methods. It can effectively manage bleeding problems through the transition from perimenopause into menopause, with many women developing amenorrhea. The LNG-IUS is well tolerated with a favorable safety profile, which generally mirrors that of women of reproductive age using it for contraception only. Moreover, the LNG-IUS plus ERT combination does not appear to be associated with clinically relevant effects on plasma lipids or other markers of cardiovascular risk. Women using the LNG-IUS plus ERT also experience improvements in quality of life, and adherence and continuation rates are high. This review will summarize the clinical evidence for the use of the LNG-IUS plus ERT in peri- and postmenopausal women and present the key attributes of this combined therapy.

  7. Management of Intrauterine Device-Associated Actinomycosis

    Science.gov (United States)

    Amin-Hanjani, Soheil

    1993-01-01

    Objective: To assess various methods of management of actinomyces-like organisms associated with intrauterine devices. Methods: A retrospective chart review of 173 patients with intrauterine device-associated actinomyces- like organisms detected on Pap smear was performed. The patients were managed by IUD removal with or without antibiotic therapy, antibiotic therapy alone, or no treatment at all. Results: The success rate as reflected in negative follow-up smear was 100% for IUD removal combined with antibiotics, 97.4% for IUD removal alone, and 36.8% for antibiotics therapy alone. Conclusions: The best way to manage intrauterine device-associated actinomyces-like organisms is removal of the device with or without antibiotics. PMID:18475332

  8. New developments in intrauterine device use: focus on the US

    Directory of Open Access Journals (Sweden)

    Nelson AL

    2016-09-01

    Full Text Available Anita L Nelson,1 Natasha Massoudi2 1Department of Obstetrics and Gynecology, Los Angeles BioMedical Research Institute at Harbor-UCLA Medical Center, David Geffen School of Medicine at UCLA, Torrance, CA, USA; 2American University of the Caribbean School of Medicine, Cupecoy, Sint Maarten Abstract: Many more women in the US today rely upon intrauterine devices (IUDs than in the past. This increased utilization may have substantially contributed to the decline in the percentage of unintended pregnancies in the US. Evidence-based practices have increased the number of women who are medically eligible for IUDs and have enabled more rapid access to the methods. Many women enjoy freedom to use IUDs without cost, but for many the impact of the Affordable Care Act has yet to be realized. Currently, there are three hormonal IUDs and one copper IUD available in the US. Each IUD is extremely effective, convenient, and safe. The newer IUDs have been tested in populations not usually included in clinical trials and provide reassuring answers to older concerns about IUD use in these women, including information about expulsion, infection, and discontinuation. On the other hand, larger surveillance studies have provided new estimates about the risks of complications such as perforation, especially in postpartum and breastfeeding women. This article summarizes significant features of each IUD and provides a summary of the differences to aid clinicians in the US and other countries in advising women about IUD choices. Keywords: copper intrauterine device, levonorgestrel intrauterine systems, noncontraceptive benefits, same-day/quick start initiation, safety, bleeding patterns, placement pain, medical eligibility

  9. Forgotten intrauterine device contributing to infertility.

    Science.gov (United States)

    Igberase, Gabriel O

    2011-07-01

    The aim of the study is to show that long standing forgotten intrauterine device contributes to infertility, reporting three cases presented at Central Hospital Warri, Nigeria, a government tertiary health center. Three cases of forgotten intrauterine contraceptive device (IUCD) contributing to infertility were seen. Two were inserted for contraceptive reasons while one was inserted while being managed for uterine synechae. Health care providers should ensure proper documentation of all procedures carried out, adequate counseling which should include taking an informed consent and also ensuring both short and long term follow up of their clients. Also all patients being evaluated for infertility and clients with past history of intrauterine device must have a speculum examination and ultrasound scan carried out.

  10. Forgotten intrauterine device contributing to infertility

    Directory of Open Access Journals (Sweden)

    Gabriel O. Igberase

    2011-10-01

    Full Text Available The aim of the study is to show that long standing forgotten intrauterine device contributes to infertility, reporting three cases presented at Central Hospital Warri, Nigeria, a government tertiary health center. Three cases of forgotten intrauterine contraceptive device (IUCD contributing to infertility were seen. Two were inserted for contraceptive reasons while one was inserted while being managed for uterine synechae. Health care providers should ensure proper documentation of all procedures carried out, adequate counseling which should include taking an informed consent and also ensuring both short and long term follow up of their clients. Also all patients being evaluated for infertility and clients with past history of intrauterine device must have a speculum examination and ultrasound scan carried out.

  11. Complications of the intrauterine device in nulliparous and parous women.

    NARCIS (Netherlands)

    Veldhuis, H.M.; Vos, A.G.; Lagro-Janssen, A.L.M.

    2004-01-01

    OBJECTIVES: The intrauterine device (IUD) is still related to pelvic inflammatory disease (PID), pregnancy, expulsion, perforation and menstrual problems, particularly in nulliparous women. We aimed to study the complications and symptoms of the intrauterine device in general practice, particularly

  12. Complications of the intrauterine device in nulliparous and parous women.

    NARCIS (Netherlands)

    Veldhuis, H.M.; Vos, A.G.; Lagro-Janssen, A.L.M.

    2004-01-01

    OBJECTIVES: The intrauterine device (IUD) is still related to pelvic inflammatory disease (PID), pregnancy, expulsion, perforation and menstrual problems, particularly in nulliparous women. We aimed to study the complications and symptoms of the intrauterine device in general practice, particularly

  13. Levonorgestrel-releasing intrauterine system vs. usual medical treatment for menorrhagia: an economic evaluation alongside a randomised controlled trial.

    Directory of Open Access Journals (Sweden)

    Sabina Sanghera

    Full Text Available OBJECTIVE: To undertake an economic evaluation alongside the largest randomised controlled trial comparing Levonorgestrel-releasing intrauterine device ('LNG-IUS' and usual medical treatment for women with menorrhagia in primary care; and compare the cost-effectiveness findings using two alternative measures of quality of life. METHODS: 571 women with menorrhagia from 63 UK centres were randomised between February 2005 and July 2009. Women were randomised to having a LNG-IUS fitted, or usual medical treatment, after discussing with their general practitioner their contraceptive needs or desire to avoid hormonal treatment. The treatment was specified prior to randomisation. For the economic evaluation we developed a state transition (Markov model with a 24 month follow-up. The model structure was informed by the trial women's pathway and clinical experts. The economic evaluation adopted a UK National Health Service perspective and was based on an outcome of incremental cost per Quality Adjusted Life Year (QALY estimated using both EQ-5D and SF-6D. RESULTS: Using EQ-5D, LNG-IUS was the most cost-effective treatment for menorrhagia. LNG-IUS costs £100 more than usual medical treatment but generated 0.07 more QALYs. The incremental cost-effectiveness ratio for LNG-IUS compared to usual medical treatment was £1600 per additional QALY. Using SF-6D, usual medical treatment was the most cost-effective treatment. Usual medical treatment was both less costly (£100 and generated 0.002 more QALYs. CONCLUSION: Impact on quality of life is the primary indicator of treatment success in menorrhagia. However, the most cost-effective treatment differs depending on the quality of life measure used to estimate the QALY. Under UK guidelines LNG-IUS would be the recommended treatment for menorrhagia. This study demonstrates that the appropriate valuation of outcomes in menorrhagia is crucial.

  14. Usage of the levonorgestrel-releasing intrauterine system (LNG-IUS) in adolescence: what is the evidence so far?

    Science.gov (United States)

    Patseadou, Magdalini; Michala, Lina

    2017-03-01

    The levonorgestrel-releasing intrauterine system (LNG-IUS) is an effective method of contraception, while also providing various non-contraceptive benefits. Although targeted primarily to adults, there is increasing experience in its use in adolescence. The aim of this review is to assess the available information on LNG-IUS usage in adolescence. We conducted an online search on MEDLINE and SCOPUS from inception to May 24, 2015. All studies that examined LNG-IUS use in teen populations were eligible for inclusion. Primary outcome measures included description of indications for LNG-IUS usage and relevant efficacy. Secondary outcomes included complications, such as device-related problems (perforation and expulsion) and other adverse events (pelvic inflammatory disease, PID). Acceptability of the LNG-IUS was also estimated through evaluation of continuation rate and reasons for removal were assessed. Twenty-one studies met our inclusion criteria. We identified only one randomized controlled trial (RCT). All other twenty studies were observational. Pregnancy rates ranged from 0 to 2.7%. Management of heavy or/and painful periods was successful in 92-100%. Menstrual manipulation in patients with developmental delay was achieved in over 93% of cases. Expulsion rates ranged from 0 to 13% and pelvic infection/cervicitis between 0 and 2.7%. There were no reported uterine perforations. Usage of the LNG-IUS in teen populations appears to be safe and efficacious both in terms of contraception and menstrual management. However, more robust evidence is needed so as to provide firm confirmation on benefits and potential side effects.

  15. The effectiveness of the levonorgestrel intrauterine system in obese women with heavy menstrual bleeding.

    Science.gov (United States)

    Shaw, Valentina; Vandal, Alain C; Coomarasamy, Christin; Ekeroma, Alec J

    2016-12-01

    To evaluate the effectiveness of the levonorgestrel intrauterine system (LNG-IUS) in obese women with heavy menstrual bleeding in Counties Manukau Auckland area, New Zealand. Prospective observational study in a tertiary teaching hospital. Twenty women with heavy menstrual bleeding (HMB) who agreed to treatment with the LNG-IUS and had a body mass index (BMI) of >30 kg/m(2) were recruited between May and December 2014. The women completed two validated tools (Menstrual Impact Questionnaire and the Pictorial Bleeding Assessment Chart) at recruitment, 6 and 12 months follow-up. Demographic, medical and laboratory variables were obtained from the relevant CMH databases. Data on side effects and satisfaction were obtained from the women at 12 months. The median age (range) and BMI of the 20 women were 40.5 years (27-52 years) and 40.6 kg/m(2) (30-68), respectively. Three LNG-IUS were removed due to infection and pain and these women were subsequently booked for a hysterectomy. The reduction in menstrual loss was estimated at 19.7% per month (95% CI (12.5%, 26.2%); P < 0.001), which translates to 73.2% per period of 6 months (95% CI (55.3%, 83.9%)) and 92.8% per period of 12 months (95% CI (80.0%, 97.4%)). The six items in the quality of life measure improved significantly in 14 women but only 12 women were satisfied with the treatment. The LNG-IUS was an effective treatment for 67% of obese women with heavy menstrual bleeding over a 12-month period, as assessed by the reduction in menstrual bleeding and the improvement in the quality of life measures. © 2016 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  16. Association of baseline bleeding pattern on amenorrhea with levonorgestrel intrauterine system use.

    Science.gov (United States)

    Mejia, Manuela; McNicholas, Colleen; Madden, Tessa; Peipert, Jeffrey F

    2016-11-01

    This study aims to evaluate the effect of baseline bleeding patterns on rates of amenorrhea reported at 12 months in levonorgestrel (LNG) 52 mg intrauterine system (IUS) users. We also assessed the effect of baseline bleeding patterns at 3 and 6 months postinsertion. In this secondary analysis of the Contraceptive CHOICE Project, we included participants who had an LNG-IUS inserted within 1 month of enrollment and continued use for 12 months. Using 12-month telephone survey data, we defined amenorrhea at 12 months of use as no bleeding or spotting during the previous 6 months. We used chi-square and multivariable logistic regression to assess the association of baseline bleeding pattern with amenorrhea while controlling for confounding variables. Of 1802 continuous 12-month LNG-IUS users, amenorrhea was reported by 4.9%, 14.8% and 15.4% of participants at 3, 6 and 12 months, receptively. Participants with light baseline bleeding or short duration of flow reported higher rates of amenorrhea at 3 and 6 months postinsertion (p<.03), while LNG-IUS users with heavy or prolonged flow were less likely to report amenorrhea at 3 and 6 months (p<.03). In a multivariable analysis, participants with self-reported heavy bleeding at baseline were less likely to report amenorrhea at 12 months than those who reported moderate bleeding (ORadj, 0.36; 95% CI, 0.16-0.69). Women with heavier menstrual bleeding are less likely than women with moderate flow to report amenorrhea following 12 months of LNG-IUS use. Baseline heavy menstrual flow reduces the likelihood of amenorrhea with LNG-IUS use, information that could impact contraceptive counseling. Anticipatory counseling can improve method satisfaction and continuation, an important strategy to continue to reduce unintended pregnancy and abortion rates. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Oral Progestogens Versus Levonorgestrel-Releasing Intrauterine System for Treatment of Endometrial Intraepithelial Neoplasia().

    Science.gov (United States)

    Marnach, Mary L; Butler, Kristina A; Henry, Michael R; Hutz, Catherine E; Langstraat, Carrie L; Lohse, Christine M; Casey, Petra M

    2017-04-01

    Limited therapeutic guidelines exist regarding medical therapy, ideal dosing, duration of therapy, or recommendations for timing of endometrial reassessment for women with endometrial intraepithelial neoplasia (EIN) who desire fertility preservation or who are not optimal surgical candidates. We aimed to determine the effectiveness of oral progestogens (OP) versus the levonorgestrel-releasing intrauterine system (LNG IUS) in the medical treatment of EIN. We retrospectively identified women with EIN at our institution from 2007 through 2014 and compared the outcomes of those treated with OP versus LNG IUS. Among 390 women, 296 were initially treated with OP and 94 with LNG IUS. Baseline characteristics of the patient groups were comparable, except for higher median body mass index in the LNG IUS group versus the OP group (37 kg/m(2) vs. 31 kg/m(2); p < 0.001). Among 332 women with follow-up endometrial biopsies (263 OP and 69 LNG IUS), EIN subcategory 1 (benign endometrial hyperplasia) resolved in 83% and 87% of patients, respectively (p = 0.31). Rates of resolution of EIN subcategory 2 (endometrial intraepithelial neoplasia) were also similar between groups (68% vs. 62%; p = 0.82). In women with EIN subcategory 3 (endometrial adenocarcinoma), 22% of those using LNG IUS and one of two women treated with OP had resolution of disease as of last follow-up. OP and LNG IUS offer similar endometrial protection for women with EIN. LNG IUS offers convenience, minimal adverse effects, reversibility, and long-term endometrial protection.

  18. Effect of Guizhifuling capsule combined with levonorgestrel releasing intrauterine system on adenomyosis

    Institute of Scientific and Technical Information of China (English)

    Dong-Tao Shi; Rui Bai

    2016-01-01

    Objective:To explore the clinical efficacy of Guizhifuling capsule combined with levonorgestrel releasing intrauterine system (LNG-IUS) in the treatment of adenomyosis (AM). Methods: A total of 80 patients with AM who were admitted in our hospital from February, 2015 to February, 2016 were included in the study and randomized into the study group and the control group. LNG-IUS was placed in patients in the two groups 7 d after menstruation. The patients in the study group were given additional Guizhifuling capsule, 3 capsules/time, 3 times/d, and the drug was withdrawn in the menstrual period. Six-month treatment was regarded as one course. PBAC was used to evaluate the menstrual blood volume before and after treatment. The chronic pain grading questionnaire method was used for dysmenorrhea degree rating. The vaginal B ultrasound 3 d after menstruation was performed to detect the uterine volume. E2, FSH, LH, and serum CA125 level before and after treatment were detected.Results: The menstrual blood volume, dysmenorrhea degree, and uterine volume after treatment in the two groups were significantly reduced when compared with before treatment (P0.05). After treatment, CA125 level in the two groups was significantly reduced when compared with before treatment (P<0.05), and the reduced degree in the study group was significantly superior to that in the control group (P<0.05).Conclusions:Guizhifuling capsule combined with LNG-IUS in the treatment of AM can significantly improve the clinical symptoms, effectively reduce CA125 level, and has no significant effect on the sex hormone levels with a satisfactory clinical efficacy; therefore, it deserves to be widely recommended in the clinic.

  19. Management of intrauterine adhesions: a novel intrauterine device.

    Science.gov (United States)

    Tu, Chun-Hua; Yang, Xiao-Li; Qin, Xiao-Yun; Cai, Li-Ping; Zhang, Ping

    2013-09-01

    Intrauterine adhesions (IUAs) are a rare but significant cause of menstrual disturbance and infertility. Most cases are caused by uterine instrumentation. Several methods have been used to prevent IUAs in the past, which can be divided into two groups: pharmacological treatment and physical barrier. However, even with the liberal use of ancillary treatments to minimize reformation of adhesions, IUAs have a high rate of recurrence. Furthermore, medical literature of the last decades has only dedicated great attention to the restoration of normal anatomy in the uterine cavity, but not on the function of the endometrium. When the lesion of the endometrium is severe, especially intrauterine fibrosis, few basal layer is left which contains plenty stem cells to regenerate functional endometrium. Loss of endometrial stem cells directly causes the proliferation of fibrous tissue and subsequent synechiae. None of current treatments can compensate the defect of loss of stem cells. On the basis of existing researches, a novel intrauterine device (IUD) is recommended in this article. The new IUD consists of a light frame which contains two isolated drug-releasing system, one for estrogen and the other for cytokines to promote regeneration of endometrium such as growth factors, and a membrane in the middle of the frame which is also the carrier of endometrium stem cell. This device not only helps to preserve the original anatomy of the uterine cavity, but also to recover the function of endometrium. Experimental and clinical studies are now needed to testify the efficiency of the novel IUD in the prevention of IUAs. If there is a marked reduction in the IUAs and/or improvement of pregnancy success in the case group compared with the control group, our hypothesis will be confirmed.

  20. Intrauterine contraceptive device appendicitis: A case report

    Institute of Scientific and Technical Information of China (English)

    Hao-Ming Chang; Teng-Wei Chen; Chung-Bao Hsieh; Chung-Jueng Chen; Jyh-Cherng Yu; Yao-Chi Liu; Kuo-Liang Shen; De-Chuan Chan

    2005-01-01

    Uterine perforation is one of the serious complications associated with use of the intrauterine contraceptive device (IUD). Uterine perforation by IUD can involve several neighboring organs. A case of acute appendicitis was caused by a Multiload Cu 375 IUD inserted previously.This is a rare complication and only fourteen previous cases were recorded in the literature.

  1. Efficacy of intrauterine device in the treatment of intrauterine adhesions.

    Science.gov (United States)

    Salma, Umme; Xue, Min; Md Sayed, Ali Sheikh; Xu, Dabao

    2014-01-01

    The primary purpose of this paper is to assess the efficacy of the use of the intrauterine device (IUD) as an adjunctive treatment modality, for intrauterine adhesions (IUAs). All eligible literatures were identified by electronic databases including PubMed, Scopus, and Web of Science. Additional relevant articles were identified from citations in these publications. There were 28 studies included for a systematic review. Of these, 5 studies were eligible for meta-analysis and 23 for qualitative assessment only. Twenty-eight studies related to the use of IUDs as ancillary treatment following adhesiolysis were identified. Of these studies, 25 studies at least one of the following methods were carried out as ancillary treatment: Foley catheter, hyaluronic acid gel, hormonal therapy, or amnion graft in addition to the IUD. There was one study that used IUD therapy as a single ancillary treatment. In 2 studies, no adjunctive therapy was used after adhesiolysis. There was a wide range of reported menstrual and fertility outcomes which were associated with the use of IUD combined with other ancillary treatments. At present, the IUD is beneficial in patients with IUA, regardless of stage of adhesions. However, IUD needs to be combined with other ancillary treatments to obtain maximal outcomes, in particular in patients with moderate to severe IUA.

  2. Two-year continuation of intrauterine devices and contraceptive implants in a mixed-payer setting: a retrospective review.

    Science.gov (United States)

    Sanders, Jessica N; Turok, David K; Gawron, Lori M; Law, Amy; Wen, Lonnie; Lynen, Richard

    2017-06-01

    As the popularity of long-acting reversible contraception increases, so does the need for accurate data on method continuation in diverse clinical settings. We determined 2-year continuation rates for the levonorgestrel 52-mg intrauterine device, the copper T380A intrauterine device, and the 68-mg etonogestrel contraceptive implant in an academic healthcare system with mixed-payer reimbursement. The purpose of this study was to examine the proportion and characteristics of women who continue intrauterine device and implant use to 2 years and to relate continuation to device type when controlling for patient characteristics. This retrospective chart review assessed University of Utah Healthcare System patients who had an intrauterine device or contraceptive implant inserted between January 1, 2004, and December 31, 2012. We identified users and dates of insertions and removals by querying billing, medication, and procedural data in the Electronic Data Warehouse. Multivariable Poisson regression was conducted to estimate incidence risk ratios and to relate the probability of 2-year continuous use to device type. Data on 8603 device insertions were obtained with the following distribution: levonorgestrel 52-mg intrauterine devices (6459; 75.1%), copper T380A intrauterine devices (1136; 13.2%), and 68-mg etonogestrel implant (1008; 11.7%). Two-year continuation rates were 77.8%, 73.1%, and 75.9%, respectively. There was no statistical difference in 2-year continuation between levonorgestrel 52-mg intrauterine device users (adjusted risk ratio, 1.1; 95% confidence interval, 1.0-1.1) and 68-mg etonogestrel implant users (adjusted risk ratio, 1.1; 95% confidence interval, 1.0-1.1) compared with copper device users, after we controlled for age, Hispanic ethnicity, payer type, and year of insertion. Older-age, self-pay, or public payer insurance (reference commercial payer) and Hispanic ethnicity were associated with 2-year continuation. Three-quarters of women with an

  3. Sigmoid Colon Migration of an Intrauterine Device

    Directory of Open Access Journals (Sweden)

    Funda Akpinar

    2014-01-01

    Full Text Available Background. Intrauterine devices (IUD are commonly used birth control methods. Colonic perforation is an infrequent but serious complication of IUD. Case. A 34-year-old woman with 2-years history of IUD, inserted at early puerperal period, presented to gynecologist with chronic pelvic pain and dyspareunia. Radiological assessment revealed that there were two copper-T devices: one in uterine cavity and another in the colonic lumen. Attempts of retrieval with colonoscopy and laparoscopy were unsuccessful. Intrauterine device embedded in sigmoid colon wall was removed with resection of the involved segment and primary anastomosis was performed. Conclusion. Although there are cases in literature that are successfully managed with colonoscopy, in chronic cases, formation of granulation tissue complicates retrieval of an IUD by this intervention.

  4. Levonorgestrel release rates over 5 years with the Liletta® 52-mg intrauterine system.

    Science.gov (United States)

    Creinin, Mitchell D; Jansen, Rolf; Starr, Robert M; Gobburu, Joga; Gopalakrishnan, Mathangi; Olariu, Andrea

    2016-10-01

    To understand the potential duration of action for Liletta®, we conducted this study to estimate levonorgestrel (LNG) release rates over approximately 5½years of product use. Clinical sites in the U.S. Phase 3 study of Liletta collected the LNG intrauterine systems (IUSs) from women who discontinued the study. We randomly selected samples within 90-day intervals after discontinuation of IUS use through 900days (approximately 2.5years) and 180-day intervals for the remaining duration through 5.4years (1980days) to evaluate residual LNG content. We also performed an initial LNG content analysis using 10 randomly selected samples from a single lot. We calculated the average ex vivo release rate using the residual LNG content over the duration of the analysis. We analyzed 64 samples within 90-day intervals (range 6-10 samples per interval) through 900days and 36 samples within 180-day intervals (6 samples per interval) for the remaining duration. The initial content analysis averaged 52.0±1.8mg. We calculated an average initial release rate of 19.5mcg/day that decreased to 17.0, 14.8, 12.9, 11.3 and 9.8mcg/day after 1, 2, 3, 4 and 5years, respectively. The 5-year average release rate is 14.7mcg/day. The estimated initial LNG release rate and gradual decay of the estimated release rate are consistent with the target design and function of the product. The calculated LNG content and release rate curves support the continued evaluation of Liletta as a contraceptive for 5 or more years of use. Liletta LNG content and release rates are comparable to published data for another LNG 52-mg IUS. The release rate at 5years is more than double the published release rate at 3years with an LNG 13.5-mg IUS, suggesting continued efficacy of Liletta beyond 5years. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Evaluation of a new, low-dose levonorgestrel intrauterine contraceptive system over 5 years of use.

    Science.gov (United States)

    Gemzell-Danielsson, Kristina; Apter, Dan; Dermout, Sylvia; Faustmann, Thomas; Rosen, Kimberly; Schmelter, Thomas; Merz, Martin; Nelson, Anita

    2017-03-01

    To evaluate the efficacy and safety of a new, low-dose levonorgestrel intrauterine contraceptive system (LNG-IUS 12) for up to 5 years of use. In this Phase III study, 2885 nulliparous and parous women aged 18-35 years were randomized to LNG-IUS 8 or LNG-IUS 12 for 3 years. After 3 years, women using LNG-IUS 12 could continue for up to 2 additional years (5 years total). The primary outcome was occurrence of pregnancy (Pearl Index). Secondary outcomes included safety, bleeding, dysmenorrhea, discontinuations, and user satisfaction. From August 2007 through May 2008, out of 2885 women who were enrolled, 1453 were randomized to LNG-IUS 12. Placement was attempted in 1452/1453 (full analysis set). Mean age at baseline was 27.1 years; 39.5% were nulliparous. The cumulative 5-year Pearl Index (PI) was 0.29; the 5-year cumulative failure rate was 1.4%. The 5-year PI for ectopic pregnancy was 0.18. Over 5 years, 55.3% of women reported study drug-related treatment-emergent adverse events (TEAEs). Crude incidences of pelvic inflammatory disease, uterine perforation, and complete/partial LNG-IUS 12 expulsion were 0.6%, 0.2%, and 3.7%, respectively. Women using LNG-IUS 12 generally experienced less frequent bleeding over time. The incidence of amenorrhea during the last 90-day reference interval (end of Year 5) was 22.6%. Overall, 870 (59.9%) and 550 (37.9%) women completed 3 and 5 years of treatment, respectively; 77.8% of women who entered the extension phase completed 5 years of use. Over 5 years, 22.6% discontinued due to TEAEs, including 13 women who discontinued due to pregnancy; 76 discontinued due to bleeding problems including amenorrhea; and 163 discontinued due to desire for pregnancy, 71.2% of whom conceived within 12 months. In this study including parous and nulliparous women, LNG-IUS 12 was highly effective over 5 years of use and associated with a favorable safety profile. LNG-IUS 12 offers women a low-dose contraceptive option for up to 5 years. Copyright

  6. Levonorgestrel-Releasing Intrauterine System (52 mg) for Idiopathic Heavy Menstrual Bleeding: A Health Technology Assessment.

    Science.gov (United States)

    2016-01-01

    Heavy menstrual bleeding affects as many as one in three women and has negative physical, economic, and psychosocial impacts including activity limitations and reduced quality of life. The goal of treatment is to make menstruation manageable, and options include medical therapy or surgery such as endometrial ablation or hysterectomy. This review examined the evidence of effectiveness and cost-effectiveness of the 52-mg levonorgestrel-releasing intrauterine system (LNG-IUS) as a treatment alternative for idiopathic heavy menstrual bleeding. We conducted a systematic review of the clinical and economic evidence comparing LNG-IUS with usual medical therapy, endometrial ablation, or hysterectomy. Medline, EMBASE, Cochrane, and the Centres for Reviews and Dissemination were searched from inception to August 2015. The quality of the evidence was assessed according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group criteria. We also completed an economic evaluation to determine the cost-effectiveness and budget impact of the LNG-IUS compared with endometrial ablation and with hysterectomy. The economic evaluation was conducted from the perspective the Ontario Ministry of Health and Long-Term Care. Relevant systematic reviews (n = 18) returned from the literature search were used to identify eligible randomized controlled trials, and 16 trials were included. The LNG-IUS improved quality of life and reduced menstrual blood loss better than usual medical therapy. There was no evidence of a significant difference in these outcomes compared with the improvements offered by endometrial ablation or hysterectomy. Mild hormonal side effects were the most commonly reported. The quality of the evidence varied from very low to moderate across outcomes. Results from the economic evaluation showed the LNG-IUS was less costly (incremental saving of $372 per person) and more effective providing higher quality-adjusted life years (incremental

  7. Timing of insertion of levonorgestrel-releasing intrauterine system: a randomised controlled trial.

    Science.gov (United States)

    van der Heijden, Pahh; Geomini, Pmaj; Herman, M C; Veersema, S; Bongers, M Y

    2017-01-01

    The objective was to assess whether patient-perceived pain during the insertion of the levonorgestrel-releasing intrauterine system (LNG-IUS) depends on the timing during the menstrual cycle. A stratified two-armed non-inferiority randomised controlled trial. Large teaching hospital in Veldhoven, the Netherlands. From October 2013 to May 2014, 60 nulliparous and 60 multiparous women were randomised. Eight women withdrew after randomisation and before insertion took place: therefore, data from 112 women were collected and analysed. Women were randomised to the groups 'during menstruation' (i.e. days 1-7 of menstruation) or 'outside menstruation' (i.e. any day of the cycle after menstruation without the presence of vaginal blood loss) in a ratio of 1 : 1. The primary outcome was pain during insertion, measured by the visual analogue scale (VAS, 0-100 mm). Second, we analysed ease of insertion, bleeding pattern, satisfaction, pregnancy, and expulsion rate. The follow-up time was 3 months. The mean VAS score for nulliparous women was 74 mm (95% confidence interval, 95% CI 67-81) in the 'during menstruation' group, compared with 66 mm (95% CI 59-74) in the 'outside menstruation' group (P = 0.14). The mean VAS score for multiparous women was 30 mm (95% CI 20-40) in the 'during menstruation group', compared with 43 mm (95% CI 32-53) in the 'outside menstruation' group (P = 0.08). There was no difference between the stratified 'during menstruation' group and the 'outside menstruation' group with regards to ease of insertion, satisfaction, bleeding pattern, and median spotting and bleeding days for the use of the LNG-IUS 3 months after insertion. As we did not find that the level of pain perceived during insertion was higher during menstruation, compared with outside menstruation, we conclude that the LNG-IUS can be inserted at any time during the menstrual cycle, especially in the case of nulliparous women. We conducted an RCT on time of insertion of

  8. Levonorgestrel-Releasing Intrauterine System (52 mg) for Idiopathic Heavy Menstrual Bleeding: A Health Technology Assessment

    Science.gov (United States)

    Schaink, Alexis; Chan, Brian; Higgins, Caroline

    2016-01-01

    Background Heavy menstrual bleeding affects as many as one in three women and has negative physical, economic, and psychosocial impacts including activity limitations and reduced quality of life. The goal of treatment is to make menstruation manageable, and options include medical therapy or surgery such as endometrial ablation or hysterectomy. This review examined the evidence of effectiveness and cost-effectiveness of the 52-mg levonorgestrel-releasing intrauterine system (LNG-IUS) as a treatment alternative for idiopathic heavy menstrual bleeding. Methods We conducted a systematic review of the clinical and economic evidence comparing LNG-IUS with usual medical therapy, endometrial ablation, or hysterectomy. Medline, EMBASE, Cochrane, and the Centres for Reviews and Dissemination were searched from inception to August 2015. The quality of the evidence was assessed according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group criteria. We also completed an economic evaluation to determine the cost-effectiveness and budget impact of the LNG-IUS compared with endometrial ablation and with hysterectomy. The economic evaluation was conducted from the perspective the Ontario Ministry of Health and Long-Term Care. Results Relevant systematic reviews (n = 18) returned from the literature search were used to identify eligible randomized controlled trials, and 16 trials were included. The LNG-IUS improved quality of life and reduced menstrual blood loss better than usual medical therapy. There was no evidence of a significant difference in these outcomes compared with the improvements offered by endometrial ablation or hysterectomy. Mild hormonal side effects were the most commonly reported. The quality of the evidence varied from very low to moderate across outcomes. Results from the economic evaluation showed the LNG-IUS was less costly (incremental saving of $372 per person) and more effective providing higher quality

  9. LNG-IUS 12: a 19.5 levonorgestrel-releasing intrauterine system for prevention of pregnancy for up to five years.

    Science.gov (United States)

    Nelson, Anita L

    2017-09-01

    Globally, intrauterine devices (IUDs) are the second most commonly used form of reversible contraception because of their high efficacy, safety, convenience and cost effectiveness. The levonorgestrel releasing intrauterine system with daily average release of 20 mcg (LNG-IUS 20) is the popular choice because of its favorable bleeding patterns and many noncontraceptive benefits. A three year (LNG-IUS 8) became available three years ago. More recently, the LNG-IUS 12 was added. This new IUD shares a smaller frame, narrow inserter and lower rate of amenorrhea with the LNG-IUS 8, but it offers the five years of contraceptive protection of the LNG-IUS 20. Areas covered: This article provides information on the contraceptive efficacy, safety and tolerability of this new IUS based on approximately 60,000 cycles of use. Where available, the impacts of subject age, parity and body mass index (BMI) on study outcomes are reported. Expert opinion: This new LNG-IUS 12 with mid-dose hormone levels, smaller frame and longer effective life fills a niche that may better meet the needs of women who might appreciate the narrow insertion tube and/or the lower rates of amenorrhea. Cost will ultimately help determine success.

  10. Characterization of biofilm formed on intrauterine devices

    OpenAIRE

    2003-01-01

    PURPOSE: Intrauterine device (IUD) is one of the most convenient contraceptive procedures used by women of Asian and African countries. Previous surveys have revealed that 75% of the IUDs recovered from patients suffering from reproductive tract infections (RTIs) were covered with a consortium of microbes. This study was designed to characterize these microbes and recommend remedial measures. METHODS: Quantitative measurement of biofilm formation was assessed by a microtitre plate assa...

  11. Intrauterine Device Removal after 22 Years

    Directory of Open Access Journals (Sweden)

    Tahereh Boryri

    2014-01-01

    Full Text Available IUD T380A is one of the most effective, reversible, long term methods of contraception all over the world based on the experience of World Health Organization and our own observation of women who continued to use the IUD beyond 10 years or even longer years. In this article one case of Intrauterine device removal after 22 years is reported without complications and pregnancy.

  12. Intrauterine devices & infection: Review of the literature

    OpenAIRE

    2014-01-01

    The relationship between use of an intrauterine device (IUD) and pelvic inflammatory disease (PID) has been studied extensively over the past 50 years. Previous research has led to considerable controversy and debate. Numerous limitations in the studies make it difficult to draw any firm conclusions from the past research or to design new approaches to study the topic. The main research barriers include uncertainty of infection/diagnoses, and inappropriate comparison groups for IUD users. Nat...

  13. Femilis(®) 60 Levonorgestrel-Releasing Intrauterine System-A Review of 10 Years of Clinical Experience.

    Science.gov (United States)

    Wildemeersch, Dirk; Andrade, Amaury; Goldstuck, Norman

    2016-01-01

    The aim of this study was to update the clinical experience with the Femilis® 60 levonorgestrel-releasing intrauterine system (LNG-IUS), now up to 10 years in parous and nulliparous women, particularly with regard to ease and safety of insertion, contraceptive performance, retention, acceptability, continuation of use, impact on menstrual blood loss (MBL), and duration of action. Using the Femilis® 60 LNG-IUS releasing 20 µg of levonorgestrel/day, the following studies were conducted: an open, prospective noncomparative contraceptive study, an MBL study, a perimenopausal study, a study for the treatment of endometrial hyperplasia, and early cancer of the uterus, a residue study. A total of 599 Femilis LNG-IUS were inserted in various clinical trials, the majority for contraceptive purposes. The total exposure in the first and second contraceptive studies, covering 558 parous and nulliparous women, was 32,717 woman-months. Femilis has high contraceptive effectiveness as only one pregnancy occurred. Expulsion of the LNG-IUS was rare with only two total and no partial expulsions (stem protruding through the cervical canal) occurred. Femilis was well tolerated, with continuation rates remaining high. Several MBL studies were conducted, totaling 80 heavy and normal menstrual bleeders, using the pictorial bleeding assessment chart method or the quantitative alkaline hematin technique. Virtually all women responded well with strongly reduced menstrual bleeding. Amenorrhea rates were high, up to 80% after three months, and ferritin levels simultaneously increased significantly. The Femilis LNG-IUS was tested in 104 symptomatic perimenopausal women for seamless transition to and through menopause, adding estrogen therapy when required. Patient tolerability appeared high as >80% requested a second and a third LNG-IUS. Twenty women presenting with nonatypical and atypical hyperplasia and one woman presenting with early endometrial carcinoma were treated with Femilis LNG

  14. Femilis® 60 Levonorgestrel-Releasing Intrauterine System—A Review of 10 Years of Clinical Experience

    Science.gov (United States)

    Wildemeersch, Dirk; Andrade, Amaury; Goldstuck, Norman

    2016-01-01

    OBJECTIVE The aim of this study was to update the clinical experience with the Femilis® 60 levonorgestrel-releasing intrauterine system (LNG-IUS), now up to 10 years in parous and nulliparous women, particularly with regard to ease and safety of insertion, contraceptive performance, retention, acceptability, continuation of use, impact on menstrual blood loss (MBL), and duration of action. STUDY DESIGN Using the Femilis® 60 LNG-IUS releasing 20 µg of levonorgestrel/day, the following studies were conducted: an open, prospective noncomparative contraceptive study, an MBL study, a perimenopausal study, a study for the treatment of endometrial hyperplasia, and early cancer of the uterus, a residue study. RESULTS A total of 599 Femilis LNG-IUS were inserted in various clinical trials, the majority for contraceptive purposes. The total exposure in the first and second contraceptive studies, covering 558 parous and nulliparous women, was 32,717 woman-months. Femilis has high contraceptive effectiveness as only one pregnancy occurred. Expulsion of the LNG-IUS was rare with only two total and no partial expulsions (stem protruding through the cervical canal) occurred. Femilis was well tolerated, with continuation rates remaining high. Several MBL studies were conducted, totaling 80 heavy and normal menstrual bleeders, using the pictorial bleeding assessment chart method or the quantitative alkaline hematin technique. Virtually all women responded well with strongly reduced menstrual bleeding. Amenorrhea rates were high, up to 80% after three months, and ferritin levels simultaneously increased significantly. The Femilis LNG-IUS was tested in 104 symptomatic perimenopausal women for seamless transition to and through menopause, adding estrogen therapy when required. Patient tolerability appeared high as >80% requested a second and a third LNG-IUS. Twenty women presenting with nonatypical and atypical hyperplasia and one woman presenting with early endometrial carcinoma

  15. Intrauterine devices in Singapore today.

    Science.gov (United States)

    Mccarthy, T G; Ratnam, S S

    1984-01-01

    The IUD has been selected by less than 1% of contraceptive users in Singapore in the past 15 years, largely because of concerns about uterine perforation and a lack of professional training in insertion techniques. However, increased public awareness of the possible complications of oral contraceptives has led to an interest in the IUD as a family planning method and the Singapore Family Planning and Population Board has introduced the Multiload Cu 250 device at its clinic. The IUD is now considered a feasible method of contraception for women in Singapore, many of whom achieve their ideal family size of 2 children between the ages of 20-25 years. Successful use of the IUD is dependent upon placement of the device at the top of the uterine cavity by an experienced physician. All devices should be changed after 4 years to reduce the risk of complications. The newer IUDs have many advantages over inert and early copper-bearing IUDs in terms of safety and efficacy.

  16. Intrauterine contraceptive devices for diabetics.

    Science.gov (United States)

    Kurz, K H; Berger, M

    1982-09-25

    A study published in 1982 by Gosden et al. reported unfavorably on the use of the IUD, in this particular case a Cu 7 200, in insulin-dependent diabetic women. In a group of 30 type 1 diabetic patients 11 became pregnant over a period of 1 year. The study did not supply data on parity, age, frequency of coitus, and diabetic control. This letter reports on the cases of 4 insulin-dependent nulligravid women aged 22, 25, 26, and 33, with an average coital frequency of 2-3 times a week. The women had been fitted with Cu T 200 or with Multiload Cu 250 devices; there were no pregnancies during the observed period of 136 women/months. The effectiveness of an IUD depends greatly on the size of the device and on its proper position within the uterine cavity. The Cu 7 200 is a symmetrical, and the vertical stem containing the copper wire is often placed to one side of the cavity, thus creating zones where sperm ascent and blastocyst implantation can happen. Moreover, the Cu 7 200 has a much lower copper-ion-releasing capacity than the Ml 250 or the Cu T 200. The Cu 7 200 also has a higher expulsion and pregnancy rate than other copper IUDs.

  17. Ectopic Intrauterine Device in the Bladder of a Pregnant Woman

    Directory of Open Access Journals (Sweden)

    Zehra Kurdoglu

    2010-01-01

    Full Text Available Background. Uterine perforation and transvesical migration of an intrauterine device are rare complications. Case. A 28-year-old woman who had an intrauterine device was admitted to our outpatient clinic with complaints of amenorrhea lasting 5 weeks and pelvic pain lasting a year. Transvaginal ultrasonography revealed embedding of the intrauterine device in the bladder. The misplaced device was removed by laparotomy. Conclusion. The followup of intrauterine device localization with transvaginal ultrasonography is essential for early detection of possible serious complications.

  18. A suspicious reason for Raynaud's phenomenon: Intrauterine device.

    Science.gov (United States)

    Diken, Adem I; Yalçınkaya, Adnan; Aksoy, Eray; Yılmaz, Seyhan; Çağlı, Kerim

    2015-06-01

    Primary Raynaud's phenomenon may be insistent in patients under medical therapy, and intrauterine devices may be an unnoticed reason in these patients. Fluctuations in female sex hormone status were reported to be associated with the emergence of primary Raynaud's phenomenon symptoms. The use of intrauterine devices was not reported to be associated with Raynaud's phenomenon previously. Intrauterine device may stimulate vascular hyperactivity regarding hormonal or unknown mechanisms that result in Raynaud's phenomenon. We present a postmenopausal patient who complained of primary Raynaud's phenomenon symptoms and had recovery after the removal of her copper intrauterine device.

  19. Primary ovarian pregnancy with intrauterine contraceptive device

    Directory of Open Access Journals (Sweden)

    Sabita Saichandran

    2015-08-01

    Full Text Available Primary ovarian pregnancy is a rare variant of extra-uterine pregnancies. However the cause for primary ovarian pregnancy is still obscure. Some studies have reported a strong correlation of this condition with intrauterine contraceptive device (IUCD. The diagnosis of ovarian ectopic pregnancy is seldom made before surgery though ultrasound proves to be an invaluable tool for its diagnosis. We describe here about a case of primary ovarian pregnancy which was diagnosed only at the time of operation and was managed with wedge resection of the ovary. [Int J Reprod Contracept Obstet Gynecol 2015; 4(4.000: 1191-1193

  20. Immediate Intrauterine Device Insertion Following Surgical Abortion.

    Science.gov (United States)

    Patil, Eva; Bednarek, Paula H

    2015-12-01

    Placement of an intrauterine device (IUD) immediately after a first or second trimester surgical abortion is safe and convenient and decreases the risk of repeat unintended pregnancy. Immediate postabortion IUD placement is not recommended in the setting of postprocedure hemorrhage, uterine perforation, infection, or hematometra. Otherwise, there are few contraindications to IUD placement following surgical abortion. Sexually transmitted infection screening should follow US Centers for Disease Control and Prevention guidelines. No additional antibiotics are needed beyond those used for the abortion. Placing immediate postabortion IUDs makes highly-effective long-acting reversible contraception more accessible to women.

  1. Incidence of actinomycosis associated with intrauterine devices.

    Science.gov (United States)

    Chatwani, A; Amin-Hanjani, S

    1994-08-01

    The incidence of intrauterine device (IUD)-associated cervicovaginal actinomycosis was evaluated. Papanicolaou-stained cervicovaginal smears from 1,520 women with IUDs were reviewed for the presence of Actinomyces-like organisms. The overall colonization rate was 11.4%. The colonization rates for the Progestasert, plastic IUDs and copper IUDs were 14.3%, 10.8% and 6.69%, respectively. The colonization rate appeared to increase with the duration of IUD use. The relatively high cervicovaginal Actinomyces colonization rate suggests that all patients with IUDs should undergo annual cytologic smears, with specific attention given to the presence of Actinomyces-like organisms.

  2. Female pelvic actinomycosis and intrauterine contraceptive devices

    Directory of Open Access Journals (Sweden)

    Faustino R Pérez-López

    2010-05-01

    Full Text Available Faustino R Pérez-López1,2, José J Tobajas1,3, Peter Chedraui41Department of Obstetrics and Gynecology, Facultad de Medicina, Universidad de Zaragoza; 2Hospital Clínico Lozano Blesa; 3Hospital Universitario Miguel Servet, Zaragoza, Spain; 4Enrique C. Sotomayor Obstetrics and Gynecology Hospital, Guayaquil, EcuadorAbstract: Female genital Actinomyces infection is relatively rare, although strongly related to long-lasting intrauterine contraceptive device (IUD application. An infective pathway has been postulated extending upward from the female perineum to the vagina and cervix. The traumatic effect of the device and a prior infection may contribute to the Actinomyces infection in the female genitalia. This disease is characterized by local swelling, suppuration, abscess formation, tissue fibrosis, tubal-ovarian mass and fistula formation. The infection spreads by contiguity often mimicking the characteristics of a malignant neoplastic process. Currently there is no consensus regarding diagnosis and screening tests, although there seems to be agreement in relation to IUD type, duration, and sexual behavior as major risk factors.Keywords: contraception, intrauterine contraceptive device, pelvic actinomycosis, sexuality

  3. A randomized trial of levonorgestrel intrauterine system insertion 6 to 48 h compared to 6 weeks after vaginal delivery; lessons learned.

    Science.gov (United States)

    Stuart, Gretchen S; Lesko, Catherine R; Stuebe, Alison M; Bryant, Amy G; Levi, Erika E; Danvers, Antoinette I

    2015-04-01

    The objective of this randomized trial was to compare breastfeeding among women who received a levonorgestrel-releasing intrauterine system within 6-48 h (early) or 4-6 weeks (standard) after an uncomplicated vaginal birth. Analysis groups of 86 women in each arm were needed to demonstrate a 20% difference in any breastfeeding. Thirty-five women were randomized to the early (N=17) and standard (N=18) arms. The combination of unsuccessful placement (2/17; 12%), expulsions (7/17; 41%) and removals (3/17; 18%) reached 71% (12/17) in the early arm, so the study was stopped. In our small study cohort, levonorgestrel-releasing intrauterine system insertion between 6 and 48 h after vaginal birth was associated with a high rate of expulsion or removal soon after insertion.

  4. Comparison of the levonorgestrel-releasing intrauterine system, hysterectomy, and endometrial ablation for heavy menstrual bleeding in a decision analysis model.

    Science.gov (United States)

    Louie, Michelle; Spencer, Jennifer; Wheeler, Stephanie; Ellis, Victoria; Toubia, Tarek; Schiff, Lauren D; Siedhoff, Matthew T; Moulder, Janelle K

    2017-08-10

    A better understanding of the relative risks and benefits of common treatment options for abnormal uterine bleeding (AUB) can help providers and patients to make balanced, evidence-based decisions. To provide comparative estimates of clinical outcomes after placement of levonorgestrel-releasing intrauterine system (LNG-IUS), ablation, or hysterectomy for AUB. A PubMED search was done using combinations of search terms related to abnormal uterine bleeding, LNG-IUS, hysterectomy, endometrial ablation, cost-benefit analysis, cost-effectiveness, and quality-adjusted life years. Full articles published in 2006-2016 available in English comparing at least two treatment modalities of interest among women of reproductive age with AUB were included. A decision tree was generated to compare clinical outcomes in a hypothetical cohort of 100 000 premenopausal women with nonmalignant AUB. We evaluated complications, mortality, and treatment outcomes over a 5-year period, calculated cumulative quality-adjusted life years (QALYs), and conducted probabilistic sensitivity analysis. Levonorgestrel-releasing intrauterine system had the highest number of QALYs (406 920), followed by hysterectomy (403 466), non-resectoscopic ablation (399 244), and resectoscopic ablation (395 827). Ablation had more treatment failures and complications than LNG-IUS and hysterectomy. Findings were robust in probabilistic sensitivity analysis. Levonorgestrel-releasing intrauterine system and hysterectomy outperformed endometrial ablation for treatment of AUB. © 2017 International Federation of Gynecology and Obstetrics.

  5. Extended use of the intrauterine device: a literature review and recommendations for clinical practice.

    Science.gov (United States)

    Wu, Justine P; Pickle, Sarah

    2014-06-01

    There are multiple advantages to "extended use" of the intrauterine device (IUD) use beyond the manufacturer-approved time period, including prolongation of contraceptive and non-contraceptive benefits. We performed a literature review of studies that have reported pregnancy outcomes associated with extended use of IUDs, including copper IUDs and the levonorgestrel intrauterine system (LNG-IUS). Among parous women who are at least 25 years old at the time of IUD insertion, there is good evidence to support extended use of the following devices: the TCu380A and the TCu220 for 12 years, the Multiload Cu-375 for 10 years, the frameless GyneFix® (330 mm²) for 9 years, the levonorgestrel intrauterine system 52 mg (Mirena®) for 7 years and the Multiload Cu-250 for 4 years. Women who are at least 35 years old at the time of insertion of a TCu380A IUD can continue use until menopause with a negligible risk of pregnancy. We found no data to support use of the LNG-IUS 13.5 mg (Skyla®) beyond 3 years. When counseling about extended IUD use, clinicians should consider patient characteristics and preferences, as well as country- and community-specific factors. Future research is necessary to determine the risk of pregnancy associated with extended use of the copper IUD and the LNG-IUS among nulliparous women and women less than 25 years old at the time of IUD insertion. More data are needed on the potential effect of overweight and obesity on the long-term efficacy of the LNG-IUS.

  6. Combined Endometrial Ablation and Levonorgestrel Intrauterine System Use in Women With Dysmenorrhea and Heavy Menstrual Bleeding: Novel Approach for Challenging Cases.

    Science.gov (United States)

    Papadakis, Efstathios P; El-Nashar, Sherif A; Laughlin-Tommaso, Shannon K; Shazly, Sherif A M; Hopkins, Matthew R; Breitkopf, Daniel M; Famuyide, Abimbola O

    2015-01-01

    To evaluate the feasibility and impact of levonorgestrel intrauterine system (LNG-IUS) on treatment failure after endometrial ablation (EA) in women with heavy menstrual bleeding (HMB) and dysmenorrhea at 4 years. Cohort study (Canadian Task Force II-2). An academic institution in the upper Midwest. All women with HMB and dysmenorrhea who underwent EA with combined placement of LNG-IUS (EA/LNG-IUS cohort, 23 women) after 2005 and an historic reference group from women who had EA alone (EA cohort, 65 women) from 1998 through the end of 2005. Radiofrequency EA, thermal balloon ablation, and LNG-IUS. The primary outcome was treatment failure defined as persistent pain, bleeding, and hysterectomy after EA at 4 years. The combined treatment failure outcome was documented in 2 patients (8.7%) in the EA/LNG-IUS group and 19 patients (29.2%) in the EA group with an unadjusted OR of .23 (95% CI, .05-1.08). After adjusting for known risk factors of failure, the adjusted OR was .19 (95% CI, .26-.88). None of the women who underwent EA/LNG-IUS had hysterectomy for treatment failure compared with 16 (24%) in the EA group (p = .009); postablation pelvic pain was documented in 1 woman (4.3%) in the EA/LNG-IUS group compared with 8 women (12.3%) in the EA group (p = .24). One woman in the EA/LNG-IUS group (4.3%) presented with persistent bleeding compared with 15 (23.1%) in the EA group (p = .059). Office removal of the intrauterine device was performed in 4 women with no complications. LNG-IUS insertion at the time of EA is feasible and can provide added benefit after EA in women with dysmenorrhea and HMB. Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.

  7. Efficacy of the levonorgestrel intrauterine system (LNG-IUS) in the prevention of the atypical endometrial hyperplasia and endometrial cancer: retrospective data from selected obese menopausal symptomatic women.

    Science.gov (United States)

    Morelli, Michele; Di Cello, Annalisa; Venturella, Roberta; Mocciaro, Rita; D'Alessandro, Pietro; Zullo, Fulvio

    2013-02-01

    The aim of this retrospective study was to evaluate the efficacy of levonorgestrel intrauterine system-releasing (LNG-IUS) insertion in preventing atypical endometrial hyperplasia (AH) and endometrial cancer (EC) in symptomatic postmenopausal overweight/obese women. A total of 34 overweight/obese postmenopausal women, presenting abnormal uterine bleeding (AUB) and endometrial hyperplasia (EH), and who were submitted to LNG-IUS insertion, were identified from registry data. Endometrial histology at LNG-IUS insertion showed simple EH in 20 cases (58.8%), complex EH in 14 cases (41.2%). At 36 months, 91% of patients showed no recurrence of AUB and a significant reduction in the mean endometrial thickness (from 8.2 ± 2.2 to 3.2 ± 1.5 mm, p LNG-IUS represents an effective treatment option to manage postmenopausal obese women affected by AUB and EH. The device seems to be able to prevent the onset of AH and EC in women at high risk. Further prospective controlled studies in a well selected group of women are needed.

  8. Intrauterine devices & infection: review of the literature.

    Science.gov (United States)

    Hubacher, David

    2014-11-01

    The relationship between use of an intrauterine device (IUD) and pelvic inflammatory disease (PID) has been studied extensively over the past 50 years. Previous research has led to considerable controversy and debate. Numerous limitations in the studies make it difficult to draw any firm conclusions from the past research or to design new approaches to study the topic. The main research barriers include uncertainty of infection/diagnoses, and inappropriate comparison groups for IUD users. Natural history studies of the aetiology of disease and observational research among IUD users suggest that the risk of PID is very low. Research linking previous IUD use to the more distant endpoint of tubal infertility reveals that the risks may be even lower than the risks of PID.

  9. Intrauterine devices & infection: Review of the literature

    Directory of Open Access Journals (Sweden)

    David Hubacher

    2014-01-01

    Full Text Available The relationship between use of an intrauterine device (IUD and pelvic inflammatory disease (PID has been studied extensively over the past 50 years. Previous research has led to considerable controversy and debate. Numerous limitations in the studies make it difficult to draw any firm conclusions from the past research or to design new approaches to study the topic. The main research barriers include uncertainty of infection/diagnoses, and inappropriate comparison groups for IUD users. Natural history studies of the aetiology of disease and observational research among IUD users suggest that the risk of PID is very low. Research linking previous IUD use to the more distant endpoint of tubal infertility reveals that the risks may be even lower than the risks of PID.

  10. Investigation of knowledge level about intrauterine device

    Directory of Open Access Journals (Sweden)

    Hediye Dagdeviren

    2013-06-01

    Full Text Available Objective: To investigate a level of knowledge about intrauterine device between females who were examined in our gynecology department. Metods: The study was conducted at Gynecology and Obstetric Department of Bakirkoy Dr. Sadi Konuk Teaching and Research Hospital between August 2012-November 2012. The study were included 189 patients who accepted to participate. For collecting data; a form of questionnaire was used which has gived information about the intrauterine device (IUD and status of socio-demographic characteristics of the patients. The questionnaire were administered by the researchers in a separate room as a face-to-face interviews. SPSS 20.0 (SPSS Inc, Chicago, IL, USA program was used for statistical analysis. Results: The mean age of the women in the study was 31.1 ± 9.9. 44.7% of women were not using any modern contraceptive method. IUD utilization rate was 3.2%. 1.6% of women had never heard IUD, %76.1 women heard copper IUD. 42% of respondents gave the wrong answer to IUD inserted into ovaries. Conclusion: The IUD which is a cheap, does not require patient compliance, and has high efficacy. In this study, we were not found a statisfically significant difference for answers to questions in patients with different socio-demographic characteristics. The main result of the study was; among all parcipitians ,even health care workers there was an important disability about level of knowledge for IUD. It is great importance the whole society, including health professionals must train about family planning. [Cukurova Med J 2013; 38(3.000: 440-445

  11. Estimated disability-adjusted life years averted by free-of-charge provision of the levonorgestrel-releasing intrauterine system over a 9-year period in Brazil.

    Science.gov (United States)

    Ferreira, Jessica M; Monteiro, Ilza; Fernandes, Arlete; Bahamondes, Maria V; Pitoli, Ana; Bahamondes, Luis

    2017-07-01

    The objective was to analyse the contribution of the provision at no cost to users of the 20 µg/day levonorgestrel-releasing intrauterine system (LNG-IUS) towards disability-adjusted life years (DALY) averted over a 9-year period. We analysed data from 15 030 new users of the LNG-IUS who had the device inserted at 26 Brazilian teaching hospitals between January 2007 and December 2015. The devices came from the International Contraceptive Access Foundation (ICA), a not-for-profit foundation that donates the devices to developing countries for use by low-income women who desire long-term contraception and who freely choose to use this device. Estimation of the DALY averted included live births averted, maternal morbidity and mortality, child mortality and unsafe abortions averted. A total of 15 030 women chose the LNG-IUS as a contraceptive method during the study period. Over the 9 years of evaluation, the estimated cumulative contribution of the Brazilian program in terms of DALY averted consisted of 486 live births, 14 cases of combined maternal mortality and morbidity, 143 cases of child mortality and 410 unsafe abortions. Provision of the LNG-IUS at no cost to low-income Brazilian women reduced unwanted pregnancies and probably averted maternal mortality and morbidity, child mortality and unsafe abortions. Family planning programs, policymakers and stakeholders based in low-resource settings could take advantage of the information that the provision of this contraceptive at no cost, or at affordable cost to a publicly-insured population, is an effective policy to help promote women's health. © Faculty of Sexual and Reproductive Healthcare of the Royal College of Obstetricians and Gynaecologists (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  12. Uterine Length in Adolescents with Developmental Disability: Are Ultrasound Examinations Necessary before Insertion of the Levonorgestrel Intrauterine System?

    Science.gov (United States)

    Whyte, Helena; Pecchioli, Yael; Oyewumi, Lamide; Kives, Sari; Allen, Lisa M; Kirkham, Yolanda A

    2016-12-01

    (1) To determine if there are any differences in uterine length between adolescents with developmental disability (DD) compared with their normally developing (ND) peers that might necessitate ultrasonography before insertion of levonorgestrel intrauterine system (LNG-IUS) in patients with DD; and (2) to characterize the LNG-IUS insertion procedure in adolescents with disabilities. This was a retrospective cohort study of 223 female adolescents with or without DDs. Seventy-five adolescents had DD; 33 underwent intrauterine system insertion in the operating room and 42 did not. A comparative cohort of 148 ND adolescents who had pelvic ultrasound examinations for abnormal uterine bleeding were included. The study period was between January 2006 and July 2013 at the Hospital for Sick Children, Toronto, Canada. Cases were identified from surgical databases and medical records. Mean uterine length on pelvic ultrasound, demographic characteristics (age, age at menarche, time from menarche to ultrasound, weight), and descriptive statistics on intrauterine system insertion. There was a statistically significant difference (P = .03) in uterine length between adolescents with and without DD (6.7 vs 7.1 cm). However, this was not a clinically significant difference because insertion of the LNG-IUS in patients with DD was successful in patients with uteri more than 5 cm long. There was no difference (P = .97) in uterine length of adolescents with DD whether they had LNG-IUS insertion or not (6.7 cm). Adolescents with DD were younger than adolescents without DD at time of ultrasound examination (P = .01). However, among patients with DD, those who underwent intrauterine system insertion were older (P = .001). Incidence of uterine anomaly in patients with DD is low (2.7%) and was the same as in ND adolescents. Rates of complications and expulsions were low and there were no failures of LNG-IUS insertion in adolescents with DD. Routine pelvic ultrasound examinations

  13. Fast-track vs. delayed insertion of the levonorgestrel-releasing intrauterine system after early medical abortion - a randomized trial.

    Science.gov (United States)

    Korjamo, Riina; Mentula, Maarit; Heikinheimo, Oskari

    2017-08-05

    To compare levonorgestrel (LNG) 52-mg intrauterine system (IUS) expulsion rates with fast-track (≤3 days) or delayed (2-4 weeks) insertion following mifepristone and misoprostol medical abortion. In this pilot trial, we randomized 108 women at ≤63 days' gestation to fast-track (n=55) or delayed (n=53) insertion. Follow-up visits occurred at 2-4 weeks, 3 months and 1 year. We assessed total and partial expulsion at 3 months and 1 year, adverse effects and bleeding profiles. We had follow-up data at 3 months and 1 year for 41 (74.5%) and 37 (69.8%) women in the fast-track group and 31 (56.4%) and 28 (52.8%) women in the delayed group. By 3 months, expulsion occurred in six (12.5%) women after fast-track and one (2.3%) woman after delayed insertion [risk ratio (RR) 5.50, 95% confidence interval (CI) 0.69-43.90]; most (n=5) of these were partial expulsions in the fast-track group. By 1 year, expulsion had occurred in seven (14.6%) and five (11.5%) women in the fast-track and delayed groups, respectively (RR 1.28, 95% CI 0.44-3.75). We found no differences in rates of vacuum aspiration, residual tissue, infection and bleeding or bleeding patterns within 3 months of insertion. Fast-track insertion of the LNG 52-mg IUS after medical abortion is feasible but may result in higher expulsion rates compared to delayed insertion. Due to lack of statistical power and high lost-to-follow-up rates, we were unable to fully address this question. Fast-tract initiation of LNG 52-mg IUS contraception after medical abortion is feasible. It results in higher expulsion rates than delayed insertion but may improve postabortal intrauterine contraception uptake. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. RELATIONSHIP BETWEEN INTRAUTERING PRESSURE,PROSTAGLANDIN CONCENTRATION AND INTRAUTERINE DEVICE

    Institute of Scientific and Technical Information of China (English)

    YANGJing; TIANXiao-Kun; CAOXiu-Juan

    1989-01-01

    Seventy-three bealthy multiparous non-pregnant women's intrauterine pressure (IUP) and levels of 6-keto-PGFla and TXB2 in uterine fluid were examined before and duringin sertion of intrauterine device (IUD) as well as a month after IUD insertion. The aim

  15. Characterization of biofilm formed on intrauterine devices

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    Pruthi V

    2003-01-01

    Full Text Available PURPOSE: Intrauterine device (IUD is one of the most convenient contraceptive procedures used by women of Asian and African countries. Previous surveys have revealed that 75% of the IUDs recovered from patients suffering from reproductive tract infections (RTIs were covered with a consortium of microbes. This study was designed to characterize these microbes and recommend remedial measures. METHODS: Quantitative measurement of biofilm formation was assessed by a microtitre plate assay on 86 samples of microorganisms dislodged from IUDs of patients with RTIs. Susceptibility of biofilm to various antimicrobial agents was also quantified. Scanning electron microscopy (SEM was used to scrutinize the microorganisms adherent to IUDs. RESULTS: The organisms associated with IUDs were predominantly composed of Staphylococcus aureus (16%, Staphylococcus epidermidis (18%, Pseudomonas aeruginosa (5%, Escherichia coli (27%, Neisseria gonorrhoeae (2%, Candida albicans (20% and Candida dubliniesis (12%. SEM studies indicated that these organisms were organized into biofilms. Studies on the in vitro adherence pattern by crystal violet staining on 96 well microtitre plates revealed that the biofilms were stably established after 60 hours. These biofilms are resistant to an array of antibiotics tested. CONCLUSION: Biofilm formation may be one of the major causes for persistent infection and antibiotic resistance in IUD users.

  16. [Intra-uterine device and nulliparous women].

    Science.gov (United States)

    Trignol-Viguier, N; Blin, E; Marret, H

    2014-06-01

    Intra-uterine device (IUD) is one of the birth control methods, which is available for nulliparous women, even though misconceptions still remain in medical or popular opinion. Only 1.3 % of nulliparous have a IUD as contraception in France while it is the second methods used by all women, after pill. The best contraception is the one chosen by women; however, the choice for a nulliparous of an IUD may be really difficult, despite the increasing number of women wishing to use it. Long-acting reversible contraceptives utilization, including IUD, is probably one of the issues to decrease the unintended pregnancies. An exhaustive and clear information about IUD is necessary to allow an informed and real choice. This prescription must consider contraindications and medical conditions for safe insertion, especially to avoid infection by screening STD (Chlamydia trachomatis and Nesseria gonorrhoeae) in nulliparous womenIUD preferred. Even if side effects such as expulsion, pelvic pains or dysmenorrhea are more frequent by nulliparous, IUD is a first intention choice for contraception to be consider, that women could obtain easily, including in emergency contraception situation.

  17. Role of levonorgestrel releasing intra-uterine system in the treatment of menorrhagia due to dysfunctional uterine bleeding and fibroid uterus

    Directory of Open Access Journals (Sweden)

    Reena Gupta

    2014-06-01

    Full Text Available Background: This study was carried out to assess the clinical effectiveness of levonorgestrel releasing intrauterine device (LNG-IUS in the treatment of menorrhagia due to either Dysfunctional Uterine Bleeding (DUB or fibroid in Indian patients, and to assess patient satisfaction with this treatment modality. Methods: Sixty women with menorrhagia, 30 due to fibroid and 30 due to DUB, meeting inclusion criteria, received LNG-IUS and were prospectively followed up for 9 months with periodic clinical assessments and transvaginal ultrasounds. Patient satisfaction was assessed on a five-point scale. Results: One patient in DUB group was lost to follow-up. In DUB patients, the treatment failure rate was only 3.4% (1 out of 29 patients. The median PBAC score reduced by 95% at 9 months. Fibroid patients also had an equally impressive 97.7% reduction of PBAC score at 9 months, although the failure rate was higher (23.3%; 7 out of 30. Majority of patients were either and lsquo;very satisfied' or and lsquo;satisfied' with the treatment, although this percentage was more in DUB (82.8% than in the fibroid group (66.7%. Haemoglobin and serum ferritin levels significantly increased in both groups. No major side effect was noted. Conclusions: LNG-IUS is an excellent treatment modality for patients of DUB, with good patient satisfaction. It is also a useful treatment option in non-submucosal small fibroids for the symptoms of menorrhagia, can reduce uterine volume and can help avoid hysterectomy, but there is no effect on fibroid volume. Majority of patients are satisfied, although satisfaction rates are less than in DUB patients. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 671-677

  18. Cardiovascular risk markers among obese women using the levonorgestrel-releasing intrauterine system: A randomised controlled trial.

    Science.gov (United States)

    Zueff, Lucimara Facio Nobre; Melo, Anderson Sanches de; Vieira, Carolina S; Martins, Wellington P; Ferriani, Rui A

    2017-07-07

    According to international guidelines, women with obesity without other comorbidities can safely use any hormonal contraceptive (HC). However, limited information is available about contraceptive safety for women with obesity since obesity is an exclusion criterion of most contraceptive clinical trials. As such little is known about the possible risks of HC exposure for women with obesity without comorbidities. One way to assess possible long-term risks in this population, even prior to the development of any clinical disease, is to measure alterations in subclinical atherosclerosis markers. We evaluated the effects of the levonorgestrel-releasing intrauterine system (LNG-IUS) on subclinical markers of cardiovascular risk in women with obesity. This is a randomised clinical trial in which 106 women with obesity [body mass index (BMI)≥30kg/m(2)] were randomised to the LNG-IUS (n=53) or to non-hormonal methods (n=53) and followed for 12 months. We evaluated waist circumference (WC), blood pressure, blood glucose, insulin, lipid profile, and endothelial function markers (carotid intima-media thickness, brachial artery flow-mediated dilation, and carotid arterial stiffness). At 12 months, BMI (p=0.005), WC (p=0.045), and glucose levels (p=0.015) were significantly lower in the LNG-IUS group than in the control group. We did not find any clinically relevant changes in subclinical markers of cardiovascular risk among with obesity women at 12 months after LNG-IUS placement compared to users of non-hormonal contraceptive methods. Copyright © 2017 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

  19. Different Bleeding Patterns with the Use of Levonorgestrel Intrauterine System: Are They Associated with Changes in Uterine Artery Blood Flow?

    Directory of Open Access Journals (Sweden)

    Carlo Bastianelli

    2014-01-01

    Full Text Available Objective. Evaluate if different bleeding patterns associated with the use of the levonorgestrel intrauterine system (LNG-IUS are associated with different uterine and endometrial vascularization patterns, as evidenced by ultrasound power Doppler analysis. Methodology. A longitudinal study, with each subject acting as its own control was conducted between January 2010 and December 2012. Healthy volunteers with a history of heavy but cyclic and regular menstrual cycles were enrolled in the study. Ultrasonographic examination was performed before and after six months of LNG-IUS placement: uterine volume, endometrial thickness, and subendometrial and myometrial Doppler blood flow patterns have been evaluated. Results. A total of 32 women were enrolled out of 186 initially screened. At six months of follow-up, all subjects showed a reduction in menstrual blood loss; for analysis, they were retrospectively divided into 3 groups: normal cycling women (Group I, amenorrheic women (Group II, and women with prolonged bleedings (Group III. Intergroup analysis documented a statistically significant difference in endometrial thickness among the three groups; in addition, mean pulsatility index (PI and resistance index (RI in the spiral arteries were significantly lower in Group I and Group III compared to Group II. This difference persisted also when comparing—within subjects of Group III—mean PI and RI mean values before and after insertion. Conclusions. The LNG-IUS not only altered endometrial thickness, but—in women with prolonged bleedings—also significantly changed uterine artery blood flow. Further studies are needed to confirm these results and enable gynecologists to properly counsel women, improving initial continuation rates.

  20. Impact of levonorgestrel-releasing intrauterine system use on the cancer risk of the ovary and fallopian tube.

    Science.gov (United States)

    Soini, Tuuli; Hurskainen, Ritva; Grénman, Seija; Mäenpää, Johanna; Paavonen, Jorma; Pukkala, Eero

    2016-11-01

    Levonorgestrel-releasing intrauterine system (LNG-IUS) is used for contraception and heavy menstrual bleeding. A long-term hormone therapy can modify the risk of gynecologic cancers. Little is known about the impact of LNG-IUS use on the risk for invasive and borderline ovarian tumor subtypes or for primary fallopian tube carcinoma. We examined the associations of LNG-IUS use with these tumors. We identified from the national Medical Reimbursement Registry of Finland the women aged 30-49 years who had used LNG-IUS for menorrhagia in 1994-2007, and from the Finnish Cancer Registry ovarian cancers and primary fallopian tube carcinomas diagnosed before the age of 55 and by the end of 2013. A total of 77 invasive ovarian cancers and seven primary fallopian tube carcinoma cases were diagnosed in a cohort of 93 843 LNG-IUS users during the follow-up of 1 083 126 women-years. The LNG-IUS users had decreased risk for both invasive ovarian cancer [standardized incidence ratio (SIR) 0.59, 95% confidence interval (CI) 0.47-0.73] and for borderline ovarian tumors (SIR 0.76, 95% CI 0.57-0.99) as compared to the background population. The risk of primary fallopian tube carcinoma was not increased (SIR 1.22, 95% CI 0.49-2.50). Decreased risks for mucinous (SIR 0.49, 95% CI 0.24-0.87), endometrioid (SIR 0.55, 95% CI 0.28-0.98), and serous ovarian carcinomas (SIR 0.75, 95% CI 0.55-0.99) were seen in LNG-IUS users. LNG-IUS use associated with decreased risk for both invasive and borderline ovarian tumors. The incidence of primary fallopian tube carcinoma did not significantly differ between LNG-IUS users and the background population.

  1. Levonorgestrel-Releasing Intrauterine Systems Versus Oral Cyclic Medroxyprogesterone Acetate in Endometrial Hyperplasia Therapy: A Meta-Analysis.

    Science.gov (United States)

    Yuk, Jin-Sung; Song, Jae Yen; Lee, Jung Hun; Park, Won I; Ahn, Hyeong Sik; Kim, Hyun Jung

    2017-05-01

    This study aimed to compare the levonorgestrel-releasing intrauterine system (LNG-IUS) with oral cyclic medroxyprogesterone acetate (MPA) in endometrial hyperplasia therapy using randomized controlled trials (RCTs). The study searched MEDLINE, EMBASE, CENTRAL, and other databases. All regression outcomes were calculated for dichotomous outcomes in terms of relative risk (RR) and 95% confidence intervals (CIs) using a Mantel-Haenszel random effects model. The search found 543 articles but selected 342 articles after the removal of duplicates. A meta-analysis found five RCTs (377 patients). The study did not analyze RR for total outcome because of high heterogeneity (I (2) = 87%). In a subgroup analysis of studies with non-obese women, the LNG-IUS treatment appeared to have a higher regression rate than oral MPA (RR 1.41; 95% CI 1.23-1.62; 4 trials, 265 patients; I (2) = 0%). In a subgroup analysis of studies with obese women, LNG-IUS appeared to have a regression rate similar to that of oral MPA (RR 1.03; 95% CI 0.94-1.13; 1 trial, 60 patients). In a subgroup analysis according to histology in the non-obese group, the LNG-IUS treatment appeared to have a higher regression rate than oral cyclic MPA in a meta-analysis of women with non-atypical endometrial hyperplasia (RR 1.36; 95% CI 1.07-1.73; 2 trials, 92 patients; I (2) = 6%) and mixed endometrial hyperplasia (atypical and non-atypical) (RR 1.44; 95% CI 1.21-1.71; 2 trials, 173 patients; I (2) = 0%). The LNG-IUS treatment has a higher regression rate than cyclic MPA in non-atypical endometrial hyperplasia and mixed endometrial hyperplasia therapy for non-obese women but has a similar regression rate, albeit limited, for obese women.

  2. Levonorgestrel-releasing intrauterine system (Mirena in compare to medroxyprogesterone acetate as a therapy for endometrial hyperplasia

    Directory of Open Access Journals (Sweden)

    Fariba Behnamfar

    2014-01-01

    Full Text Available Background: This study was designed to evaluate the comparison of insertion of levonorgestrel (LNG-releasing intrauterine system versus oral medroxyprogesterone acetate on endometrial hyperplasia in a randomized controlled trial. Materials and Methods: A total of 60 women with the initial histopathological diagnosis of endometrial hyperplasia in two groups received LNG or medroxyprogesterone (10 mg/d orally for 12 days a month for 3 months. Endometrial biopsy was obtained for all patients after 3 months of treatment. Response to treatment was defined based on the histopathology of the post treatment pipelle endometrial specimens in three categories of resolution, persistence and progression. Results: Treatment response rate in patients in the LNG group was 89.3% (25 of 28 patients, versus 70.4% (19 of 27 patients in patients in the medroxyprogesterone group. The rate of persistence was 10.7% (3 of 28 patients and 22.2% (6 of 27 patients in LNG and medroxyprogesterone groups respectively. No progression of endometrial hyperplasia observed in any of the patients in LNG group, but progression of endometrial hyperplasia was observed in 7.4% (2 of 27 patients in the medroxyprogesterone group. There was no statistically significant difference between groups regarding the response to treatment (P = 0.15. Side effects such as bloating, weight gain, fatigue and hair loss were comparable between the groups (P > 0.05. Hirsutism was significantly more in the medroxyprogesterone group than LNG group (P = 0.013. Conclusion: Results showed that the use of LNG for treating endometrial hyperplasia for 3 months was associated with high-treatment response rate and the low proportion of patients with progression compared to the use of medroxyprogesterone.

  3. Effects of combined oral contraceptives, depot medroxyprogesterone acetate and the levonorgestrel-releasing intrauterine system on the vaginal microbiome.

    Science.gov (United States)

    Brooks, J Paul; Edwards, David J; Blithe, Diana L; Fettweis, Jennifer M; Serrano, Myrna G; Sheth, Nihar U; Strauss, Jerome F; Buck, Gregory A; Jefferson, Kimberly K

    2017-04-01

    Prior studies suggest that the composition of the vaginal microbiome may positively or negatively affect susceptibility to sexually transmitted infections (STIs) and bacterial vaginosis (BV). Some female hormonal contraceptive methods also appear to positively or negatively influence STI transmission and BV. Therefore, changes in the vaginal microbiome that are associated with different contraceptive methods may explain, in part, effects on STI transmission and BV. We performed a retrospective study of 16S rRNA gene survey data of vaginal samples from a subset of participants from the Human Vaginal Microbiome Project at Virginia Commonwealth University. The subset included 682 women who reported using a single form of birth control that was condoms, combined oral contraceptives (COCs), depot medroxyprogesterone acetate (DMPA) or the levonorgestrel-releasing intrauterine system (LNG-IUS). Women using COCs [adjusted odds ratio (aOR) 0.29, 95% confidence interval (CI) 0.13-0.64] and DMPA (aOR 0.34, 95% CI 0.13-0.89), but not LNG-IUS (aOR 1.55, 95% CI 0.72-3.35), were less likely to be colonized by BV-associated bacteria relative to women who used condoms. Women using COCs (aOR 1.94, 95% CI 1.25-3.02) were more likely to be colonized by beneficial H2O2-producing Lactobacillus species compared with women using condoms, while women using DMPA (aOR 1.09, 95% CI 0.63-1.86) and LNG-IUS (aOR 0.74, 95% CI 0.48-1.15) were not. Use of COCs is significantly associated with increased vaginal colonization by healthy lactobacilli and reduced BV-associated taxa. COC use may positively influence gynecologic health through an increase in healthy lactobacilli and a decrease in BV-associated bacterial taxa. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Combined Oral Medroxyprogesterone/Levonorgestrel-Intrauterine System Treatment for Women With Grade 2 Stage IA Endometrial Cancer.

    Science.gov (United States)

    Hwang, Ji Young; Kim, Da Hee; Bae, Hyo Sook; Kim, Mi-La; Jung, Yong Wook; Yun, Bo Seong; Seong, Seok Ju; Shin, Eunah; Kim, Mi Kyoung

    2017-05-01

    The aim of this study was to evaluate the oncologic and pregnancy outcomes of combined oral medroxyprogesterone acetate (MPA)/levonorgestrel-intrauterine system (LNG-IUS) treatment in young women with grade 2-differentiated stage IA endometrial adenocarcinoma who wish to preserve fertility. We retrospectively reviewed the medical records of patients with grade 2 stage IA endometrial adenocarcinoma who had received fertility-sparing treatment at CHA Gangnam Medical Center between 2011 and 2015. All of the patients were treated with combined oral MPA (500 mg/d)/LNG-IUS, and follow-up dilatation and curettage were performed every 3 months. A total of 5 patients were included in the study. The mean age was 30.4 ± 5.3 years (range, 25-39 years). After a mean treatment duration of 11.0 ± 6.2 months (range, 6-18 months), complete response (CR) was shown in 3 of the 5 patients, with partial response (PR) in the other 2 patients. One case of recurrence was reported 14 months after achieving CR. This patient was treated again with combined oral MPA/LNG-IUS and achieved CR by 6 months. The average follow-up period was 44.4 ± 26.2 months (range, 12-71 months). There were no cases of progressive disease. No treatment-related complications arose. Combined oral MPA/LNG-IUS treatment is considered to be a reasonably effective fertility-sparing treatment of grade 2 stage IA endometrial cancer. Although our results are encouraging, it is preliminary and should be considered with experienced oncologists in well-defined protocol and with close follow-up.

  5. 21 CFR 884.5360 - Contraceptive intrauterine device (IUD) and introducer.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Contraceptive intrauterine device (IUD) and... Gynecological Therapeutic Devices § 884.5360 Contraceptive intrauterine device (IUD) and introducer. (a) Identification. A contraceptive intrauterine device (IUD) is a device used to prevent pregnancy. The device...

  6. Expanding Access to a New, More Affordable Levonorgestrel Intrauterine System in Kenya: Service Delivery Costs Compared With Other Contraceptive Methods and Perspectives of Key Opinion Leaders.

    Science.gov (United States)

    Rademacher, Kate H; Solomon, Marsden; Brett, Tracey; Bratt, John H; Pascual, Claire; Njunguru, Jesse; Steiner, Markus J

    2016-08-11

    The levonorgestrel intrauterine system (LNG IUS) is one of the most effective forms of contraception and offers important non-contraceptive health benefits. However, it is not widely available in developing countries, largely due to the high price of existing products. Medicines360 plans to introduce its new, more affordable LNG IUS in Kenya. The public-sector transfer price will vary by volume between US$12 to US$16 per unit; for an order of 100,000 units, the public-sector transfer price will be approximately US$15 per unit. We calculated the direct service delivery cost per couple-years of protection (CYP) of various family planning methods. The model includes the costs of contraceptive commodities, consumable supplies, instruments per client visit, and direct labor for counseling, insertion, removal, and resupply, if required. The model does not include costs of demand creation or training. We conducted interviews with key opinion leaders in Kenya to identify considerations for scale-up of a new LNG IUS, including strategies to overcome barriers that have contributed to low uptake of the copper intrauterine device. The direct service delivery cost of Medicines360's LNG IUS per CYP compares favorably with other contraceptive methods commonly procured for public-sector distribution in Kenya. The cost is slightly lower than that of the 3-month contraceptive injectable, which is currently the most popular method in Kenya. Almost all key opinion leaders agreed that introducing a more affordable LNG IUS could increase demand and uptake of the method. They thought that women seeking the product's non-contraceptive health benefits would be a key market segment, and most agreed that the reduced menstrual bleeding associated with the method would likely be viewed as an advantage. The key opinion leaders indicated that myths and misconceptions among providers and clients about IUDs must be addressed, and that demand creation and provider training should be prioritized

  7. Expanding Access to a New, More Affordable Levonorgestrel Intrauterine System in Kenya: Service Delivery Costs Compared With Other Contraceptive Methods and Perspectives of Key Opinion Leaders

    Science.gov (United States)

    Rademacher, Kate H; Solomon, Marsden; Brett, Tracey; Bratt, John H; Pascual, Claire; Njunguru, Jesse; Steiner, Markus J

    2016-01-01

    ABSTRACT Background: The levonorgestrel intrauterine system (LNG IUS) is one of the most effective forms of contraception and offers important non-contraceptive health benefits. However, it is not widely available in developing countries, largely due to the high price of existing products. Medicines360 plans to introduce its new, more affordable LNG IUS in Kenya. The public‐sector transfer price will vary by volume between US$12 to US$16 per unit; for an order of 100,000 units, the public-sector transfer price will be approximately US$15 per unit. Methods: We calculated the direct service delivery cost per couple-years of protection (CYP) of various family planning methods. The model includes the costs of contraceptive commodities, consumable supplies, instruments per client visit, and direct labor for counseling, insertion, removal, and resupply, if required. The model does not include costs of demand creation or training. We conducted interviews with key opinion leaders in Kenya to identify considerations for scale-up of a new LNG IUS, including strategies to overcome barriers that have contributed to low uptake of the copper intrauterine device. Results: The direct service delivery cost of Medicines360’s LNG IUS per CYP compares favorably with other contraceptive methods commonly procured for public-sector distribution in Kenya. The cost is slightly lower than that of the 3-month contraceptive injectable, which is currently the most popular method in Kenya. Almost all key opinion leaders agreed that introducing a more affordable LNG IUS could increase demand and uptake of the method. They thought that women seeking the product’s non-contraceptive health benefits would be a key market segment, and most agreed that the reduced menstrual bleeding associated with the method would likely be viewed as an advantage. The key opinion leaders indicated that myths and misconceptions among providers and clients about IUDs must be addressed, and that demand creation

  8. A randomized clinical trial to compare levonorgestrel-releasing intrauterine system (Mirena vs trans-cervical endometrial resection for treatment of menorrhagia

    Directory of Open Access Journals (Sweden)

    Ghazizadeh S

    2011-07-01

    Full Text Available Shirin Ghazizadeh1, Fatemeh Bakhtiari1, Haleh Rahmanpour2, Fatemeh Davari-Tanha1, Fatemeh Ramezanzadeh11Valie-Asr Reproductive Health Research Center, Valie-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran; 2Department of Obstetrics and Gynecology, Ayatollah Mousavi Hospital, Zanjan, IranObjective: To compare the acceptability, efficacy, adverse effects, and user satisfaction of the levonorgestrel intrauterine system (LNG-IUS and trans-cervical resection of the endometrium (TCRE for the treatment of menorrhagia.Method: 104 women with menorrhagia were divided into 2 groups: 52 women had the LNG-IUS inserted and 52 underwent TCRE. Menstrual pattern, pictorial blood loss assessment chart score, adverse effects, and rates of acceptability and satisfaction, were recorded at 6 and 12 months after the procedure.Results: After a year there were reductions of 93.9% and 88.4% in menstrual blood loss in the TCRE and LNG-IUS groups, respectively. Amenorrhea was more common in the TCRE group and spotting and systemic effects in the LNG-IUS group. Satisfaction rates of the TCRE group were higher than the LNG-IUS group (80.8% vs 69.2%, but the difference was not statistically significant.Conclusion: Although both treatments were found to be equally effective, LNG-IUS was less invasive and can be advised for younger women with a desire to preserve fertility.Keywords: menorrhagia, trans-cervical endometrial resection, levonorgestrel-releasing intrauterine system

  9. Actinomyces-like organisms in cervical smears: the association with intrauterine device and pelvic inflammatory diseases

    Science.gov (United States)

    Kim, Yeo Joo; Youm, Jina; Kim, Jee Hyun

    2014-01-01

    Objective To investigate the incidence of actinomyces-like organisms in routine cervical smears of Korean women and to evaluate its association with the development of pelvic inflammatory disease (PID) in these women. Methods The results of cervical smears between 2011 and 2012 at a single university hospital were searched. If positive for actinomyces-like organisms, the medical record of the patient was searched and development of PID was followed. If the data were not available in the medical record, the patient was contacted by telephone. Results The incidence of actinomyces-like organisms in cervical smears was 0.26% (52/20,390). Forty-two women (80.8%) were intrauterine device (IUD) users: the copper-IUD in 25 women and the levonorgestrel-releasing intrauterine system in 13 women (type unknown in 4 women). The majority (71.4%, 30/42) of the IUD users maintained the IUD. Prophylactic antibiotics were prescribed to 12 women. Two continuous IUD users were later diagnosed with PID, but these cases were not pelvic actinomycosis. Conclusion It would be a reasonable option to choose the expectant management for asymptomatic women who incidentally showed actinomyces-like organisms in their cervical smear. PMID:25264530

  10. Rectal perforation with an intrauterine device: a case report.

    Science.gov (United States)

    Eichengreen, Courtney; Landwehr, Haley; Goldthwaite, Lisa; Tocce, Kristina

    2015-03-01

    A 27-year-old woman presented for routine examination 1 year after intrauterine device (IUD) placement; strings were not visualized. The device was found to be penetrating through the rectal mucosa. It was removed easily through the rectum during an examination under anesthesia. Perforated IUDs with rectal involvement require thoughtful surgical planning to optimize outcomes.

  11. Female pelvic actinomycosis and intrauterine contraceptive devices

    OpenAIRE

    2010-01-01

    Faustino R Pérez-López1,2, José J Tobajas1,3, Peter Chedraui41Department of Obstetrics and Gynecology, Facultad de Medicina, Universidad de Zaragoza; 2Hospital Clínico Lozano Blesa; 3Hospital Universitario Miguel Servet, Zaragoza, Spain; 4Enrique C. Sotomayor Obstetrics and Gynecology Hospital, Guayaquil, EcuadorAbstract: Female genital Actinomyces infection is relatively rare, although strongly related to long-lasting intrauterine contraceptive dev...

  12. Does levonorgestrel-releasing intrauterine system increase breast cancer risk in peri-menopausal women? An HMO perspective.

    Science.gov (United States)

    Siegelmann-Danieli, Nava; Katzir, Itzhak; Landes, Janet Vesterman; Segal, Yaakov; Bachar, Rachel; Rabinovich, Hadas Rotem; Bialik, Martin; Azuri, Joseph; Porath, Avi; Lomnicky, Yossef

    2017-09-14

    To evaluate the association between levonorgestrel-releasing intrauterine system (LNG-IUS) use and breast cancer (BC) risk. A cohort of all Maccabi Healthcare Services (MHS) female members aged 40-50 years between 1/2003 and 12/2013 was used to identify LNG-IUS users as "cases," and 2 age-matched non-users as "controls." Exclusion criteria included: prior BC diagnosis, prior (5 years pre-study) and subsequent treatment with other female hormones or prophylactic tamoxifen. Invasive tumors were characterized by treatments received (chemotherapy, hormonal therapy, trastuzumab, or combination thereof). The analysis included 13,354 LNG-IUS users and 27,324 controls (mean age: 44.1 ± 2.6 vs. 44.9 ± 2.8 years; p < 0.0001). No significant differences in 5-year Kaplan-Meier (KM) estimates for overall BC risk or ductal carcinoma in situ occurrence were observed between groups. There was a trend towards higher risk for invasive BC in LNG-IUS users (5-year KM-estimate: 1.06% vs. 0.93%; p = 0.051). This difference stemmed primarily from the younger women (40-45 years; 0.88% vs. 0.69%, p = 0.014), whereas in older women (46-50 years), it was non-significant (1.44% vs. 1.21%; p = 0.26). Characterization of invasive BC by treatment demonstrated that LNG-IUS users had similar proportions of tumors treated with hormonal therapy, less tumors treated with trastuzumab, (7.5% vs. 14.5%) and more tumors treated with chemotherapy alone (25.8% vs. 14.9%; p = 0.041). In peri-menopausal women, LNG-IUS was not associated with an increased total risk of BC, although in the subgroup of women in their early 40's, it was associated with a slightly increased risk for invasive tumors.

  13. Intrauterine device quo vadis? Why intrauterine device use should be revisited particularly in nulliparous women?

    Directory of Open Access Journals (Sweden)

    Wildemeersch D

    2015-01-01

    Full Text Available Dirk Wildemeersch,1 Norman Goldstuck,2 Thomas Hasskamp,3 Sohela Jandi,4 Ansgar Pett4 1Gynecological Outpatient Clinic and IUD Training Center, Ghent, Belgium; 2Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Western Cape, South Africa; 3GynMünster, Münster, 4Gynecological Outpatient Clinic, Berlin, Germany Background: Long-acting reversible contraceptive (LARC methods, including intrauterine devices (IUDs and the contraceptive implant, are considered the best methods for preventing unintended pregnancies, rapid repeat pregnancy, and abortion in young women. An opinion paper of 2012 by the American College of Obstetricians and Gynecologists recommends Mirena and Paragard for use in nulliparous and adolescent women. However, these IUDs are not designed for young women and are not optimal as they often lead to early discontinuation. Objective: This article was written with the objective to respond to the urgent need to improve intrauterine contraception as it is likely that the objectives of LARC will not be met without significant improvement of IUD design. Anatomical variations in size and shape of the uterus are not sufficiently considered, producing harm and suffering, which often lead to early removal of the IUD. Proposed problem solving: The article describes why IUDs should be revisited to meet the challenge of LARC and proposes how to solve these problems. The opinion statement presented here may be considered provocative but is based on hundreds of women with IUD problems who consult or are referred to the practices of the authors of this article due to the disproportion between the IUD and their small uterine cavity. The solution is simple but requires a revision of the current design of IUDs. One-dimensional (longitudinal IUDs are likely to be the first option. Framed devices with shortened transverse arm and IUDs which adapt to the width of the given

  14. Pelvic actinomycosis associated with intrauterine device use: case report

    Energy Technology Data Exchange (ETDEWEB)

    Alfuhaid, T. [Dept. of Medical Imaging, Univ. Health Centre and Mount Sinai Hospital, Toronto General Hospital, Toronto, Ontario (Canada); Reinhold, C. [Radiology, Gastroenterology and Gynecology, McGill Univ. Health Centre, Montreal General Hospital, Montreal, Quebec (Canada)

    2003-06-01

    Pelvic actinomycosis is a rare disease that may complicate longstanding intrauterine device (IUD) use. Its timely recognition is crucial to minimize morbidity and avoid the erroneous diagnosis of malignancy with subsequent, unnecessary surgery. We describe a case of pelvic actinomycosis. The role of magnetic resonance imaging (MRI) in recognizing this infectious disease process is stressed. (author)

  15. Comparative effectiveness and impact on health-related quality of life of hysterectomy vs. levonorgestrel intra-uterine system for abnormal uterine bleeding.

    Science.gov (United States)

    Cozza, G; Pinto, A; Giovanale, V; Bianchi, P; Guarino, A; Marziani, R; Frega, A; Caserta, D

    2017-05-01

    To compare hysterectomy and levonorgestrel intra-uterine system (LNG-IUS) for the treatment of abnormal uterine bleeding (AUB) and iron deficiency anemia. Retrospective study evaluating quality of life, sexual function, satisfaction and blood hemoglobin concentration improvement in 60 pre-menopausal women treated with hysterectomy or LNG-IUS. All analysis was performed with statistical software SPSS 21.0 (SPSS Inc., Chicago, IL, USA). Despite superior control of bleeding and dysmenorrhea observed after hysterectomy, LNG-IUS showed similar impact on blood hemoglobin levels, quality of life, satisfaction and sexual function resulting more cost-effective. In the absence of contraindications, LNG-IUS should always be the first therapeutic choice for chronic AUB. Surgical treatment must be considered as an "extrema ratio".

  16. Application of a hormonal intrauterine device causing uterine perforation: A case report

    Directory of Open Access Journals (Sweden)

    Žižić Vojislav

    2011-01-01

    Full Text Available Introduction. The last decade of the usage of intrauterine contraception has been marked by the application of levonorgestrel-releasing hormonal devices. A hormonal intrauterine device (IUD releases a certain amount of progestogen, whose effect on endometrium is such that, apart from preventing unwanted pregnancy, also regulates the menstrual bleeding by reducing the quantity and the duration of haemorrhage. This effect of hormonal IUDs has led to their additional indications and use, so that nowadays these IUDs are used not only as contraceptives but for therapeutic purposes as well. Case Outline. After examination and treatment in an out-patient department, a 38-year-old woman was referred to our hospital due to suspected spontaneous uterine perforation caused by hormonal IUD (Mirena® one month after its application. Clinical and sonographic examinations were unable to determine the uterine perforation or the exact IUD location. Radiographic examination confirmed the presence of the IUD in the abdomen, so it was decided to operate on the patient. Perforation in the isthmus of the uterus and to the right was identified intraoperatively. By exploration of the genital organs and the abdominal cavity, the IUD was finally located in the omentum. Conclusion. Even in cases of adequate indications for hormonal IUD application, the doctor’s experience and complying with all the principles of appropriate insertion, we should always consider the possibility of the occurrence of serious complications, which sometimes may even require surgery. The extragenital position of IUD, as in this case, may create serious difficulties in the detection of location. A possible development of asymptomatic complications additionally emphasizes the necessity of regular check-ups of all IUD users.

  17. Precision intrauterine contraception may significantly increase continuation of use: a review of long-term clinical experience with frameless copper-releasing intrauterine contraception devices

    Directory of Open Access Journals (Sweden)

    Wildemeersch D

    2013-04-01

    Full Text Available Dirk Wildemeersch,1 Ansgar Pett,2 Sohela Jandi,2 Thomas Hasskamp,3 Patrick Rowe,4 Marc Vrijens5 1Gynecological Outpatient Clinic and IUD Training Center, Ghent, Belgium; 2Gynecological Outpatient Clinic, Berlin, Germany; 3Gynecological Outpatient Clinic, Münster, Germany; 4Formely IUD Research Group at the UNDP/UNFPA/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland; 5Gynecological Outpatient Clinic, Ghent, Belgium Objective: The purpose of this paper is to review the experience with the frameless, anchored, GyneFix copper-releasing intrauterine contraceptive devices (IUCDs/IUDs (Contrel Europe, Belgium, and to demonstrate their high acceptability and low rate of discontinuation of use, which could contribute to current efforts that aim to reduce radically the high number of unintended pregnancies and induced abortions, particularly in young women. Materials and methods: This paper is based on studies that examined the differences in uterine volume and cavity size, related to age and parity, and on original clinical research data and practical experience with frameless copper IUDs, as well as on literature data on the IUD–endometrial cavity relationship of conventional IUDs, with special reference to side effects and user discontinuation. Results: The mean transverse diameter in nulliparous and parous women is significantly less than the length of the transverse arm of the TCu380A IUD (ParaGard, Duramed, NY, USA or the levonorgestrel intrauterine system (Mirena, Bayer, Germany. Small, frameless, flexible, and unidimensional copper IUDs appear to be well tolerated, with less impact on menstrual bleeding, resulting in low discontinuation rates when compared with standard-size conventional IUDs, which often result in increased expulsion rates, complaints of pain and erratic or increased menstrual bleeding, and subsequent high rates of

  18. Pelvic actinomycosis in association with an intrauterine device.

    Science.gov (United States)

    Garland, S M; Rawling, D

    1993-02-01

    A case of pelvic actinomycosis is described which occurred in association with the use of an intrauterine device (IUD). Initially medical management alone was used, but surgical intervention was necessitated for multiple pelvic abscesses. We would strongly recommend that any IUD be removed should it be associated with actinomyces on genital smears and/or culture. If sepsis is also apparent, IUD removal with use of long-term antibiotics is required.

  19. Understanding benefits and addressing misperceptions and barriers to intrauterine device access among populations in the United States

    Directory of Open Access Journals (Sweden)

    Yoost J

    2014-07-01

    Full Text Available Jennie Yoost Marshall University Department of Obstetrics and Gynecology, Huntington, WV, USA Abstract: Three intrauterine devices (IUDs, one copper and two containing the progestin levonorgestrel, are available for use in the United States. IUDs offer higher rates of contraceptive efficacy than nonlong-acting methods, and several studies have demonstrated higher satisfaction rates and continuation rates of any birth control method. This efficacy is not affected by age or parity. The safety of IUDs is well studied, and the risks of pelvic inflammatory disease, perforation, expulsion, and ectopic pregnancy are all of very low incidence. Noncontraceptive benefits include decreased menstrual blood loss, improved dysmenorrhea, improved pelvic pain associated with endometriosis, and protection of the endometrium from hyperplasia. The use of IUDs is accepted in patients with multiple medical problems who may have contraindications to other birth control methods. Yet despite well-published data, concerns and misperceptions still persist, especially among younger populations and nulliparous women. Medical governing bodies advocate for use of IUDs in these populations, as safety and efficacy is unchanged, and IUDs have been shown to decrease unintended pregnancies. Dispersion of accurate information among patients and practitioners is needed to further increase the acceptability and use of IUDs. Keywords: IUD, contraception, levonorgestrel, copper

  20. 左炔诺孕酮宫内缓释系统在妇科疾病治疗中的作用%Effects of levonorgestrel-releasing intrauterine system in treating gynecological diseases

    Institute of Scientific and Technical Information of China (English)

    李广华; 何金良

    2011-01-01

    背景:左炔诺孕酮宫内缓释系统有很高的避孕可靠性,可对子宫内膜产生明显的抑制作用.目的:阐述左炔诺孕酮宫内缓释系统在妇科疾病治疗中的作用.方法:由第一作者检索CBM、PubMed数据库(http://www.ncbi.nlm.nih.gov/PubMed)、万方数据库(http://www.wanfangdata.com.cn)及google学术网1990/2010有关左炔诺孕酮宫内缓释系统治疗妇科疾病的文献,排除重复性研究.结果与结论:共保留17篇文献进行归纳总结.结果显示,左炔诺孕酮宫内缓释系统作为释放微量孕激素的宫内缓释系统,可安全、有效地应用于避孕,治疗月经过多、内异症、子宫腺肌病,以及激素替代治疗中对子宫内膜的保护等,对治疗子宫肌瘤引起的月经过多也有良好效果.提示左炔诺孕酮宫内缓释系统治疗妇科疾病效果显著,但还需要大样本、长期的临床研究加以验证.%BACKGROUND: Levonorgestrel-releasing intrauterine system is reliable in contraception by inhibiting endometrium.OBJECTIVE: To elucidate effects of levonorgestrel-releasing intrauterine system in treating gynecological diseases.METHODS: A computer-based online search of CBM, PubMed database (http://www.ncbi.nlm.nih.gov/PubMed), Wanfang database (http://www.wanfangdata.com.cn), and google search was performed for articles related to levonorgestrel-releasing intrauterine system in treating gynecological diseases, published between 1990 and 2010. Repetitive studies were excluded.RESULTS AND CONCLUSION: A total of 17 articles were included. As intrauterine progestogen-releasing system,levonorgestrel-releasing intrauterine system can be used as a safe and effective contraception method. In addition, it can treat menorrhagia, endometriosis, adenomyosis, protect endometrium, and ameliorate hysteromyoma-induced menorrhagia. Results revealed that levonorgestrel-releasing intrauterine system can effectively treat gynecological diseases. However, large

  1. Analysis of the Effect of Levonorgestrel Releasing Intrauterine System in the Treatment of Uterine Gland Myopathy%左炔诺孕酮宫内缓释系统治疗子宫腺肌症效果分析

    Institute of Scientific and Technical Information of China (English)

    陶俐辛

    2015-01-01

    目的:探究子宫腺肌症采用左炔诺孕酮宫内缓释系统治疗的临床疗效。方法选取42例子宫腺肌症患者,均采用左炔诺孕酮宫内缓释系统治疗,分析临床疗效。结果治疗后患者痛经评分、月经量、子宫体积、Hb(血红蛋白浓度)以及CA125(糖类抗原125)等均优于治疗前(P <0.05)。结论子宫腺肌症采用左炔诺孕酮宫内缓释系统治疗效果显著。%Objective The clinical curative effect of adenomyosis treated with levonorgestrel releasing intrauterine system.Methods Select 42 cases of patients with uterine gland muscle disease,al the levonorgestrel releasing intrauterine system in the treatment,to observe and compare the clinical indexes of patients before and after treatment.ResultsAfter treatment, dysmenorrhea score, menstrual volume, uterine volume, Hb (hemoglobin concentration) and CA125 (carbohydrate antigen 125) were superior to those of the treatment (P < 0.05). ConclusionAdenomyosis of levonorgestrel releasing intrauterine system in the treatment effect is significant.

  2. A levonorgestrel-releasing intrauterine system embedded in the omentum in a woman with abdominal pain: a case report

    Science.gov (United States)

    2009-01-01

    Introduction The Mirena intrauterine system has been licensed as a contraceptive in the United Kingdom since May 1995. The use of an intrauterine system as a primary method of contraception among women has been slowly increasing over the last few years and they now account for about 3% of contraceptive use in England. The Mirena intrauterine system now also has a license for the management of idiopathic menorrhagia. Women may be informed that the rate of uterine perforation associated with intrauterine contraceptive use is low (0-2.3 per 1000 insertions). The rate of perforation reported with the Mirena intrauterine system in a large observational cohort study was 0.9 per 1000 insertions. Case presentation In this case report, the diagnosis of an intraperitoneal Mirena intrauterine system was noted nearly four years after its insertion, despite the patient having had a vaginal hysterectomy and admissions to hospital in the interim with complaints of abdominal pain. Conclusion This case report demonstrates clearly that whenever there is a question of a intrauterine system having fallen out following an ultrasound scan report showing an empty uterus, clinicians should also perform an abdominal X-ray. PMID:20062790

  3. A levonorgestrel-releasing intrauterine system embedded in the omentum in a woman with abdominal pain: a case report

    Directory of Open Access Journals (Sweden)

    Phillips Kevin

    2009-11-01

    Full Text Available Abstract Introduction The Mirena intrauterine system has been licensed as a contraceptive in the United Kingdom since May 1995. The use of an intrauterine system as a primary method of contraception among women has been slowly increasing over the last few years and they now account for about 3% of contraceptive use in England. The Mirena intrauterine system now also has a license for the management of idiopathic menorrhagia. Women may be informed that the rate of uterine perforation associated with intrauterine contraceptive use is low (0-2.3 per 1000 insertions. The rate of perforation reported with the Mirena intrauterine system in a large observational cohort study was 0.9 per 1000 insertions. Case presentation In this case report, the diagnosis of an intraperitoneal Mirena intrauterine system was noted nearly four years after its insertion, despite the patient having had a vaginal hysterectomy and admissions to hospital in the interim with complaints of abdominal pain. Conclusion This case report demonstrates clearly that whenever there is a question of a intrauterine system having fallen out following an ultrasound scan report showing an empty uterus, clinicians should also perform an abdominal X-ray.

  4. Hair copper in intrauterine copper device users.

    Science.gov (United States)

    Thiery, M; Heyndrickx, A; Uyttersprot, C

    1984-03-01

    The antifertility effect of copper-bearing IUDs is based on continuous release of copper, which is a result of the reaction between the metal and the uterine secretions. Released cupric ions collect in the endometrium and in the uterine fluid but significant accumulation has not been found in the bloodstream or elsewhere. Following Laker's suggestion that hair be used for monitoring essential trace elements, e.g., copper, we checked the copper content of the hair of women wearing copper-bearing IUDs. Samples of untreated pubic hair removed by clipping before diagnostic curettage were obtained from 10 young (24-34 years old), white caucasian females who until then had been wearing an MLCu250 IUD for more than 1 year. Pubes from 10 comparable (sex, age, race) subjects who had never used a Cu-containing device served as controls. The unwashed material was submitted to the toxicology laboratory, where the copper content was assessed by flameless atomic absorption, a technique whose lower limit of measurement lies at a concentration of 0.05 mcg Cu/ml fluid (50 ppb). Hair samples were washed to remove extraneous traces of metal according to the prescriptions of the International Atomic Energy Agency, weighed, and mineralized, after which a small volume (10 mcl) of the diluted fluid was fed into the graphite furnace. Each sample (75-150 mg) was analyzed 4 times, both before and after washing. Since the cleaning procedure reduces the weight of the sample (mainly by the removal of fat, dust, etc.) this explains why the percentage copper content of washed hair is higher than that of unwashed hair belonging to the same subject. The results indicate that there was no significant difference (Mann-Whitney U test) between the mean copper levels of both unwashed and washed pubes from women who were using or had never used an MLCu250 IUD. We therefore conclude that the use of this copper-containing device is not associated with significant accumulation of copper in (pubic) hair.

  5. Intrauterine Contraceptive Device Migrated into the Urinary Bladder and a Review of the Literature

    Directory of Open Access Journals (Sweden)

    Orhan Zorba

    2013-08-01

    Full Text Available Intrauterine contraceptive devices are being used in clinical practice since 1962. Due to their efficiency and low cost, intrauterine contraceptive devices are the most popular method of reversible contraception in developing countries. The incidence of migration of an intrauterine contraceptive device, and related uterine perforation ranges from 0.003% to 0.87%. Intrauterine contraceptive device may migrate into urinary bladder, appendix, rectum, colon, peritoneum, anterior abdominal wall or ovary. Foreign bodies like sutures, stents, and needles in the urinary bladder act as niduses for calculi formation. Intrauterine contraceptive device migrated into the bladder can also become a nidus for a stone formation.Herein we report about a case whose intrauterine contraceptive devices had migrated into the bladder, and presented with lower urinary tract symptoms and suprapubic discomfort 6 years after its insertion.

  6. [Ombrelle 250: a new contraceptive intrauterine device].

    Science.gov (United States)

    Audebert, A J

    1986-10-01

    The umbrella 250 is a new IUD developed in France to minimize rigidity and penetration of the uterine wall so as to lessen side effects of local pain and bleeding. The flexible, supple vactor has the characteristics of a spring to ensure that it remains in place in the fundal position required for efficacy. The device is in the shape of a T whose vertical branch is coated with copper threads containing 250 sq mm of copper. The umbrella 250 comes in 1 size, 31.5 mm long, and is adaptable to any uterine cavity. The cumulative rates of events per 100 women after 12, 24, and 36 months respectively were .2, .9, and .9 for pregnancy; .6, .6, and .6 for expulsion; 1.9, 3.7, and 4.0 for removal for pain or bleeding; .8, 1.7, and 2.8 for removal for other medical reason; 1.7, 5.7, and 7.0 for removal to become pregnant; and .2, 1.2, and 1.4 for removal for personal reasons. The continuation rates were 95.1, 87.0, and 83.9 after 12, 24, and 36 months. There were 461, 373, and 149 insertions and 5755, 10,813, and 13,768 women-months of use in each of the 3 years. A multicenter study covering 925 insertions after 12 months showed 2 accidental pregnancies, 4 expulsions, 27 removals for pain and bleeding, 6 removals for infection, 10 removals for other medical reasons, and 16 removals to become pregnant. 89 patients were lost to follow-up. The continuation rate was 92, and the experience covered 9054 women-months of use. The patients were selected according to the usual criteria for IUD use. Most patients had at least 1 child and were at least 30 years old. The rates of expulsion and removal for pain and bleeding appear to be low, but a true comparative study has not been completed.

  7. [Intravesical migration of an intrauterine contraceptive device complicated by stones].

    Science.gov (United States)

    Joual, Abdenbi; Querfani, Badreddine; Taha, Abellatif; El Mejjad, Amine; Frougui, Younes; Rabii, Redouane; Debbagh, Adil; El Mrini, Mohamed

    2004-06-01

    Transuterine migration of an intrauterine contraceptive device (IUCD) is a rare complication. The authors report a case of IUCD that migrated into the bladder and subsequently became calcified, leading to a false diagnosis of bladder stones. A 38-year-old woman with an IUCD for 3 years presented with haematuria and signs of bladder irritation. Ultrasound and plain abdominal x-rays suggested a diagnosis of bladder stones. The positive diagnosis of migrated and calcified IUCD was only established after surgical extraction of the stone.

  8. Pyometra Perforation Caused by Actinomyces without Intrauterine Device Involvement

    Directory of Open Access Journals (Sweden)

    Hideharu Hagiya

    2013-01-01

    Full Text Available An 86-year-old woman with diabetes mellitus and severe decubitus at the sacral and calcaneal regions stemming from poor daily activity was diagnosed with pyometra perforation caused by Actinomyces. No foreign materials, including an IUD, were found inside the uterus. Pyometra is usually caused by Enterobacteriaceae or anaerobes derived from the gastrointestinal tract. The virulence of Actinomyces is rather low, and, in almost all the reported cases of Actinomyces-related pyometra, an intrauterine device (IUD was involved. Although rare, Actinomyces may be ascribed as a virulent pathogen that causes pyometra in the absence of foreign materials.

  9. Pyometra Perforation Caused by Actinomyces without Intrauterine Device Involvement.

    Science.gov (United States)

    Hagiya, Hideharu

    2013-01-01

    An 86-year-old woman with diabetes mellitus and severe decubitus at the sacral and calcaneal regions stemming from poor daily activity was diagnosed with pyometra perforation caused by Actinomyces. No foreign materials, including an IUD, were found inside the uterus. Pyometra is usually caused by Enterobacteriaceae or anaerobes derived from the gastrointestinal tract. The virulence of Actinomyces is rather low, and, in almost all the reported cases of Actinomyces-related pyometra, an intrauterine device (IUD) was involved. Although rare, Actinomyces may be ascribed as a virulent pathogen that causes pyometra in the absence of foreign materials.

  10. Abdominal and endometrial actinomycosis associated with an intrauterine device.

    Science.gov (United States)

    O'Brien, P. K.

    1975-01-01

    Actinomycotic endometrial infection associated with an intrauterine device (IUD) complicated chronic abdominal inflammatory disease in a 28-year-old woman. Colonies of organisms with morphologic resemblance to and staining reactions of Actinomyces israelii were observed in tissue adherent to the IUD and in inflamed omental and pericolic tissues. However, the organism could not be cultured. Because intact tissues are resistant to actinomyces it is likely that the IUD created an environment favouring the establishment and growth of the organism. Images FIG. 1 FIG. 2 PMID:1116090

  11. Pelvic colonization with Actinomyces in women using intrauterine contraceptive devices.

    Science.gov (United States)

    Hager, W D; Douglas, B; Majmudar, B; Naib, Z M; Williams, O J; Ramsey, C; Thomas, J

    1979-11-01

    Recent reports suggest a relationship between intrauterine contraceptive device (IUD) use and colonization or infection of the genital tract with Actinomyces species. This prospective, case-controlled study was designed to determine the incidence of colonization or infection with Actinomyces in IUD users. None of 50 control patients and four of 50 study patients (8%) had Actinomyces identified. None of the patients with positive results had symptomatic pelvic infection. Cervical cytology was effective in detecting each of the four study patients with positive results. It appears that the presence of any type of IUD is a major predisposing factor to colonization with Actinomyces.

  12. Postmenopausal hormone therapy-also use of estradiol plus levonorgestrel-intrauterine system is associated with an increased risk of primary fallopian tube carcinoma.

    Science.gov (United States)

    Koskela-Niska, Virpi; Pukkala, Eero; Lyytinen, Heli; Ylikorkala, Olavi; Dyba, Tadeusz

    2015-10-15

    Data on the possible impact of postmenopausal hormone therapy (HT) on the incidence of rare primary fallopian tube carcinoma (PFTC) are scarce. Therefore, we conducted a nationwide case-control study analyzing the association between the use of different HTs and PFTC. All women aged 50 years or older with an incident PFTC (n = 360) during 1995-2007 were identified from the Finnish Cancer Registry. For each case of PFTC, ten age- and place of residence-matched controls were selected from the Finnish National Population Register, which also provided information on parity. Data on HT purchases were received from the Prescription Register, and data on hysterectomies and sterilizations from the National Care Register. Controls with a salpingectomy before the PFTC diagnosis of the respective case were excluded. The PFTC risk in relation to different HTs was estimated with a conditional logistic regression model, adjusted for parity, age at last delivery, hysterectomy and sterilization. The use for five years or more of estradiol combined with levonorgestrel-releasing-intrauterine system (odds ratio 2.84, 95% confidence interval 1.10-7.38) and sequential estradiol-progestin therapy (EPT; 3.37; 2.23-5.08) were both linked with increases in the risk of PFTC, while the risk with use of estradiol-only therapy or continuous EPT was not statistically significantly increased. The OR for the use of tibolone for one year or more was 1.56 (0.55-4.41). The use of HT is related to an increased risk of PFTC, particularly when a progestin component is intrauterine or systemic progestin is given in sequential manner.

  13. 左炔诺孕酮宫内缓释系统治疗子宫腺肌病研究进展%Research of Levonorgestrel-releasing Intrauterine System Treatment for Adenomyosis

    Institute of Scientific and Technical Information of China (English)

    隋孟松

    2011-01-01

    Levonorgestrel-releasing intrauterine system is a new hormonal intrauterine contraceptive system. The system have the long-term effective in releasing levonorgestrel. In recent yeats,it found that in addition to long-term contraceptive effects, the system also can treat some gynecological diseases, especially in the treatment of adenomyosis, with efficacy, long term effective and low side effects, etc. The mechanism of levonorgestrel and the progress in the clinical application in recent years were reviewed in this paper.%左炔诺孕酮宫内缓释系统作为一种新型激素宫内避孕系统,长期有效释放左炔诺孕酮发挥作用.近年来发现其除了具有长期避孕作用外,对一些妇科疾病具有治疗作用,尤其在子宫腺肌病的治疗中,具有疗效明显、作用时间长及不良反应小等优点.现就近年来左炔诺孕酮的作用机制及在临床上的应用进展进行综述.

  14. Evaluation of quality of life and cost-effectiveness of definitive surgery and the levonorgestrel intrauterine system as treatment options for heavy menstrual bleeding.

    Science.gov (United States)

    Adigüzel, Cevdet; Seyfettinoğlu, Sevtap; Aka Satar, Deniz; Arlier, Sefa; Eskimez, Eda; Kaya, Fatma; Nazik, Hakan

    2017-06-12

    This study aimed to compare the levonorgestrel intrauterine system (LNG-IUS) with abdominal hysterectomy (TAH) and total laparoscopic hysterectomy (TLH) as first-line treatments for heavy menstrual bleeding (HMB). Ninety-eight patients aged 20-55 years who complained of regular heavy menstrual bleeding were enrolled in the study. The TAH group included 29 patients, the LNG-IUS group included 34, and the TLH group included 35. These groups were compared in terms of quality of life and the cost-effectiveness of the selected methods. Quality of life was assessed using the 36-Item Short Form (SF-36), and cost-effectiveness was assessed according to the current cost of each approach. The quality of life parameters, with the exception of mental health, improved significantly in the LNG-IUS, TAH, and TLH groups. The mean costs of the LNG-IUS, TAH, and TLH procedures were $99.15 ± 4.90, $538.82 ± 193.00 and $1617.05 ± 258.44, respectively (P < 0.05). Overall, LNG-IUS was the most cost-effective treatment option. The outcome measures of the SF-36 revealed that after 6 months, these treatments were equal in terms of quality of life, except for mental health. LNG-IUS was the most cost-effective approach.

  15. The efficacy of long-term maintenance therapy with a levonorgestrel-releasing intrauterine system for prevention of ovarian endometrioma recurrence.

    Science.gov (United States)

    Kim, Mi-La; Cho, Yeon Jean; Kim, Mi Kyoung; Jung, Yong Wook; Yun, Bo Seong; Seong, Seok Ju

    2016-09-01

    To evaluate the cumulative recurrence rates of ovarian endometrioma among patients using a levonorgestrel-releasing intrauterine system (LNG-IUS) after conservative laparoscopic surgery. A retrospective review was conducted of premenopausal women who underwent conservative laparoscopic surgery for ovarian endometrioma and subsequent treatment with LNG-IUS at two gynecologic surgery centers in South Korea between January 1, 2007, and September 30, 2014. Eligible patients had no residual ovarian lesions before LNG-IUS insertion, underwent insertion within 12 months of primary surgery, and were followed up for at least 6 months afterwards. Recurrence was defined as a cystic mass (≥2 cm in diameter) detected by transvaginal ultrasonography. Overall, 61 patients were included. The mean duration of follow-up was 42.9 ± 22.0 months (range 8-98). Recurrence of ovarian endometrioma was detected among 7 (11%) of the patients. On Kaplan-Meier analysis, the cumulative recurrence rates were 4.0%, 6.3%, and 25.5% at 24, 36, and 60 months after surgery, respectively. In multivariate analysis, nulliparity at surgery was the only risk factor for recurrence (hazard ratio 5.892, 95% confidence interval 1.139-30.484; P=0.034). Long-term maintenance therapy with LNG-IUS after conservative surgery might be a treatment option to consider to prevent ovarian endometrioma recurrence among premenopausal women. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  16. Postoperative Levonorgestrel-Releasing Intrauterine System Insertion After Gonadotropin-Releasing Hormone Agonist Treatment for Preventing Endometriotic Cyst Recurrence: A Prospective Observational Study.

    Science.gov (United States)

    Kim, Min Kyoung; Chon, Seung Joo; Lee, Jae Hoon; Yun, Bo Hyon; Cho, SiHyun; Choi, Young Sik; Lee, Byung Seok; Seo, Seok Kyo

    2017-01-01

    The aim of this study was to evaluate the effectiveness of postoperative levonorgestrel-releasing intrauterine system (LNG-IUS) insertion after gonadotropin-releasing hormone agonist (GnRH-a) treatment for preventing endometriotic cyst recurrence. The LNG-IUS was applied to 28 women who had undergone surgery for endometriosis followed by 6 cycles of GnRH-a treatment. Clinical characteristics, endometriosis recurrence, and adverse effects were analyzed. Student t test was performed for analysis. Before surgery, 20 (71.4%) patients had dysmenorrhea, and the mean pain score (visual analog scale [VAS]) was 4.26. The numbers of women diagnosed with stage III endometriosis and stage IV endometriosis were 15 (53.6%) and 13 (46.4%), respectively, according to the revised American Fertility Society scoring system. The mean cancer antigen 125 levels and VAS scores were significantly lower after treatment than before treatment (11.61 vs 75.66 U/mL, P < .0001 and 0.50 vs 4.26 U/mL, P < .0001, respectively). Of the 28 patients, 13 (46.4%) simultaneously had adenomyosis, and 2 (7.1%) underwent LNG-IUS removal because of unresolved vaginal bleeding and dysmenorrhea. Recurrence was noted in 2 (7.1%) women. Postoperative LNG-IUS insertion after GnRH-a treatment is an effective approach for preventing endometriotic cyst recurrence, especially in women who do not desire to conceive.

  17. Correlation between uterine artery Doppler indices and menstrual irregularities among levonorgestrel releasing intrauterine system and depot medroxyprogesterone acetate users: a prospective observational study.

    Science.gov (United States)

    Rezk, Mohamed; Al-Halaby, Alaa; Emarh, Mohamed; Shawky, Mohamed

    2017-08-01

    To ascertain whether menstrual irregularities among users of levonorgestrel releasing intrauterine system (LNG-IUS) and depot medroxyprogesterone acetate (DMPA), were associated with changes in uterine artery Doppler indices or not. This three-year prospective observational study included 102 women using LNG-IUS and 104 women using DMPA for contraception. Participants were followed at regular intervals over three years with performance of transvaginal ultrasound to measure uterine artery pulsatility index (PI) and resistance index (RI) before starting the method and at six months, 12 months, two and three years thereafter. Data was collected and tabulated. Significant changes in uterine artery PI and RI were detected. PI indices were reduced after six months of use in both groups and elevated significantly at 12 months in both groups compared to initial values (p < .001) while RI significantly reduced after six months in both groups and elevated significantly at 12 months, two and three years in both groups compared to initial values (p < .001). Both PI and RI significantly reduced in women suffered abnormal uterine bleeding and significantly elevated in women experienced amenorrhea irrespective of the method used (p < .001). LNG-IUS and DMPA induce hemodynamic changes in the uterine arteries denoting positive correlation with menstrual irregularities. Larger multicentre studies are warranted to potentiate our findings.

  18. Appliable Study on Levonorgestrel Intrauterine System%左炔诺孕酮宫内缓释系统应用研究

    Institute of Scientific and Technical Information of China (English)

    林农; 曹小明

    2003-01-01

    宫内节育器(IUD)是育龄妇女的主要避孕工具,其发展与完善大大提高了育龄妇女对IUD的接受性,拓宽了IUD应用范围。而释放左旋18-甲基炔诺酮(LNG)的宫内节育器(LNG-IUD),近年来称之为LNG宫内缓释系统,即LNG-IUS(Levonorgestrel Intrauterine System),是当前国内外公认的性能优良的宫内抗生育系统,具有IUD使用的长效性及口服避孕药的高效性,又减少IUD的副作用,同时还具有治疗多种妇科疾病及绝经后激素替代治疗的辅助作用。

  19. Non -contraceptive therapeutic uses of Levonorgestrel releasing -intrauterine systems%左炔诺孕酮宫内缓释系统的非避孕应用

    Institute of Scientific and Technical Information of China (English)

    尚思慧; 林琬君

    2011-01-01

    左炔诺孕酮宫内缓释系统(delayed levonorgestrel -releasing intrauterine system,LNG - IUS)是90年代上市的新型避孕系统(商品名:曼月乐),其通过每天释放20μg的左炔诺孕酮至宫腔,使子宫内膜腺体萎缩、间质蜕膜样变、黏膜变薄,实现孕激素的非全身给药,应用于月经过多、子宫内膜异位症和子宫腺肌病、子宫肌瘤、激素替代治疗期间的子宫内膜保护及子宫内膜增生和早期的子宫内膜癌等,从而开辟了在非避孕领域的许多新的应用.

  20. Prosprective study of the forearrm bone mineral density of long-term users of levonorgestrel - releasing intrauterine syustem

    OpenAIRE

    Maria Valeria Bahamondes Makuch

    2009-01-01

    Resumo: Introdução: A osteoporose é uma doença sistêmica que afeta principalmente as mulheres. Alguns dos fatores que aceleram a aparição desta doença são a idade e o uso, por longa data, de métodos anticoncepcionais com somente progestágenos. O sistema intrauterino liberador de levonorgestrel (SIU-LNG) é um método difundido para a contracepção e o tratamento de diversas patologias ginecológicas. Na literatura não foram identificados estudos longitudinais prospectivos, com usuárias de longa d...

  1. Intrauterine contraceptive device embedded in the omentum – case report

    Directory of Open Access Journals (Sweden)

    Zolnierczyk P

    2015-12-01

    Full Text Available Piotr Zolnierczyk, Krzysztof Cendrowski, Wlodzimierz Sawicki Department of Obstetrics, Gynecology and Oncology, 2nd Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland Abstract: This report describes the case of a 29-year-old patient, female (nulliparous who had an intrauterine device (IUD inserted in 2010 and who has had no gynecological control since then (for 4 years. After this time, the asymptomatic patient had a gynecological appointment, during which a doctor did not find the strings of IUD in the speculum. Ultrasound examination did not reveal the presence of the IUD in the uterine cavity, which led to the suspicion of its presence outside the uterus. The patient was referred to a hospital, where she underwent ultrasound and X-ray examination of the pelvis that confirmed the presence of the IUD outside the uterus. Laparoscopy was performed during which the IUD was localized as being embedded in the omentum. It was removed by performing a resection of a part of the omentum with inflammatory infiltration. The patient was discharged home on the second postoperative day in a good condition. This case confirms the need for gynecological control and ultrasound examination shortly after insertion. An ultrasound or/and X-ray is mandatory in any case of absence of IUD strings previously visible in the vagina, if the patient did not observe its expulsion. Keywords: intrauterine device, myometrium, IUD threads, uterine cavity, ultrasound examination

  2. Actinomyces in cervical smears of women using intrauterine contraceptive devices.

    Science.gov (United States)

    Mali, B; Joshi, J V; Wagle, U; Hazari, K; Shah, R; Chadha, U; Gokral, J; Bhave, G

    1986-01-01

    Cervical smears from 1,784 women who attended the family planning clinics of the Institute for Research in Reproduction were examined for the presence of Actinomyces-like organisms. Among 815 intrauterine contraceptive device (IUD) users, the repeat smears from 57 women were positive for Actinomyces-like organisms, giving a prevalence rate of 6.99%. Immunofluorescent staining using specific antisera confirmed the presence of A. israelii in all 57 women. Forty IUD users whose smears were positive for Actinomyces-like organisms underwent bacteriologic culture studies; A. israelii was isolated in 23 of these cases. The clinical findings at the time of smear collection in the 57 IUD users were within normal limits. The initial cervical smears of all IUD users and both the initial and repeat smears of all nonusers were negative for Actinomyces-like organisms. The data indicate that prolonged use (greater than 2 years) of an inert or copper intrauterine device promotes the overgrowth of Actinomyces in the vagina and that this can be detected by routine cervical cytology.

  3. Use of frameless intrauterine devices and systems in young nulliparous and adolescent women: results of a multicenter study

    Directory of Open Access Journals (Sweden)

    Wildemeersch D

    2014-08-01

    Full Text Available Dirk Wildemeersch,1 Sohela Jandi,2 Ansgar Pett,2 Kilian Nolte,3 Thomas Hasskamp,4 Marc Vrijens5 1Gynecological Outpatient Clinic and IUD Training Center, Ghent, Belgium; 2Gynecological Outpatient Clinic, Berlin, 3Gynecological Outpatient Clinic, Uetze, 4GynMünster, Münster, Germany; 5Gynecological Outpatient Clinic, Ghent, Belgium Background: The purpose of this study was to provide additional data on the experience with frameless copper and levonorgestrel (LNG intrauterine devices (IUDs in nulliparous and adolescent women. Methods: Nulliparous and adolescent women, 25 years of age or younger, using the frameless copper IUD or the frameless LNG-releasing intrauterine system (IUS, were selected from previous studies and a current multicenter post-marketing study with the frameless copper IUD. The small copper-releasing GyneFix® 200 IUD consists of four copper cylinders, each 5 mm long and only 2.2 mm wide. The frameless FibroPlant® LNG-IUS consists of a fibrous delivery system releasing the hormone levonorgestrel (LNG-IUS. The main features of these intrauterine contraceptives are that they are frameless, flexible, and anchored to the fundus of the uterus. Results: One hundred and fifty-four nulliparous and adolescent women participated in the combined study. One pregnancy occurred with the GyneFix 200 IUD after unnoticed early expulsion of the device (cumulative pregnancy rate 1.1 at one year. Two further expulsions were reported, one with the GyneFix 200 IUD and the other with the FibroPlant LNG-IUS. The cumulative expulsion rate at one year was 1.1 with the copper IUD and 2.2 with the LNG-IUS. The total discontinuation rate at one year was low (3.3 and 4.3 with the copper IUD and LNG-IUS, respectively and resulted in a high rate of continuation of use at one year (96.7 with the copper IUD and 95.7 with the LNG-IUS, respectively. Continuation rates for both frameless copper IUD and frameless LNG-IUS remained high at 3 years (>90%. There

  4. Intrauterine device and upper-genital-tract infection.

    Science.gov (United States)

    Grimes, D A

    2000-09-16

    Concern about upper-genital-tract infection related to intrauterine devices (IUDs) limits their wider use. In this systematic review I summarise the evidence concerning IUD-associated infection and infertility. Choice of an inappropriate comparison group, overdiagnosis of salpingitis in IUD users, and inability to control for the confounding effects of sexual behaviour have exaggerated the apparent risk. Women with symptomless gonorrhoea or chlamydial infection having an IUD inserted have a higher risk of salpingitis than do uninfected women having an IUD inserted; however, the risk appears similar to that of infected women not having an IUD inserted. A cohort study of HIV-positive women using a copper IUD suggests that there is no significant increase in the risk of complications or viral shedding. Similarly, fair evidence indicates no important effect of IUD use on tubal infertility. Contemporary IUDs rival tubal sterilisation in efficacy and are much safer than previously thought.

  5. Abdominal actinomycosis associated with intrauterine device: CT features.

    Science.gov (United States)

    Laurent, T; de Grandi, P; Schnyder, P

    1996-01-01

    Abdominal actinomycosis is a severe and progressive peritoneal infection, due to an anerobic gram-positive bacterium, Actinomyces israelii. The presence of a long-standing intrauterine device (IUD) is a well-known risk factor in young women. We report two cases of pelviperitoneal actinomycosis appearing in two young women with acute low abdominal pain. Abdominal CT demonstrated multiple solid or encapsulated peritoneal masses with marked contrast enhancement and infiltration of the adjacent mesenteric fat. Laparoscopy confirmed the presence of intraperitoneal abscesses which contained Actinomyces israelii. High doses of amoxicillin and clavulanic acid (Augmentine) were given and following CT scan after 2 and 6 weeks showed a slow, but complete, resolution of the lesions. Although the radiologic presentation of actinomycosis is nonspecific, the diagnosis should be raised in the presence of pseudotumoral mesenteric infiltration, particularly in young women with an IUD. Abdominal CT is a useful method for diagnosis and for follow-up.

  6. [Actinomyces-like organisms infection in intrauterine devices wearers].

    Science.gov (United States)

    Pan, L

    1993-05-01

    The prevalence of actinomyces-like organisms in cervicovaginal smears of 2,327 Chinese women, including 1,279 intrauterine devices (IUD) wearers and 1,048 non wearers, was investigated. Cervical smears were stained by the Papanicolaou method for the microscopic examination of actinomyces-like organisms. The relationship between actinomyces-like organisms infection and occupations, age, duration of IUD wearing and clinical symptoms were analysis. The result showed that the overall detection rate of actinomyces-like organisms in 2,327 women was 0.69%. The detection rates in IUD wearers and non-wearers were 1.1% and 0.2%, respectively, which were significantly different (P actinomyces-like organisms infection was significantly higher in women wearing IUD for more than seven years. Whereas the occupation or age of women did not affect the detection rate significantly.

  7. Randomized placebo-controlled trial of CDB-2914 in new users of a levonorgestrel-releasing intrauterine system shows only short-lived amelioration of unscheduled bleeding

    Science.gov (United States)

    Warner, P.; Guttinger, A.; Glasier, A.F.; Lee, R.J.; Nickerson, S.; Brenner, R.M.; Critchley, H.O.D.

    2010-01-01

    BACKGROUND The levonorgestrel-releasing intrauterine system (LNG-IUS) is a highly effective contraceptive. However, during early months of use unscheduled vaginal bleeding is common, sometimes leading to discontinuation. This study aimed to determine whether intermittent administration of progesterone receptor modulator CDB-2914 would suppress unscheduled bleeding during the first 4 months after insertion of the LNG-IUS. METHODS CDB-2914 150 mg, in divided doses, or placebo tablets, were administered over three consecutive days starting on Days 21, 49 and 77 after LNG-IUS insertion, in a double-blind randomized controlled trial of women aged 19–49 years, newly starting use of LNG-IUS. Daily bleeding diaries were completed for 6 months, and summarized across blocks as percentage days bleeding/spotting (BS%). RESULTS Of 69 women randomized to receive CDB-2914, and 67 placebo, 61 and 55, respectively, completed the trial. BS% decreased with time in both arms, but showed a much steeper treatment-phase gradient in the placebo arm (P < 0.0001), so that a benefit of CDB-2914 in the 28 days after first treatment (−11% points, 95% CI −19 to −2), converted to a disadvantage by 64 days after the third treatment (+10% points, 95% CI 1–18). CONCLUSIONS The effect of CDB-2914 on BS% was initially beneficial but then by third treatment was disadvantageous. Nevertheless, only 3% (4/136) of all women discontinued LNG-IUS. These findings give insight into possible mechanisms and suggest future research directions. ISRCTN Trial no. ISRCTN58283041; EudraCT no. 2006-006511-72. PMID:19897857

  8. Dilatation and curettage is more accurate than endometrial aspiration biopsy in early-stage endometrial cancer patients treated with high dose oral progestin and levonorgestrel intrauterine system.

    Science.gov (United States)

    Kim, Da Hee; Seong, Seok Ju; Kim, Mi Kyoung; Bae, Hyo Sook; Kim, Mi La; Yun, Bo Seong; Jung, Yong Wook; Shim, Jeong Yun

    2017-01-01

    To determine whether less invasive endometrial (EM) aspiration biopsy is adequately accurate for evaluating treatment outcomes compared to the dilatation and curettage (D&C) biopsy in early-stage endometrial cancer (EC) patients treated with high dose oral progestin and levonorgestrel intrauterine system (LNG-IUS). We conducted a prospective observational study with patients younger than 40 years who were diagnosed with clinical stage IA, The International Federation of Gynecology and Obstetrics grade 1 or 2 endometrioid adenocarcinoma and sought to maintain their fertility. The patients were treated with medroxyprogesterone acetate 500 mg/day and LNG-IUS. Treatment responses were evaluated every 3 months. EM aspiration biopsy was conducted after LNG-IUS removal followed D&C. The tissue samples were histologically compared. The diagnostic concordance rate of the two tests was examined with κ statistics. Twenty-eight pairs of EM samples were obtained from five patients. The diagnostic concordance rate of D&C and EM aspiration biopsy was 39.3% (κ value=0.26). Of the seven samples diagnosed as normal with D&C, three (42.8%) were diagnosed as normal by using EM aspiration biopsy. Of the eight samples diagnosed with endometrioid adenocarcinoma by using D&C, three (37.5%) were diagnosed with endometrioid adenocarcinoma by using EM aspiration biopsy. Of the 13 complex EM hyperplasia samples diagnosed with the D&C, five (38.5%) were diagnosed with EM hyperplasia by using EM aspiration biopsy. Of the samples obtained through EM aspiration, 46.4% were insufficient for histological evaluation. To evaluate the treatment responses of patients with early-stage EC treated with high dose oral progestin and LNG-IUS, D&C should be conducted after LNG-IUS removal.

  9. Immediate versus delayed initiation of the levonorgestrel-releasing intrauterine system following medical termination of pregnancy - 1 year continuation rates: a randomised controlled trial.

    Science.gov (United States)

    Korjamo, R; Mentula, M; Heikinheimo, O

    2017-06-26

    To assess the 1-year continuation rates and new pregnancies following immediate versus delayed insertion of the levonorgestrel-releasing intrauterine system (LNG-IUS) after medical termination of pregnancy (MTOP) up to 20 weeks of gestation. A randomised controlled trial. Helsinki University Hospital, Finland, January 2013 to December 2014. A total of 267 women requesting MTOP and planning LNG-IUS for post-MTOP contraception. Insertion of LNG-IUS occurred immediately (0-3 days) or after a delay (2-4 weeks) following MTOP. Follow-up visits were at 3 months and 1 year after MTOP. LNG-IUS use at 1 year after MTOP. Women were randomised to immediate (n = 134) or delayed (n = 133) insertion of the LNG-IUS, and 133 and 131 were analysed; 127 (95.5%) women received immediate insertion and 111 (84.7%) women had delayed insertion of the LNG-IUS (risk ratio [RR] 1.13, 95% CI 1.04-1.22). The verified numbers of women continuing the LNG-IUS use at 1 year were 83 (62.4%) and 52 (39.7%) (RR 1.57, 95% CI 1.23-2.02). The numbers of new pregnancies were 6 (4.5%) and 16 (12.2%) (RR 0.37, 95% CI 0.15-0.91), and numbers of subsequent TOPs were 4 (3.0%) and 5 (3.8%) (RR 0.79, 95% CI 0.22-2.87). Immediate insertion of the LNG-IUS following MTOP resulted in higher 1-year continuation rates compared with delayed insertion. In addition, those receiving immediate insertion demonstrated a decreased new pregnancy rate, but no difference in the numbers of another TOP. Immediate LNG-IUS insertion after MTOP results in a higher 1-year continuation compared with delayed insertion. © 2017 Royal College of Obstetricians and Gynaecologists.

  10. Assessment of the quality of cervical mucus among users of the levonorgestrel-releasing intrauterine system at different times of use.

    Science.gov (United States)

    Moraes, Leticia G; Marchi, Nadia M; Pitoli, Ana C; Hidalgo, Maria M; Silveira, Carolina; Modesto, Waleska; Bahamondes, Luis

    2016-08-01

    The quality of cervical mucus (CM) among the levonorgestrel-releasing intrauterine system (LNG-IUS) users is controversial. The objectives were to assess CM compared to the levels of oestradiol (E2) and the frequency of cycles with luteal activity among users of the LNG-IUS. In total, 224 LNG-IUS users for between two months and five years were recruited at a Brazilian family planning clinic. For the cross-sectional part of the study, we enrolled 175 LNG-IUS users at 2, 6 12, 24, 36, 48, and 60 months after insertion (25 women in each group), and we performed one evaluation. For the prospective part of the study, we enrolled 49 LNG-IUS users at the same lengths of use after insertion (7 women in each group), and we evaluated these women once a week for five consecutive weeks. . Mean (± SEM) CM scores of all evaluations among women with single and weekly evaluations were between 3.3 ± 0.9 and 8.5 ± 0.3, respectively independently of the length of use of the LNG-IUS. Mean E2 values ranged from 45.5 ± 6.8 to 472.5 ± 34.7 pg/ml and the maximum ovarian follicle diameter on the days of evaluation varied from 14.0 ± 1.3 to 31.2 ± 0.4 mm. The mean CM score of all evaluations, independent of the length of use of the LNG-IUS and normal levels of serum E2, was below 10 was according to the WHO is inadequate for sperm penetration.

  11. Dilatation and curettage is more accurate than endometrial aspiration biopsy in early-stage endometrial cancer patients treated with high dose oral progestin and levonorgestrel intrauterine system

    Science.gov (United States)

    2017-01-01

    Objective To determine whether less invasive endometrial (EM) aspiration biopsy is adequately accurate for evaluating treatment outcomes compared to the dilatation and curettage (D&C) biopsy in early-stage endometrial cancer (EC) patients treated with high dose oral progestin and levonorgestrel intrauterine system (LNG-IUS). Methods We conducted a prospective observational study with patients younger than 40 years who were diagnosed with clinical stage IA, The International Federation of Gynecology and Obstetrics grade 1 or 2 endometrioid adenocarcinoma and sought to maintain their fertility. The patients were treated with medroxyprogesterone acetate 500 mg/day and LNG-IUS. Treatment responses were evaluated every 3 months. EM aspiration biopsy was conducted after LNG-IUS removal followed D&C. The tissue samples were histologically compared. The diagnostic concordance rate of the two tests was examined with κ statistics. Results Twenty-eight pairs of EM samples were obtained from five patients. The diagnostic concordance rate of D&C and EM aspiration biopsy was 39.3% (κ value=0.26). Of the seven samples diagnosed as normal with D&C, three (42.8%) were diagnosed as normal by using EM aspiration biopsy. Of the eight samples diagnosed with endometrioid adenocarcinoma by using D&C, three (37.5%) were diagnosed with endometrioid adenocarcinoma by using EM aspiration biopsy. Of the 13 complex EM hyperplasia samples diagnosed with the D&C, five (38.5%) were diagnosed with EM hyperplasia by using EM aspiration biopsy. Of the samples obtained through EM aspiration, 46.4% were insufficient for histological evaluation. Conclusion To evaluate the treatment responses of patients with early-stage EC treated with high dose oral progestin and LNG-IUS, D&C should be conducted after LNG-IUS removal. PMID:27670255

  12. Use of frameless intrauterine devices and systems in young nulliparous and adolescent women: results of a multicenter study

    OpenAIRE

    Wildemeersch D; Jandi S; Pett A; Nolte K; Hasskamp T; Vrijens M

    2014-01-01

    Dirk Wildemeersch,1 Sohela Jandi,2 Ansgar Pett,2 Kilian Nolte,3 Thomas Hasskamp,4 Marc Vrijens5 1Gynecological Outpatient Clinic and IUD Training Center, Ghent, Belgium; 2Gynecological Outpatient Clinic, Berlin, 3Gynecological Outpatient Clinic, Uetze, 4GynMünster, Münster, Germany; 5Gynecological Outpatient Clinic, Ghent, Belgium Background: The purpose of this study was to provide additional data on the experience with frameless copper and levonorgestrel (LNG) intrauterin...

  13. Overcoming barriers to levonorgestrel-releasing intrauterine system placement: an evaluation of placement of LNG-IUS 8 using the modified EvoInserter® in a majority nulliparous population.

    Science.gov (United States)

    Gemzell-Danielsson, Kristina; Apter, Dan; Lukkari-Lax, Eeva; Roth, Katrin; Serrani, Marco

    2017-08-24

    To report placement success rate, and ease and pain associated with placement, of the levonorgestrel-releasing intrauterine system (LNG-IUS) 8 using the modified EvoInserter® placement device. This was a pooled analysis using data from three previously reported Phase III studies in nulliparous (83.3%) or parous (16.7%) women aged 12-35 years (N=965). LNG-IUS 8 was placed using the modified Evolnserter®. The main outcomes assessed were placement success, ease of placement as reported by healthcare professionals (HCPs), pain at placement as reported by participants, and assessment of the EvoInserter® placement device by HCPs. LNG-IUS 8 placement using the modified EvoInserter® with an insertion tube diameter of 3.8 mm was successful in 99.5% of subjects. HCPs rated the placement procedure as "easy" in 91.6% of cases. Placement pain was reported as absent by 19.1% of participants, as mild by 39.3%, as moderate by 31.6%, and as severe by 10.0%. Overall 89.2% of HCPs completely agreed that the device was easy to prepare and 85.7% completely agreed that placement of an LNG-IUS was easy/simple with the EvoInserter®. Post hoc exploratory analyses indicated a significant association between ease/pain of placement and patient age and between pain of placement and parity. The modified Evolnserter® was associated with a high placement success rate, ease of placement, and manageable pain, and was assessed to have a user-friendly design. These findings suggest that the EvoInserter® may remove some concerns among HCPs about difficult placement of LNG-IUSs, thereby encouraging increased uptake of an effective contraceptive. Results reported in this study further strengthen evidence of the high placement success rate, ease of deployment, and manageable pain associated with the modified EvoInserter® placement device. These findings might reduce concerns among HCPs about placement of LNG-IUSs, meaning uptake of such contraceptives is increased. Copyright © 2017 The Authors

  14. A multicentre, open-label, randomised phase III study comparing a new levonorgestrel intrauterine contraceptive system (LNG-IUS 8) with combined oral contraception in young women of reproductive age.

    Science.gov (United States)

    Borgatta, Lynn; Buhling, Kai J; Rybowski, Sarah; Roth, Katrin; Rosen, Kimberly

    2016-10-01

    To compare user satisfaction and adverse events (AEs) with a levonorgestrel intrauterine system (LNG-IUS 8; average levonorgestrel release rate approximately 8 μg/24 h over the first year [total content 13.5 mg]) and a 30 μg ethinyl estradiol/3 mg drospirenone (EE/DRSP) combined oral contraceptive (COC) in a population of young women. Nulliparous and parous women (aged 18-29 years) with regular menstrual cycles (21-35 days) were randomised to LNG-IUS 8 or EE/DRSP for 18 months. The primary endpoint was the overall user satisfaction rate at month 18/end of study visit. Overall, 279 women were randomised to LNG-IUS 8 with attempted placement and 281 women were randomised to EE/DRSP and took ≥1 pill; the mean age was 23.7 and 23.9 years, and 77.4% and 73.3% were nulliparous, respectively. At month 18/end of study, 82.1% and 81.9% of women, respectively, reported being 'very satisfied' or 'satisfied' with their treatment; however, significantly more LNG-IUS 8 users reported a preference to continue their treatment post-study (66.2% vs 48.8%; p = 0.0001). There were two pregnancies (one ectopic pregnancy, one spontaneous abortion) reported in the LNG-IUS 8 group and six (three live births, two spontaneous abortions, one induced abortion) in the EE/DRSP group. LNG-IUS 8 and EE/DRSP were associated with similarly high user satisfaction rates. However, LNG-IUS 8 users were significantly more likely to prefer to continue their contraceptive method post-study, indicating that a levonorgestrel intrauterine system is an appealing contraceptive option for young women.

  15. The use of intrauterine contraceptive devices, pelvic inflammatory disease, and Chlamydia trachomatis infection.

    Science.gov (United States)

    Edelman, D A

    1988-04-01

    With the same epidemiologic approach taken in a recent study that suggested that oral contraceptive use may not protect against chlamydial pelvic inflammatory disease, the risks of chlamydial pelvic inflammatory disease were evaluated for intrauterine contraceptive device users. Compared with women using no method of contraception, intrauterine contraceptive device users were not found to be at any higher risk of cervical chlamydial infection. Whether this places intrauterine contraceptive device users at no increased risk of chlamydial pelvic inflammatory disease cannot be ascertained from the available data. Further research is needed before any conclusions can be made regarding the risks of chlamydial pelvic inflammatory disease to users of intrauterine contraceptive devices, oral contraceptives, and other contraceptive methods.

  16. Bacteriological cultures of removed intrauterine devices and pelvic inflammatory disease.

    Science.gov (United States)

    Tsanadis, G; Kalantaridou, S N; Kaponis, A; Paraskevaidis, E; Zikopoulos, K; Gesouli, E; Dalkalitsis, N; Korkontzelos, I; Mouzakioti, E; Lolis, D E

    2002-05-01

    Intrauterine devices (IUDs) are highly effective, long-term methods of contraception. Although evidence of a direct association between IUD use and pelvic inflammatory disease (PID) is scarce, concerns about PID related to IUDs use has limited their use throughout the world. We designed this study to examine the effect of IUDs on PID. For the study, we recruited 200 participants from among women who requested an IUD as a means of contraception. The IUDs were removed 36 months later or in case of PID. No PID cases were recorded during the follow-up period. Prior to IUD insertion, 121 women (60.5%) had symptoms and/or signs of lower genital tract infection, whereas during the follow-up period 179 women (89.5%) had symptoms and/or signs of lower genital tract infection. The Papanicolaou smears were negative for Actinomyces throughout the study period. Also, cultures for sexualy transmitted disease microorganisms were negative throughout the study period. Following IUD removal, 189 IUD cultures (94.5%) were positive. The bacterial flora of the removed IUDs consisted of common aerobic and anaerobic microorganisms that do not account for PID. The most common microorganisms identified were Staphylococcus coagulase negative, Eschericia coli, and Enterococcus faecalis. IUDs are a very effective and safe method of contraception if potential recipients are selected carefully. Culture of the removed IUDs and therapeutic management of women with positive cultures are not recommended when women are asymptomatic for PID.

  17. Ureteric Obstruction Caused by a Migrated Intrauterine Device

    Directory of Open Access Journals (Sweden)

    Xuesong Yang

    2017-01-01

    Full Text Available We present an extremely rare case of ureteric obstruction caused by a migrated intrauterine device. A 36-year-old female with complaints of almost 10 months left flank pain presented to our hospital. She used an IUD for contraception for 6 months after the birth of her first child. The IUD was not visible then. Ultrasonography (US revealed that left severe hydronephrosis and upper ureterectasis. Pelvic computed tomography (CT found that IUD was located very close to the lower ureter which was adjacent to the third anatomize physiological narrow. Laparoscopy was performed to remove the migrated IUD. After 5 months of surgery, left hydronephrosis was exacerbated. This time we chose to perform the ureterocystostomy to relieve the hydronephrosis. We reported this rare case to remind that we must keep alert to the loss of the IUD to prevent it may cause severe injury of the nearby organs. IUD must be carefully researched for possible perforation of the uterus and migration to the pelvic organs.

  18. Use of drugs and intrauterine devices for birth control.

    Science.gov (United States)

    Meeker, C I

    1969-05-08

    The current use of oral contraceptives and intrauterine devices for population control is reviewed including the mechanism of their antifertility actions and the use-effectiveness of each method. The use-effectiveness of the IUD has been calculated as 1.5-3.0 pregnancies per 100 woman-years of exposure. The IUD has a high continuation rate (70% after 2 years) and is excellent for poorly motivated population groups. The most serious common side-effect--pelvic infection--can be controlled by more careful screening and modern antibiotic therapy. Other side-effects include irregular bleeding and uterine perforation, but not at significantly high levels. Oral contraceptives have been found to be virtually 100% effective, even in the new lower dose preparations containing around .5 mg progesterone and .05-.15 mg estrogen per tablet. New hormonal contraceptive approaches include pills which progesterone only, high postcoital estrogen administration, and long-acting injectable progestogen (Depo-Provera). All of these methods are highly effective but have some undesirable side-effects and require further study. Careful examination of the recent research reports connecting oral contraceptive use with increased risk of thromboembolism indicate that whatever the danger in oral contraceptive use, the direct physical hazards of pregnancy after contraceptive failure are much higher and more serious. Though a 100% safe contraceptive is a desirable ideal, the safety of current oral contraceptives and IUDs is higher than most other aspects of modern life.

  19. Regression of latent endometrial precancers by progestin infiltrated intrauterine device.

    Science.gov (United States)

    Ørbo, Anne; Rise, Cecil E; Mutter, George L

    2006-06-01

    PTEN tumor suppressor inactivation is the earliest step in endometrial carcinogenesis, occurring in morphologically unremarkable endometrial glands in half of normal women. We test the hypothesis that sex hormones positively or negatively select for these "latent precancers" by examining their emergence, persistence, and regression rates under differing hormonal conditions. Perimenopausal and postmenopausal women had an intake endometrial biopsy and underwent hormonal therapy with progestin-impregnated intrauterine device (IUD; n = 21), cyclic oral progestins (n = 28), or surveillance only (n = 22) with follow-up biopsies. For comparison, premenopausal naturally cycling endometrial biopsies were studied as single time points in 87 patients and multiple surveillance time points in 34 patients. Biopsies in which any PTEN protein-null glands were found by immunohistochemistry were scored as containing a latent endometrial precancer. All groups had a similar proportion of latent precancers at intake but differed after therapy. Emergence rates were highest (21%) for the naturally cycling premenopausal group compared with just 9% for untreated perimenopausal women. The IUD group had the highest rate of regression, with a 62% pretherapy and 5% post-therapy rate of latent precancers. This contrasted to nonsignificant changes for the oral progestin and untreated control groups. Delivery of high doses of progestins locally to the endometrium by IUD leads to ablation of preexisting PTEN-inactivated endometrial latent precancers and is a possible mechanism for reduction of long-term endometrial cancer risk known to occur in response to this hormone.

  20. A minimalist technique for insertion of intrauterine devices

    Directory of Open Access Journals (Sweden)

    Norman David Goldstuck

    2015-05-01

    Full Text Available The world’s population is approaching 7 billion. As a general rule, the countries with the highest population have the least available healthcare resources, the most notable exception being the United States of America (USA. Most of these countries have an urgent need to reduce their populations. The intrauterine device (IUD is used by the largest number of contraceptives world-wide and it has a proven record in reducing unwanted pregnancies. Its efficacy rate as a long-acting reversible contraceptive is matched only by subdermal implants which are not as cost effective. Although the rates of pelvic infection are elevated in many countries with low-resource health care systems, we now know that pelvic infection rates are independent of IUD usage. This is therefore no longer a contraindication for using IUDs on a large scale in family planning programs. The technique of IUD insertion as described in most textbooks and journals is unnecessarily complex and based on ritual rather than good clinical evidence. This is particularly interesting in that at a time where we prefer evidence based medicine there are still so many clinical practice sacred cows. This article advocates a simplification of the technique for inserting IUDs. The scientific rationale for simplifying the technique is presented, as well as evidence that it is as safe if not safer than the currently suggested methods, if used for the correct type of IUD acceptors.

  1. The intrauterine device in modern contraception: Still an actuality?

    Science.gov (United States)

    Tinelli, Andrea; Tinelli, Raffaele; Malvasi, Antonio; Cavallotti, Carlo; Tinelli, Francesco G

    2006-09-01

    The intrauterine devices (IUD) is a contraceptive method largely used as an effective, safe and economic method of contraception; IUD efficacy is demonstrated to be about 97%, and copper IUD contraceptive failure frequency is about 0.8% for the first year of use, and this is about 0.1-0.2% for the progestin IUD. IUD benefits are different; it produces a well-defined contraceptive efficacy for long time, is useful for sexual activity and is rather free from common problems. However, IUD utilization is associated with an increasing risk of pelvic infection (0.5%) in the 8 years from initial use, and the common risk of pelvic inflammatory infection (PID) is about one to two cases per year; this risk, for copper IUD users, is 0.2-0.5% per year. The possible side effects of IUD use are: pelvic pain, irregular meshes, infections, bleeding and uterine perforation; we report a uterine perforation due to IUD migration in the Retzius space, diagnosed on transvaginal ultrasonography, confirmed on CT and removed by laparoscopy. In any case, the IUD remains the mainstay of family planning measures in developing countries but, unfortunately, its association with possible serious complications, change the cost-benefit link and restrict its utilization by a large part of the general population.

  2. Pelvic actinomycosis and usage of intrauterine contraceptive devices.

    Science.gov (United States)

    Kelly, J; Aaron, J

    1982-01-01

    Pelvic inflammatory disease (PID) is one of the most commonly encountered serious infectious disease entities in gynecology. The past decade has witnessed many advances in our understanding of the pathogenesis of PID. It is now evident that such pelvic infections are largely polymicrobial in origin, with major involvement by anaerobic organisms. Salpingo-oophoritis is a part of the spectrum of PID. Included among this group of infections are tubo-ovarian abscesses, traditionally referred to as either gonococcal or non-gonococcal in origin. Within the latter group of infections the importance of anaerobic organisms has also been elucidated. Of particular interest is the reported observation of an increased frequency of salpingo-oophoritis among users of intrauterine devices (IUDs). These reports have noted the specific occurrence of serious pelvic infections due to Actinomyces species, and this will be the topic of the infectious disease conference. Our patient presented with a chronic illness characterized by lethargy, back pain, fever, and anemia; subsequently evaluation disclosed the presence of a large pelvic mass which was confirmed as a tubo-ovarian abscess at surgery. Histological evaluation demonstrated involvement by Actinomyces species. This patient's illness is discussed as a complication of chronic IUD usage with reference to specific management for this emerging problem.

  3. Intrauterine Contraceptive Device Migration Presenting as Abdominal Wall Swelling: A Case Report

    Directory of Open Access Journals (Sweden)

    Imtiaz Wani

    2011-01-01

    Full Text Available A number of complications are reported with the use of intrauterine contraceptive devices. These may pursue asymptomatic course or present as an acute abdomen after migration into peritoneal cavity. The authors here are reporting an abdominal wall swelling caused by transuterine migration of a copper intrauterine contraceptive device in a 28-year-old female. An open approach was used, and impacted foreign body was retrieved.

  4. Uterine doughnut by intrauterine device-induced photon attenuation on three-phase bone scintigraphy: artifact

    Energy Technology Data Exchange (ETDEWEB)

    Sohn, Myung Hee; Jeong, Hwan Jeong; Lim, Seok Tae [Chonbuk National University Medical School, Jeonju (Korea, Republic of)

    2007-02-15

    A 44-year-old female underwent three-phase bone scintigraphy for an evaluation of right hip joint pain. The blood-flow and blood-pool images show a pelvic blush with a photopenic center (doughnut) prior to bladder filling. On the three hour delayed image, the pelvic uptake disappeared. The scintigraphic findings indicated the possibility of an early pregnancy. However, plain radiography demonstrated an intrauterine device. A uterine doughnut developed as a result of photon attenuation of intrauterine device.

  5. Levonorgestrel-releasing intrauterine system vs oral progestins for non-atypical endometrial hyperplasia: a systematic review and metaanalysis of randomized trials.

    Science.gov (United States)

    Abu Hashim, Hatem; Ghayaty, Essam; El Rakhawy, Mohamed

    2015-10-01

    We sought to evaluate the therapeutic efficacy of levonorgestrel-releasing intrauterine system (LNG-IUS) with oral progestins for treatment of non-atypical endometrial hyperplasia (EH). Searches were conducted on PubMed, SCOPUS, and CENTRAL databases to August 2014, and reference lists of relevant articles were screened. The search was limited to articles conducted on human beings and females. The PRISMA Statement was followed. Seven randomized controlled trials (n = 766 women) were included. Main outcome measures were the therapeutic effect rate (histological response) after 3, 6, 12, and 24 months of treatment; rate of irregular vaginal bleeding; and the hysterectomy rate per woman randomized. The Cochrane Collaboration risk of bias tool was used for quality assessment. Metaanalysis was performed with fixed effects model. LNG-IUS achieved a highly significant therapeutic response rate compared with oral progestins after 3 months of treatment (odds ratio [OR], 2.30; 95% confidence interval [CI], 1.39-3.82; P = .001, 5 trials, I(2) = 0%, n = 376), after 6 months of treatment (OR, 3.16; 95% CI, 1.84-5.45; P < .00001, 4 trials, I(2) = 0%, n = 397), after 12 months of treatment (OR, 5.73; 95% CI, 2.67-12.33; P < .00001, 2 trials, I(2) = 0%, n = 224), and after 24 months of treatment (OR, 7.46; 95% CI, 2.55-21.78; P = .0002, 1 trial, n = 104). Subgroup analysis showed evidence of highly significant therapeutic response following LNG-IUS compared with oral progestins for non-atypical simple as well as complex EH (OR, 2.51; 95% CI, 1.14-5.53; P = .02, 6 trials, I(2) = 0%, n = 290; and OR, 3.31; 95% CI, 1.62-6.74; P = .001, 4 trials, I(2) = 0%, n = 216, respectively). Compared with oral progestins, LNG-IUS achieved significantly fewer hysterectomies (OR, 0.26; 95% CI, 0.15-0.45; P < .00001, 3 trials, n = 362, I² = 42%). No difference was observed in the rate of irregular vaginal bleeding between both groups (OR, 1.12; 95% CI, 0.54-2.32; P = .76, 2 trials, n = 207, I

  6. Levonorgestrel intrauterine contraceptive device in heavy menstrual bleeding: our experience in a tertiary level government hospital

    Directory of Open Access Journals (Sweden)

    Renuka Malik

    2016-02-01

    Conclusions: LNG-IUCD is an effective and acceptable non-surgical alternative to a common problem of HMB. The success rate was 94% in our study with only 3 patients needing hysterectomy due to expulsion. Emphasis on counseling patients of troublesome spotting and correct fundal placement is essential. [Int J Reprod Contracept Obstet Gynecol 2016; 5(2.000: 327-333

  7. Twelve-month contraceptive continuation and repeat pregnancy among young mothers choosing postdelivery contraceptive implants or postplacental intrauterine devices.

    Science.gov (United States)

    Cohen, Rebecca; Sheeder, Jeanelle; Arango, Natalia; Teal, Stephanie B; Tocce, Kristina

    2016-02-01

    To compare discontinuation rates and incidence of repeat pregnancy within 1 year among young mothers choosing postplacental intrauterine devices (IUDs) versus postpartum contraceptive implants. We enrolled a prospective cohort of postpartum adolescents and young women who chose either postplacental IUDs or postpartum contraceptive implants prior to hospital discharge. We used chart review and phone interviews to assess device discontinuation (by request or expulsion) and pregnancy within 12 months. Of the 244 13-22 year-old participants, 82 chose IUDs (74 levonorgestrel IUDs and 8 copper IUDs), and 162 chose implants. Both groups had participant-requested discontinuation rates of 14% (9/67 IUD; 19/135 implant) within 1 year. Participants choosing IUDs had a 25% (17/67) expulsion rate. Median time to expulsion was 4.1 weeks (range: 0.4-29.3 weeks, 16/17 within 12 weeks), and participants recognized 15/17 expulsions. IUD initiators had significantly higher pregnancy rates by 12 months (7.6% vs. 1.5%, p=0.04). Most pregnancies occurred when women discontinued their initial device and did not start alternative contraception. Participant-requested discontinuation was similar in both groups. Differences in overall device discontinuation rates were due to IUD expulsions. Pregnancy rates by 12 months postpartum were lower than previously reported in this age group in both implant initiators and IUD initiators. Young mothers who choose postplacental IUDs or postpartum contraceptive implants are unlikely to request removal within the first year. Clinicians should counsel postplacental IUD users that early expulsion is common (25%) and may be unrecognized (11% of expulsions). Patients should have a plan for contraceptive management should expulsion occur. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Successful Treatment of Early Endometrial Carcinoma by Local Delivery of Levonorgestrel: A Case Report

    Directory of Open Access Journals (Sweden)

    D. Wildemeersch

    2010-01-01

    Full Text Available We describe a case of a 67-year-old Caucasian woman with an early, moderately-differentiated adenocarcinoma of the endometrium. A levonorgestrel-releasing intrauterine system was inserted, which she tolerated well. A full D&C, following removal of the device, was performed after 9 months, confirming absence of tumoral tissue. Examination after 24 months showed a very thin endometrium, indicating complete remission.

  9. Gonadotropin-Releasing Hormone Agonist Combined With a Levonorgestrel-Releasing Intrauterine System or Letrozole for Fertility-Preserving Treatment of Endometrial Carcinoma and Complex Atypical Hyperplasia in Young Women.

    Science.gov (United States)

    Zhou, Huimei; Cao, Dongyan; Yang, Jiaxin; Shen, Keng; Lang, Jinghe

    2017-07-01

    The aim of this study was to evaluate the efficacy and safety with gonadotropin-releasing hormone agonist (GnRHa) combined with a levonorgestrel-releasing intrauterine system or an aromatase inhibitor (letrozole) in young women with well-differentiated early endometrial carcinoma (EC) and complex atypical hyperplasia (CAH). We performed a retrospective analysis including the clinical characteristics of 29 patients younger than 45 years with early well-differentiated endometrioid adenocarcinoma of the uterus (EC) or CAH who were treated at the Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, from January 2012 to April 2016. Eighteen patients were treated with the combination of intramuscular injections of GnRHa every 4 weeks with the levonorgestrel intrauterine hormonal system (Mirena® Bayer Health Care Pharmaceutical Inc, Wayne, NY) was inserted. Eleven patients were treated with the combination of intramuscular injections of GnRHa every 4 weeks with oral letrozole 2.5 mg daily. The patients underwent follow-up with endometrial sampling by hysteroscopy and curettage for endometrial response every 3 months. After a median follow-up of 18.7 months (range, 5.6-54.9 months), 15 women (88.2%) in the EC group and 12 women (100%) in the CAH group had complete response (CR) after GnRHa combination treatment. Among the women who achieved CR, 1 woman (8.3%) with CAH and 1 woman (5.9%) with EC had recurrence after CR, and they finally underwent a hysterectomy. Time to CR was similar in the 2 groups (4.5 ± 1.9 months in the CAH group vs 5.0 ± 2.9 months in the EC group). Ten women (34.5%) had CR after the first 3 months, 8 women (27.6%) had CR after 6 months, and 9 women (31.0%) had CR after 9 months. Both GnRHa with the levonorgestrel-releasing intrauterine system and GnRHa with letrozole are alternative treatments for women with CAH and EC who desire fertility preservation. A larger multicenter trial of the fertility-preserving treatment is

  10. 子宫内放置曼月乐节育环治疗子宫腺肌症的临床观察%Clinical observation of levonorgestrel intrauterine system in uterus treat-ing adenomyosis

    Institute of Scientific and Technical Information of China (English)

    朱少萍; 罗小茶; 黄慧文; 林小凤; 梁金兴

    2015-01-01

    Objective To investigate the clinical efficacy of levonorgestrel intrauterine system in uterus treating adeno-myosis. Methods 84 patients with adenomyosis treated in our hospital from February 2010 to October 2014 were se-lected as research objects,and they were randomly divided into control group and study group,with 42 cases in each group.control group was treated with medicine,study group was treated with levonorgestrel intrauterine system.dysmenor-rhea improvement,uterine volume,serum CA125,hemoglobin and clinical efficacy before and after treatment were com-pared between two groups. Results The total marked rate in study group was 88.1%,while in control group,it was 69.0%with statistical difference (P<0.05),symptoms of dysmenorrheal,decreased serum CA125 in study group was better than that in control group (P<0.05). Conclusion Levonorgestrel intrauterine system placed in the uterus adenomyosis treat-ment is effective and safe,which has a high clinical value.%目的:探讨子宫内放置曼月乐节育环治疗子宫腺肌症的临床效果。方法选取本院2010年2月~2014年10月收治的84例子宫腺肌症患者作为研究对象,随机分为对照组和研究组,每组42例。对照组采用药物治疗,研究组采用曼月乐节育环进行治疗,比较两组治疗前后痛经改善情况、子宫体积、血清CA125、血红蛋白及临床疗效。结果研究组的治疗总有效率为88.1%,而对照组仅为69.0%,两组差异有统计学意义(P<0.05),且研究组的痛经症状、血清CA125改善情况优于对照组(P<0.05)。结论曼月乐节育环置于子宫内治疗子宫腺肌症的效果确切、安全性高,具有较高的临床推广价值。

  11. Clinically silent polymicrobial amnionitis and intrauterine fetal death associated with a Cu-7 intrauterine contraceptive device.

    Science.gov (United States)

    Waites, K B; Bobo, R A; Davis, R O; Brookings, E S; Cassell, G H

    1984-12-15

    This article presents a case of silent polymicrobial amnionitis with subsequent intrauterine fetal death in a 34-year old woman who conceived with a Cu-7 IUD in place. There were no apparent pregnancy complications or symptoms of uterine infection during early pregnancy. At 16 weeks gestation, the patient underwent amniocentesis for cytogenetic studies. 5 different microorganisms--Corynebacterium, Staphylococcus warneri, Staphylococcus epidermidis, Streptococcus mitis, and Ureaplasma urealyticum--were isolated from the amniotic fluid. 2 week later, intrauterine fetal death was detected. U. urealyticum was at this point isolated from the cervix and placental and fetal tissues. This organism, which has been associated with chorioamnionitis, spontaneous abortion, and neonatal death, is suspected to have contributed to the fetal death in this case. U. urealyticum can invade the amniotic sac with fetal membranes intact and persist for 8 weeks without overt effects. This case illustrates the risks associated with nonremoval of an IUD after contraceptive failure.

  12. Partial and complete expulsion of the Multiload 375 IUD and the levonorgestrel-releasing IUD after correct insertion

    OpenAIRE

    Merki-Feld, G.S.; Schwarz, D.; Imthurn, B.; Keller, P. J.

    2008-01-01

    OBJECTIVE: The contraceptive efficacy of intrauterine devices (IUD) is thought to relate to the position of the IUD in the uterine cavity. Several trials examined the number of copper IUD expulsions, but none evaluated the partial and complete expulsion rate of the levonorgestrel-releasing device (LNG-IUD). STUDY DESIGN: This retrospective cohort study compares the dislocation rate of the Multiload 375 IUD (ML 375) and the LNG-IUD in 214 women (107 subjects with each IUD). Transvaginal ultras...

  13. Microbial and cytopathological study of intrauterine contraceptive device users

    Directory of Open Access Journals (Sweden)

    Agarwal Krishna

    2004-09-01

    Full Text Available CONTEXT: Intrauterine contraceptive device (IUCD is a commonly used birth-spacing method which is fitted into maternal system. Clinical, microbial and cytopathological monitoring of women using these devices are important for ascertaining their side effects, risk of genital tract infection and carcinogenic potential. AIMS: To study clinical, microbial and cytopathological changes in IUCD users in a tertiary care hospital. DESIGN: Prospective analytic. SETTING: Tertiary hospital. MATERIAL AND METHODS: women visiting Family Planning clinic for follow up (IUCD users, n=100 or for IUCD insertion (controls, n=50 were enrolled in the study. Each subject underwent detailed history, general physical, systemic, and per local examination. Vaginal discharge was subjected to pH testing, KOH and wet mount examination, gram staining, and for culture and sensitivity. Bacterial vaginosis was defined using Nugent criteria. Cervical smears were examined and reported as per Bethesda system. STATISTICAL ANALYSIS: The information was entered into Microsoft Excel spreadsheet. The results were analyzed using EPI Info version-6 and Stata statistical software version 7 packages. Two-tailed t-test, chi2 test with Yates correction and two-tailed Fisher Exact tests were applied. RESULTS: Most women used CuT 200 (92%. Median duration of use was 2 years. Chief complaints of IUCD users included backache (54%, vaginal discharge (46%, pain lower abdomen (34%, dyspareunia (22%, menorrhagia (18% and dysmenorrhea (14%. Mean hemoglobin was lower in IUCD users than controls (11.2±1.7 versus 11.9±1.8 g/dL, p 0.02. Proportion of women with anemia was higher in IUCD users than in controls (29% versus 16%, p 0.12. Cervical erosion was significantly increased in study group as compared the controls (20% versus 0%, p=0.00 whereas only insignificant increase in vaginitis (6% versus 0%, p=0.17. Trichomonas vaginalis and fungal hyphae positivity and gram stain findings and bacterial

  14. 左炔诺孕酮宫内缓释系统治疗子宫腺肌病的新进展%The Progress of Levonorgestrel-releasing Intrauterine System (LNG-IUS) Treat Adenomyosis

    Institute of Scientific and Technical Information of China (English)

    杨丹鹤; 付强; 丛丽莉; 王俊文

    2016-01-01

    左炔诺孕酮宫内缓释系统(levonorgestrel-releasing intrauterine system,LNG-IUS,商品名:曼月乐)是一种激素宫内避孕系统.近年来,发现其除了具有长期避孕效果外,对一些妇科疾病也具有治疗效果,尤其是子宫腺肌病.它具有作用时间长、疗效明显及不良反应小等优点.现就左炔诺孕酮宫内缓释系统的作用机制、疗效及副作用进行综述.

  15. 左炔诺孕酮宫内缓释系统治疗子宫腺疾症的疗效分析%Curative effect analysis of levonorgestrel releasing Intrauterine system which is used in adenomyosis

    Institute of Scientific and Technical Information of China (English)

    刘侠

    2014-01-01

    Objective To study curative effect of Levonorgestrel releasing Intrauterine system which is used in the treatment of adenomyosis.Method Follow the 60 cases of adenomyosis treated with levonorgestrel-releasing intrauterine system from October,2011 to October,2012. The follow-up of two years,Before treatment and after treatment 3,6,12,24 months Visual analog scale (VAS),serum carcinoembryonic antigen (CA125) value,changes and treatment of endometrial menstrual quantity,2 years of patient satisfaction.Results The placement of levonorgestrel releasing intrauterine system after the symptoms of dysmenorrhea patients obviously relieved, menstrual quantity obvious reduction, the menstrual period is shortened obviously,ultrasound examination of the endometrial thickness was significantly thinner,Compared with before treatment, the difference had statistical significance;Compared with before treatment, no significant difference of serum CA125 level and the size of the uterus. The main adverse reactions are:vaginal spotting, a little off the ring, amenorrhea,At the end of 2 satisfaction is 94.58%,the continuation rate was 100%.Conclusion Levonorgestrel releasing intrauterine system is an effective method for treatment of uterine adenomyosis,or suitable for dysmenorrhea and menorrhagia patients with adenomyosis.%目的:探讨子宫腺疾症患者宫内放置左炔诺孕酮宫内缓释系统(LNG-IUS)的临床疗效。方法随机选取2011年10月—2012年10月因子宫腺肌症就诊于我院的患者60例,均放置左炔诺孕酮宫内缓释系统。随诊两年,观察治疗前,治疗后3,6,12和24个月时视觉模拟评分(VAS)、血清癌抗原(CA125)值,月经量、子宫内膜变化及治疗2年患者满意度。结果放置左炔诺孕酮宫内缓释系统后患者痛经症状明显缓解,月经量明显减少,经期明显缩短,超声复查子宫内膜厚度明显变薄,与治疗前比较,差异有统计学意义;血清CA125水

  16. 左炔诺孕酮宫内缓释系统的非避孕作用的临床研究%Clinical study of non-contraception effection for levonorgestrel-releasing intrauterine system

    Institute of Scientific and Technical Information of China (English)

    程玉梅

    2010-01-01

    @@ 左炔诺孕酮宫内缓释系统(delayed levonor-gestrel-releasing intrauterine system, LNG-IUS)是一种有效的长效避孕药物,国内现有的商品名为曼月乐,内含52 mg左炔诺孕酮(levonorgestrel, LNG),每日释放20 μg,直接作用于宫腔,抑制子宫内膜的生长,使宫颈黏液变稠,抑制精子活动机能,从而阻止受孕,达到与绝育术相媲美的避孕效果[1],有效期至少5年,目前在全球120多个国家被批准用于避孕.

  17. A clinical and ultrasound study on the use of postplacental intrauterine device

    Directory of Open Access Journals (Sweden)

    João Henrique Araújo Fernandes

    2004-06-01

    Full Text Available Objective: To evaluate the relation of postplacental intrauterinedevice insertion immediately after vaginal delivery and cesareansection and its effects on the following: continuation, expulsionrate and eventual removals. To verify if ultrasound is an adequatemethod to follow-up postplacental IUD insertions. To assess if theimmediate insertion of postplacental IUD leads to an increasedrisk of uterine infections and perforations, or greater likelihood ofpregnancy during the observation period. Methods: A group of 50patients who had an intrauterine device introduced within tenminutes after delivery of the placenta were studied. Twenty-fivewomen had vaginal delivery and 25 had cesarean sections. Theintrauterine device used in this study was the Multiload CU 375,standard model, manufactured by Organon Ltd., in Ireland. Theintrauterine device was inserted in those who had vaginal deliveryeither manually and under anesthesia, or with an inserter, whichdid not require anesthesia. In patients who had cesarean sections,the insertion was manual. Clinical and ultrasound follow up wasperformed four times: 48 hours postpartum, and at 6, 12 and 24weeks. The distance from the top of the intrauterine device to theuterine fundus was measured by ultrasound. Results: This studyshowed a significant difference in postplacental intrauterinedevices inserted after vaginal deliveries and cesarean sections.The expulsion/removal rate was 32% among the subjects who hadan intrauterine device inserted after vaginal delivery. There wereno expulsions or removals in those submitted to cesarean sections.In the control ultrasound of intrauterine devices inserted aftervaginal delivery, at 6 weeks, the distance of 10 mm from the top ofthe device to the fundus was an average standard measurementto determine continuation (distance 10 mm,the IUD would be expelled or be removed. There were no cases ofuterine infections or perforations, and no pregnancies during thecourse of this study

  18. Intrauterine contraceptive device-associated pelvic actinomycosis caused by Actinomyces urogenitalis.

    Science.gov (United States)

    Elsayed, S; George, A; Zhang, K

    2006-04-01

    We report a case of intrauterine contraceptive device (IUD) associated pelvic actinomycosis due to Actinomyces urogenitalis in a previously healthy young adult woman. Diagnosis was confirmed by 16S ribosomal RNA gene sequencing of bacterial colonies growing from the extracted device. This is the first documented report of human infection caused by this micro-organism.

  19. An Intrauterine Device Detected in Ovary during Cesarean Section: A Case Report

    OpenAIRE

    Fazil Avci; Hakan Kiran; Murat Bakacak; Gürkan Kiran; Salih Serin

    2015-01-01

    The copper T Intrauterine Device is a common method of contraception used throughout the world. Intrauterine or ectopic pregnancies may be caused by complications with an IUD. The aim of this study was to present an ongoing term pregnancy with a copper T extrauterine device localized in the ovary. Assessment of the clinical features of a term pregnancy complicated by an IUD. A 32-year-old female was fitted with a copper T IUD in October 2009. She was hospitalized due to a term pregnancy with ...

  20. Committee Opinion No. 642: Increasing Access to Contraceptive Implants and Intrauterine Devices to Reduce Unintended Pregnancy.

    Science.gov (United States)

    2015-10-01

    Unintended pregnancy persists as a major public health problem in the United States. Although lowering unintended pregnancy rates requires multiple approaches, individual obstetrician-gynecologists may contribute by increasing access to contraceptive implants and intrauterine devices. Obstetrician-gynecologists should encourage consideration of implants and intrauterine devices for all appropriate candidates, including nulliparous women and adolescents. Obstetrician-gynecologists should adopt best practices for long-acting reversible contraception insertion. Obstetrician-gynecologists are encouraged to advocate for coverage and appropriate payment and reimbursement for every contraceptive method by all payers in all clinically appropriate circumstances.

  1. Variação de peso em usuárias de sistema intra-uterino liberador de levonorgestrel, DIU T-cobre e acetato de medroxiprogesterona no Brasil Weight variation in users of the levonorgestrel-releasing intrauterine system, of the copper IUD and of medroxyprogesterone acetate in Brazil

    Directory of Open Access Journals (Sweden)

    Daniela Angerame Yela

    2006-02-01

    Full Text Available OBJETIVO: Determinar a variação de peso corpóreo em mulheres usuárias de sistema intra-uterino liberador de 20 mg/dia de levonorgestrel (SIU-LNG, Mirena® e compará-la com a variação de peso de usuárias de dispositivo intra-uterino T cobre 380A (DIU Tcu e usuárias de acetato de medroxiprogesterona de depósito (AMP-D ao longo de cinco anos. MÉTODOS: Foram analisadas 163 mulheres usuárias de SIU-LNG que tiveram a inserção do mesmo em 1998 durante a admissão para o estudo. Cada mulher foi pareada por peso (± 1kg e por idade (± 1 ano no início do estudo, com as usuárias de DIU Tcu e AMP-D. Todas as mulheres foram seguidas por até cinco anos. Nesse período foram medidos seus pesos e calculados os índices de massa corpórea (IMC. RESULTADOS: A média de idade das usuárias de SIU-LNG foi 27±6,7 anos, enquanto que das usuárias de DIU Tcu foi 28±6,6 anos e das usuárias de AMP-D foi de 26,9±6,5 anos. O peso inicial era 62,9 ± 0,8 kg, 62,8 ± 0,8 kg e 62,5 ± 0,9 kg para as usuárias de SIU-LNG, DIU Tcu e AMP-D, respectivamente. O IMC no início do estudo era 25 (±0,3, 26,4 (±0,3 e 25,5 (±0,4 para as usuárias de SIU-LNG, DIU Tcu e AMP-D, respectivamente. Foi observado um aumento de peso de 3,1 kg, 4,9 kg e 8,2 kg para as usuárias de SIU-LNG, DIU Tcu e AMP-D, respectivamente, ao final do quinto ano (p=0,009. O IMC também apresentou um aumento em todos os grupos (IMC final de 26,3 ± 0,7, 28,5 ± 0,8 e 28,7 ± 1,3 para as usuárias de SIU-LNG, DIU Tcu e AMP-D, respectivamente. A análise multivariada mostrou que o uso de AMP-D e seu tempo de uso foram significativos em relação ao ganho de peso. CONCLUSÃO: O uso de SIU-LNG não mostrou aumento significativo no ganho de peso ao longo dos cinco anos, bem como diferença na variação de peso quando comparado com o uso de DIU Tcu.BACKGROUND: Assess weight variations in Brazilian users of the 20 µg/day levonorgestrel-releasing intrauterine system (LNG-IUS, Mirena® for

  2. [Study of pregnancies in women with intrauterine devices of copper].

    Science.gov (United States)

    Albert, A; Carrasco, F; Dueñas, J J; Navarro, J

    1983-01-01

    The authors analyze the intrauterine pregnancies observed in women with four different models of copper IUD. The study was made in a period of 54 months on 3216 insertions. The pregnancy index oscillated between 1.22 of the ML Cu-250 and 4.13 of the 7 Cu-200 (balanced percentage). The permanence of the IUD "in situ" in pregnant women increased the incidence of spontaneous abortions. The authors do not observe infections in pregnant women with the IUD, nor do they register malformations in the newborn.

  3. Exploring Trends in Intrauterine Device (IUD) Usage among Women in the United States: A Literature Review

    Science.gov (United States)

    Nobiling, Brandye; Drolet, Judy C.

    2012-01-01

    Intrauterine devices (IUDs) have not been popular contraceptives in the US for the past 40 years. Recent evidence, however, has shown a slight rebirth in use, from a rate of approximately 2% in 2002 to over 5% in 2008 (Guttmacher Institute, 2010). Empirical evidence is favorable of IUD use in most women, but the still-low usage rate suggests…

  4. A clinical observation of therapeutic effect of levonorgestrel-releasing intrauterine system for 129 women%129例曼月乐的临床应用观察

    Institute of Scientific and Technical Information of China (English)

    解秀珍

    2009-01-01

    Objective To observe clinical efficacy and safety of levonorgestrel-releasing intrauterine system (LNG-IUS). Methods 81 healthy women who only required contraception, 32 women with adenomyosis (AM) who required contraception and treatment, 6 women after conservative operation for endometriosis (EMs) who wanted an attempting treatment and 10 women with dysfunctional uterine bleeding (DUB) presenting menorrhagia (confirmed by diagnostic curettage and pathological examination) required treatment were inserted LNG-IUS into their uterine cavity timely and were regularily followed-up for contraceptive effect, menstruation, dysmenorrhea severity, size of uterine and endometrial thickness. Results The pregnancy rate in women carring LNG-IUS was 0. After 12 months treatment of LNG-IUS, the menstrual amounts of all women were reduced significantly to (8±3)% of that before treatment (P<0.01). The serum level of CA125 of the patients with AM dropped from 72±50kU/L to 31±24kU/L, and the difference was statistically significant (t=2.373,P<0.05). The endometrial thickness of patients with DUB was thinned from 13.2±5.1mm to 5.9±1.9mm, and the difference was statistically significant (t=3.452,P<0.01). The symptom dysmenorrhea of healthy women and patients with AM was completely remitted, while that of 4 patients with EMs was completely or remarkably remitted, and that of 2 patients with EMs was partly remitted. Conclusion LNG-IUS presents significant contraceptive effect and therapeutic effect for AM and DUB, also, it exerts certain therapeuitc effect for EMs.%目的 探讨曼月乐的临床应用疗效.方法 对于健康妇女单纯要求避孕者81例,子宫腺肌症患者要求避孕及治疗者32例,子宫内膜异位症患者保守手术后要求尝试治疗者6例,月经过多的功能性子宫出血(经诊刮病理确诊)患者要求治疗者10例,适时宫内放置曼月乐,定期随访观察避孕效果、月经、痛经程度、子宫腺肌症患者子宫大小、

  5. Observation on the clinical efficacy of levonorgestrel -intrauterine releasing system%左炔诺孕酮宫内缓释系统临床效果观察

    Institute of Scientific and Technical Information of China (English)

    李俊英; 郝增平

    2011-01-01

    Objective; To explore the clinical efficacy of levonorgestrel - intrauterine releasing system ( LNG - IUS) for contraception, adenomyosis, hysteromyoma and dysfunctional uterine bleeding. Methods: LNG -IUS was placed in 94 patients with induced abortion , adenomyosis, hysteromyoma and dysfunctional uterine bleeding in the hospital from December 2003 to March 2007. The factors such as contraceptive effectiveness, menstruation, hemoglobin and blood CA125 levels were observed at 1, 3, 6 and 12 months after placement of LNG - IUS. Results; Among 30 cases with induced abortion, LNG - IUS of one case dropped after 20 days and she got pregnancy at five months; among the other 29 cases, 20.00% of the cases had abdominal pain, then the pain was relieved after 3 months; 70.00% of the cases were found with irregular vaginal bleeding, then they recovered after 6 months. Among 64 cases with adenomyosis, hysteromyoma and dysfunctional uterine bleeding, LNG - IUS of one case moved down after 1 month. Dysmenorrhea of all the cases relieved after 3 months. At 12 months, the amount of menstruation reduced by 89. 26% , the menstruation shortened by 3. 58 days, the menstrual cycle prolonged by 6. 51 days, the incidence of amenorrhea was 57. 81% , the level of hemoglobin increased by 2.91 g/L, and the level of CA125 decreased by 40. 10%, the volumes of uteri and fibroids decreased significantly. No uterine cavity infection and pregnancy with IUD occurred. Conclusion; LNG - IUS has good contraceptive effect, and it is also effective for adenomyosis, hysteromyoma and dysfunctional u-terine bleeding.%目的:探讨左炔诺孕酮宫内缓释系统(LNG-IUS)对避孕、子宫腺肌病、子宫肌瘤及功能失调性子宫出血的临床疗效。方法:选择2003年12月~2007年3月北京友谊医院妇产科早孕人工流产、子宫腺肌病、子宫肌瘤及功能失调性子宫出血患者94例,放置LNG-IUS,观察放置后1、3、6、12个月的避孕效果、

  6. Secondary Vesical Calculus Resulting from Migration of an Intrauterine Contraceptive Device

    Directory of Open Access Journals (Sweden)

    Suvarna Vagholkar

    2012-01-01

    Full Text Available Intrauterine contraceptive device (IUCD is the commonest form of contraception used in view of less systemic side effects. However, there are a multitude of local complications caused by it. Of all the local complications described, migration of the device into adjacent organs is the most morbid of all complications. A patient presenting with history of loss or disappearance of the intrauterine contraceptive device accompanied by urinary symptoms should raise the doubt of a migrated device with the formation of a secondary calculus. This prompts further radiological investigations and merits surgical intervention either endourologically or by open surgery depending upon the merits of the case. A case report elucidating this fact is presented.

  7. 左炔诺孕酮宫内缓释系统治疗子宫内膜息肉临床分析%Clinical Analysis of Levonorgestrel-Releasing Intrauterine System in the Treatment of Endometrial Polyps

    Institute of Scientific and Technical Information of China (English)

    刘琛姝; 王永莉; 尹淑杰

    2014-01-01

    目的:对子宫内膜息肉患者采用左炔诺孕酮宫内缓释系统治疗,探讨和分析其临床治疗效果。方法:选择12个月内宫腔镜确诊子宫内膜息肉发生2次或2次以上患者40例,随机分为两组,试验组20例,采用宫腔镜下子宫内膜息肉电切后同时放置曼月乐环1枚;对照组20例,采用宫腔镜下子宫内膜息肉电切术后口服优思明治疗。所有患者均选择术后每3个月复查阴道B超,术后1年常规宫腔镜检查,进而比较两组子宫内膜增生及子宫内膜息肉复发的情况。结果:试验组和对照组子宫内膜息肉复发率分别为5.0%(1/20)、25.0%(5/20);此外,左炔诺孕酮宫内缓释系统放置前后月经量及内膜厚度的变化进行比较,差异具有统计学意义(P0.05)。结论:对子宫内膜息肉患者采用宫腔镜下子宫息肉电切术治疗,同时放置左炔诺孕酮宫内缓释系统治疗,可有效地防止患者复发,且不良反应少,值得在临床上应用。%Objective:To investigate and analyze the clinical effect of levonorgestrel-releasing intrauterine system in the treatment of endometrial polyps. Method:40 patients of endometrial polyps occurred 2 times or more than 2 times diagnosed with hysteroscopy were selected and randomly divided into two groups.The experimental group(20 patients) was given hysteroscopic endometrial polypectomy and one Mirena ring while the control group(20 patients)were given hysteroscopic endometrial polyp resection and Yasmin. After surgery,all patients were given vaginal B every 3 months ,and were given routine hysteroscopy in 1 year later. Endometrial hyperplasia and endometrial polyps recurrence in two groups was compared. Result:The experimental group and the control group of endometrial polyp recurrence rates were 5%(1/20),25%(5/20),respectively. Before and after Levonorgestrel-releasing intrauterine system placed,the menstrual flow and endometrial

  8. 左炔诺孕酮宫内缓释系统对子宫腺肌症患者卵巢功能的影响%Effect of levonorgestrel releasing intrauterine system to adenomyosis ovarian function in patients

    Institute of Scientific and Technical Information of China (English)

    朱允英

    2016-01-01

    Objective To observe the effect of levonorgestrel releasing intrauterine system to adenomyosis ovarian function in patients. Methods Patients with adenomyosis hospital from March 2014 to June 2015 were treated 70 cases, according to the chronological order of admission into two groups, control group and the observation group, 35 patients in each. The control group were treated with mifepristone treatment, the observation group were treated with levonorgestrel-releasing intrauterine system for treatment, the two groups were observed menstrual menstruation and ovarian case index level. Results The observation group patients menstrual period, menstrual cycle and dysmenorrhea degree than the control group, the difference was significant (P<0.05);observation group patients ovarian function level indicator values than the control group, the difference was significant (P<0.05). Conclusion Levonorgestrel releasing intrauterine system used in the treatment of patients with adenomyosis, ovarian function in patients with good impact and improve patient menstrual cycle and menstrual pain situation, worthy of promotion and application.%目的::观察左炔诺孕酮宫内缓释系统对子宫腺肌症患者卵巢功能的影响。方法:选取本院2014年3月~2015年6月收治的子宫腺肌症患者70例,按入院时间顺序分为两组,对照组及观察组,各35例。对照组患者给予米非司酮进行治疗,观察组患者给予左炔诺孕酮宫内缓释系统进行治疗,观察两组患者月经经期情况及卵巢指标水平。结果:观察组患者治疗后月经期、月经周期及痛经程度明显优于对照组,差异显著(P<0.05);观察组患者治疗后卵巢功能水平指标数值明显优于对照组,差异显著(P<0.05)。结论:左炔诺孕酮宫内缓释系统应用于子宫腺肌症患者治疗,对患者卵巢功能影响好,且有效改善了患者经期周期及经期疼痛情况,值得推广及应用。

  9. Clinical observation of levonorgestrel-releasing intrauterine system on endometrial hyperplasia disease%左炔诺孕酮宫内缓释系统治疗子宫内膜增生症的临床观察

    Institute of Scientific and Technical Information of China (English)

    王植红

    2013-01-01

    Objective To discuss the therapeutic effect of levonorgestrel-releasing intrauterine system ( LNG-IUS)on endometrial hyperplasia disease. Methods 100 cases of pctients who admitted to our hospital from January 2011 to January 2012 were chose and divided into conventional hormone group and LNG-IUS group randomly,50 cases in each group. Conventional group was given progestational hormone (medroxyprogesterone) after 5 days of diagnostic dilatation and LNG-IUS group was placed levonorgestrel-releasing intrauterine system after 5 days of diagnostic dilatation. The change of menstrual quantity, hemoglobin levels, endometrial thickness and adverse reactions of the two groups were compared before and after treatment. Results After one course of treatment, there were 21 cases of patients in conventional group whose menstrual quantity was too much,and its cure rate was 58% ,while there were 4 cases of patients in LNG-IUS group whose menstrual quantity was too much,its cure rate was 92% .there was significant difference between the two groups(P<0. 05 ). The hemoglobin levels of LNG-IUS group were 12% , higher than that of conventional group, its endometrial thickness was 8 % , lower than that of conventional group after one course of treatment, the adverse reactions of conventional group included weight gain, nausea, swirl and liver/kidney damages, while LNG-IUS group's adverse reaction was uterine irregular punctate hemorrhage. Conclusion Levonorgestrel-releasing intrauterine system has better effects on endometrial hyperplasia disease than conventional oral progestational hormone and has fewer adverse reactions.%目的 探讨左炔诺孕酮宫内节育系统(LNG-IUS)对子宫内膜增生症的治疗作用.方法 2011年1月至2012年1月我院收治的100例子宫内膜增生症患者,随机分为对照组(孕激素组)和试验组(LNG-IUS组)各50例.对照组于诊断性刮宫术后第5天给予孕激素(醋酸甲羟孕酮),试验组于诊断性刮宫术后第5天宫

  10. 左炔诺孕酮宫内释放系统治疗子宫腺肌症28例临床观察%Levonorgestrel Releasing Intrauterine System in Treatment of Adenomyosis Clinical Observation of 28 Cases

    Institute of Scientific and Technical Information of China (English)

    昌新霞

    2015-01-01

    目的:探讨左炔诺孕酮宫内释放系统治疗子宫腺肌症临床观察。方法选取我院就诊的子宫腺肌症患者60例,随机分为实验组28例、对照组32例,实验组患者刮宫后按操作要求放置左炔诺孕酮宫内释放系统进行治疗,对照组患者采用米非司酮口服治疗。结果实验组患者的治愈率为32.1%、有效率为96.4%;对照组患者的治愈率21.9%、有效率为75%,两组数据差异具有统计学意义(P<0.05)。结论本文通过对左炔诺孕酮宫内释放系统治疗子宫腺肌症患者临床效果的对比研究,进一步证实了LNG-IUS为患有子宫腺肌症的患者进行临床治疗提供了新的选择方案,它不但能避孕,还使患者的月经情况得到显著改善、痛经指数大大降低、子宫体积也日渐减小,临床效果非常可观。%Objective To investigate the clinical observation of levonorgestrel releasing intrauterine system in treatment of adenomyosis. Methods 60 patients with adenomyosis in our hospital were selected,randomly divided into the experimental group of 28 cases,32 cases in the control group,atients in the experimental group after curettage according to operational equirements placed levonorgestrel releasing intrauterine system in treatment,the control group were treated by mifepristone. Results The patients in the experimental group. The cure rate was 32.1%,effective rate was 96.4%; the control group patients 21.9% cure rate,effective rate was 75%,statistical y significant differences between the two groups(P< 0.05)data. Conclusion Through comparative study on release system for the treatment of adenomyosis patients clinical effect of levonorgestrel releasing intrauterine,further confirmed the LNGIUS with adenomyosis patients provides a new selection scheme for clinical treatment,it can not only contraception,also make menstruation,dysmenorrhea patients obtained significant improvement is greatly reduced,the uterus index

  11. The Effect Observation of Levonorgestrel-releasing Intrauterine System in Adenomyosis%左炔诺孕酮宫内缓释系统治疗子宫腺肌症的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    吴小平; 林美丽

    2014-01-01

    Objective:To study clinical effect of Levonorgestrel-releasing Intrauterine System in adenomyosis.Method:40 cases of uterine adenomyosis patients in our hospital from January 2012 to March 2013 were admitted for the study,the Levonorgestrel-releasing Intrauterine System was placed into the patient utero,the menstrual flow,dysmenorrhea of the degree,uterine size change were observed and analysed before and after treatment.Result:Before treatment the dysmenorrhea score,menstrual flow,CA125,uterine size were (84.12±4.90)points,(212.01±53.01)ml,(70.38±68.50)U/ml,(190.16±90.04)cm3,placed 3 months in patients with dysmenorrhea score,menstrual flow,CA125,respectively (21.50±8.11)points,(48.21±14.88)ml,(26.01±25.42)U/ml,the difference were statistically significant(P0.05).In addition,patients had no significant adverse reactions.Conclusion:The effect of Levonorgestrel-releasing Intrauterine System in the treatment of adenomyosis is obvious,this method can effectively improve patient menstrual flow,dysmenorrhea and other symptoms,and safe,reliable,it is worthy of clinical application.%目的:观察左炔诺孕酮宫内缓释系统治疗子宫腺肌症的临床疗效。方法:选取2012年1月-2013年3月笔者所在医院收治的40例子宫腺肌症患者为研究对象,将左炔诺孕酮宫内缓释系统放置到患者宫内,对放置前后患者月经量、痛经程度、子宫大小变化等进行全面的观察和分析。结果:放置前患者痛经评分、月经量、CA125、子宫大小分别为(84.12±4.90)分、(212.01±53.01)ml、(70.38±68.50)U/ml、(190.16±90.04)cm3,放置后3个月患者痛经评分、月经量、CA125分别为(21.50±8.11)分、(48.21±14.88)ml、(26.01±25.42)U/ml,差异有统计学意义(P0.05)。此外,患者均无出现明显不良反应。结论:左炔诺孕酮宫内缓释系统治疗子宫腺肌症效果明显,能有效改善患者月经量、痛经等症状,且安全可靠,值得在临床上推广应用。

  12. [Incrustation of marker threads of intrauterine devices in the uterine cavity and cervix uteri].

    Science.gov (United States)

    Patai, K; Berényi, M; Gimes, G

    1986-01-01

    If the indicating thread of intrauterine contraceptive devices is situated inside the uterine cavity, it is incrustated in the same way with calcium carbonate like the device itself. In 20 per cent the intracervical part of the thread is incrustated, too. The danger of an ascending inflammatory disease is increasing with the precipitation of substances, probably, denaturated fibrine or mucine according to the infrared spectral analysis.

  13. Immediate postpartum versus 6-week postpartum intrauterine device insertion: a feasibility study of a randomized controlled trial.

    Science.gov (United States)

    Bryant, Amy G; Kamanga, Gift; Stuart, Gretchen S; Haddad, Lisa B; Meguid, Tarek; Mhango, Chisale

    2013-06-01

    This study aimed to evaluate the feasibility of conducting a randomized controlled trial of postpartum intrauterine device insertion and to demonstrate that the postpartum intrauterine device is acceptable to women. Women attending prenatal care at a maternity hospital in Lilongwe, Malawi were recruited into a trial comparing immediate (10 minutes to 48 hours) to 6 week postpartum insertion. Feasibility of recruiting and consenting 140 women and randomizing 70% of them was evaluated. Satisfaction with the intrauterine device was also assessed. One hundred fifteen women consented and 49 (61%) were randomized. Twenty-six women were assigned to immediate insertion, and 23 to insertion at 6 weeks postpartum. Thirty (24%) women received the device as part of the study protocol, and 28 (93%) had the device in place at 12 weeks postpartum. The intrauterine device is acceptable to some postpartum women in Malawi, but conducting a randomized clinical trial may not be feasible.

  14. The "nylon T" intrauterine device: surface area versus copper adjunct.

    Science.gov (United States)

    Kamal, I; Shaaban, H; Ezzat, R; Zaki, S

    1981-04-01

    A study to evaluate the relative effect of copper ions and increased surface area added through the wiring of the stem of the inert "T" device was performed. The experimental design was set up to test a hypothesis that the effectiveness of a copper device is a result of the increase in surface area of the IUD and not a result of the copper itself. Ninety-eight TCu 200 mm2 devices were stripped of their copper wire and rewound with a "nylon" thread of the same length, caliber and surface area. the devices were then repacked and gas sterilized. The 98 "nylon T" devices were fitted early in 1977 and followed up for 2 years. The major finding was that the replacement of copper wire on the "copper T" device by a "nylon" thread, "nylon T", had shown a comparable antifertility effect.

  15. Immediate Post-abortal Insertion of the Levonorgestrel-releasing Intrauterine System: A Systematic Review%人工流产术后即时放置左炔诺孕酮宫内缓释系统的系统评价

    Institute of Scientific and Technical Information of China (English)

    王彩燕; 黄紫蓉; 邹燕

    2013-01-01

    Objective: To evaluate the effectiveness and safety of immediate post-abortal insertion of the levonorgestrel-releasing intrauterine system (LNG-IUS). Methods: The Medline, Embase, Cochrane Library, CJFD, CBM, VIP and Wanfangdata were searched for researches to compare immediate post-abortal insertion of the levonorgestrel-releasing intrauterme device with copper IUD (Cu IUD) or post-menstrual insertion of the LNG-IUS. Two reviewers independently extracted data and assessed the quality of the evidence. Meta analysis was conducted using RevMan 5.0. Results: Totally, 17 articles and 5 512 women were included. Comparing with immediate post-abortal insertion of the copper IUD, less pregnancy, more amenorrhea occurred among women with immediate post-abortal insertion of the LNG-IUS. Both groups experienced similar rates of expulsions and removals for medical reasons and irregular bleedings. Comparing with post-menstrual insertion, women with post-abortal insertion of the LNG-IUS experienced less irregular bleedings in 6 months after insertion (RR=0.42, 95%CI=0.22~0.83, P=0.01). In 12 months after insertion, both groups experienced similar rates of pregnancy, expulsion, removal for medical reasons, amenorrhea and irregular bleedings. Conclusion: Immediate post-abortal insertion of the levonorgestrel-releasing intrauterine system (LNG-IUS) is safe and effective.%目的:系统评价人工流产术后即时放置左炔诺孕酮宫内缓释系统(LNG-IUS)的临床疗效和安全性.方法:计算机检索Medline、Embase、Cochrane图书馆、中国期刊全文数据库、中国生物医学文献数据库、中文科技期刊数据库、万方数据资源系统.纳入比较人工流产术后即时放置LNG-IUS与人工流产术后即时放置含铜宫内节育器(CuIUD),以及人工流产术后即时放置LNG-IUS与月经期放置LNG-IUS的研究.由2位评价者独立进行文献筛选及数据提取.采用Cochrane协作网提供的RevMan5.0进

  16. Development of endometrioid adenocarcinoma despite Levonorgestrel-releasing intrauterine system: a case report with discussion and review of the RCOG/BSGE Guideline on the Management of Endometrial Hyperplasia.

    Science.gov (United States)

    van der Meer, A C L; Hanna, L S

    2017-02-01

    Obesity is a significant risk factor for the development of endometrial hyperplasia and cancer. More conservative prevention and management strategies are attractive due to the increased surgical risk and complication rates associated with obesity. The Levonorgestrel-releasing intrauterine system (LNG-IUS, Mirena) has been shown to reduce the risk of developing endometrial cancer. The recent joint Green Top Guideline on the Management of Endometrial Hyperplasia published by the Royal College of Obstetricians and Gynaecologists (RCOG) with the British Society for Gynaecological Endoscopy (BSGE) recommends the LNG-IUS for the medical management of endometrial hyperplasia without atypia. This case study reports on the development of endometrioid adenocarcinoma despite the presence of an LNG-IUS following a negative hysteroscopy in a 56-year-old woman with morbid obesity. This report highlights the need for patients and clinicians to remain vigilant to the early warning signs of developing endometrial cancer, especially in those at an increased risk secondary to obesity. © 2016 World Obesity Federation.

  17. Effects of hormone therapy on the endometrium in postmenopausal women: a one year randomized trial of low dose oral estradiol in association with a levonorgestrel-releasing intrauterine system or drospirenone

    Directory of Open Access Journals (Sweden)

    Luiza Schvartzman

    2013-09-01

    Full Text Available OBJECTIVES: to compare the endometrial effects and uterine bleeding patterns associated with treatment using (1 levonorgestrel-releasing intrauterine system (LNG-IUS and estradiol (1 mg/day, p.o. or (2 orally administered drospirenone (2 mg/day andestradiol (1 mg/day. METHODS: thirty-four patients (aged 52.53 ± 4.44 in the LNG-IUS group and 53.15 ± 4.018 in the DRSP group were randomized. The severity of menopausal symptoms was evaluated using the Kupperman index every three months. Transvaginal ultrasound, hysteroscopy and histological evaluation were repeated after 12 months. During this period, patients kept menstrual calendars. All categorical variables were described as percentages. Variables were tested for normal distribution and Student's t test was applied for independent samples and ANOVA forrepeated measures when appropriate. Data were considered to be significant when p<0.05. RESULTS: slight vaginal bleeding was reported in the first month of treatment by 53.3% of patients from the LNG-IUS/estradiol group compared with 7.7% of patients from the drospirenone/estradiol group. There were no differences in endometrial thickness between the two groups throughout the study period. End-of-study histological findings showed atrophic endometrium in 53.3% of patients in the LNG-IUS/estradiol group compared with 76.9% of patients in the drospirenone/estradiol group. CONCLUSIONS: our results suggest good endometrial protection with both HT regimens.

  18. 左炔诺孕酮宫内缓释系统治疗子宫内膜异位症的研究进展%Research Progress in Levonorgestrel Intrauterine Releasing System Treating Endometriosis

    Institute of Scientific and Technical Information of China (English)

    李水莲

    2013-01-01

    左炔诺孕酮宫内缓释系统(LNG-IUS),以20 μg/d的剂量释放高效孕激素,使子宫内膜腺体萎缩,间质蜕膜样变,黏膜变薄,能有效缓解子宫内膜异位症(EMs)患者痛经、深部性交痛及慢性盆腔痛,可缩小子宫体积,减少月经量,降低保守性手术后中/重度痛经复发率.近年来,LNG-IUS用于缓解EMs和防止其复发均取得了较好效果.%Levonorgestrel intrauterine releasing system( LNG-IUS ),through releasing 20 μ g/d dose of efficient progestational hormone, making the endometrial glands atrophy, interstitial decidual change, mucous membrane thinned,can effectively relieve EMs patients dysmenorrhea, deep sexual pain and chronic pelvic pain,reduce uterine volume,reduce menstrual quantity,and reduce the moderate/severe dysmenorrhea recurrence rate of conservative surgery. In recent years, LNG-IUS has achieved good effect in relieving EMs and preventing the recurrence.

  19. The mechanism of action of hormonal contraceptives and intrauterine contraceptive devices.

    Science.gov (United States)

    Rivera, R; Yacobson, I; Grimes, D

    1999-11-01

    Modern hormonal contraceptives and intrauterine contraceptive devices have multiple biologic effects. Some of them may be the primary mechanism of contraceptive action, whereas others are secondary. For combined oral contraceptives and progestin-only methods, the main mechanisms are ovulation inhibition and changes in the cervical mucus that inhibit sperm penetration. The hormonal methods, particularly the low-dose progestin-only products and emergency contraceptive pills, have effects on the endometrium that, theoretically, could affect implantation. However, no scientific evidence indicates that prevention of implantation actually results from the use of these methods. Once pregnancy begins, none of these methods has an abortifacient action. The precise mechanism of intrauterine contraceptive devices is unclear. Current evidence indicates they exert their primary effect before fertilization, reducing the opportunity of sperm to fertilize an ovum.

  20. Does insertion and use of an intrauterine device increase the risk of pelvic inflammatory disease among women with sexually transmitted infection? A systematic review.

    Science.gov (United States)

    Mohllajee, Anshu P; Curtis, Kathryn M; Peterson, Herbert B

    2006-02-01

    Concerns exist as to whether the insertion of copper and levonorgestrel-releasing intrauterine devices (IUDs) increases the risk of pelvic inflammatory disease (PID) among women with sexually transmitted infection (STI). We searched the MEDLINE database for all articles published between January 1966 and March 2005 that included evidence relevant to IUDs and STIs and PID. None of the studies that examined women with STIs compared the risk of PID between those with insertion or use of an IUD and those who had not received an IUD. We reviewed indirect evidence from six prospective studies that examined women with insertion of a copper IUD and compared risk of PID between those with STIs at the time of insertion with those with no STIs. These studies suggested that women with chlamydial infection or gonorrhea at the time of IUD insertion were at an increased risk of PID relative to women without infection. The absolute risk of PID was low for both groups (0-5% for those with STIs and 0-2% for those without).

  1. Adequacy of the device intrauterine by ultrasound evaluation: postpartum and post-abortion insertion versus insertion during the menstrual cycle

    National Research Council Canada - National Science Library

    de Holanda, Antônio Arildo Reginaldo; Pessoa, Aline de Melo; Holanda, Julita de Campos Pipolo; de Melo, Maria Helena Vieira; Maranhão, Técia Maria de Oliveira

    2013-01-01

    To compare by transvaginal ultrasound the position of the intrauterine device (IUD) inside the uterine cavity, depending on the time of insertion, postpartum and post-abortion, and during the menstrual cycle...

  2. Association of amoebae and actinomyces in an intrauterine contraceptive device user.

    Science.gov (United States)

    Arroyo, G; Quinn, J A

    1989-01-01

    A patient wearing an intrauterine contraceptive device (IUD) was diagnosed as being colonized by Actinomyces and amoebae by examination of a routine Papanicolaou smear. The patient received vaginal treatment with metronidazole, which temporarily eliminated the protozoa; however, it was necessary to remove the IUD to definitively eradicate the microorganisms. Follow-up Papanicolaou smears taken after removal of the IUD have been normal and free of both microorganisms.

  3. Effect of intrauterine copper device on cervical cytology and its comparison with other contraceptive methods

    Directory of Open Access Journals (Sweden)

    Sipra Bagchi

    2016-08-01

    Conclusions: There was no significant risk of cervical dysplasia or invasive carcinoma in IUCD users up to 2 years of use while other contraceptives (except barrier one showed increased incidence of mild dysplasia (LSIL after 1 year of use. Though risk of cervical malignancy is less with intrauterine copper devices, regular follow up should be done in long term users. [Int J Reprod Contracept Obstet Gynecol 2016; 5(8.000: 2795-2798

  4. Translocation of an Intrauterine Contraceptive Device: Incidental Finding in the Rectosigmoid Colon

    Science.gov (United States)

    Vilallonga, R.; Rodriguez, N.; Vilchez, M.; Armengol, M.

    2010-01-01

    The presence of an intrauterine device (IUD) within the colon is rare. Complications have been reported with IUDs among which uterine perforation. Translocation of IUDs to the uterine cavity, to the bladder and also through the wall of the bowel, and sigmoid colon has been reported. We believe there may be a case that surgeons should know the result of despite being a priori gynaecological complication. This paper reports on a case of colon perforation by an IUD. PMID:20613996

  5. Contraceptive efficacy of a novel intrauterine device (IUD) in white-tailed deer.

    Science.gov (United States)

    Malcolm, Karl D; Van Deelen, Timothy R; Drake, David; Kesler, Darrel J; Vercauteren, Kurt C

    2010-02-01

    Overabundant white-tailed deer (Odocoileus virginianus) pose risks to property, health, and safety of human beings. Public concerns about lethal management can impair efforts to address these issues, particularly in urban settings. Several techniques developed for reducing reproductive output of deer have limited utility because they require repeated dosing to achieve permanent effect and face uncertain regulatory approval for use beyond experimentation. From 10 August 2006 through 30 December 2007, we evaluated the contraceptive efficacy of copper-containing intrauterine devices (IUDs) implanted trans-cervically in white-tailed deer at the E.S. George Reserve in Pinckney, Michigan. Intrauterine devices were implanted before (n=9) and shortly after (n=10) the breeding season. Post-breeding season IUD treatment was in conjunction with a 5cm(3) dose of 5mg/ml prostaglandin F(2alpha) (PGF(2alpha)), delivered subcutaneously. Intrauterine devices reduced pregnancy rates when administered prior to breeding (PIUDs prior to the breeding season and survived to the end of the study became pregnant (due to loss of the implant) during the second year while all (n=16) does without implants conceived. Cervical changes associated with early pregnancy made trans-cervical implantation after the breeding season challenging, and resulted in improperly placed IUDs in 2 treated does. The apparent expulsion of IUDs by pregnant does that received the combined treatment after breeding suggests IUD treatment should be limited to the pre-breeding season. Intrauterine devices show potential as a tool for small-scale deer population management via non-steroidal reproductive inhibition.

  6. Role of uterine forces in intrauterine device embedment, perforation, and expulsion

    OpenAIRE

    Goldstuck ND; Wildemeersch D

    2014-01-01

    Norman D Goldstuck,1 Dirk Wildemeersch2 1Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Western Cape, South Africa; 2Gynecological Outpatient Clinic and IUD Training Center, Ghent, Belgium Background: The purpose of this study was to examine factors that could help reduce primary perforation during insertion of a framed intrauterine device (IUD) and to determine factors that contribute in generating enough ut...

  7. Ureteric erosion and obstruction: A rare but dreaded complication of intrauterine contraceptive device

    Science.gov (United States)

    Priyadarshi, Vinod; Sehgal, Nidhi; Sen, Dipanwita

    2017-01-01

    Though intrauterine contraceptive device (IUCD) is a safe and most frequently used long-term contraceptive method, it has some complications. Uterine perforation and intra-abdominal migration have been reported often, but a retroperitoneal migration is exceptional. Here, we are reporting an IUCD which perforated the uterus and migrated to the retroperitoneum; impinging into and obstructing left ureter causing severe hydroureteronephrosis due to the development of the left lower ureteric stricture. PMID:28216944

  8. Vesicocervical fistula: rare complication secondary to intrauterine device (Lippes loop) erosion.

    Science.gov (United States)

    Magudapathi, Chandrakala; Manickam, Ramalingam; Thangavelu, Kavitha

    2015-06-01

    We report a case of vesicocervical fistula following intrauterine device (Lippes loop) erosion following insertion 45 years ago. Vesicocervical fistula was suspected clinically. Ultrasound and magnetic resonance imaging confirmed the presence of a foreign body. Biopsy and magnetic resonance imaging were performed to rule out malignancies of the urogenital tract. The fistula was managed by laparotomy, hysterectomy, and bladder flap closure. We report this case because of its rarity.

  9. Intravesical Migration and Calcification of Intrauterin Device: A Case Report and Review of the Literature

    OpenAIRE

    2015-01-01

    Intrauterine device (IUD) is widely used for the long duration of protection, cost-effectiveness and for being a reversible contraceptive method as well as having low complication rates. Despite low complication rates, various IUD-related complications, such as spontaneous aborts, bleeding, infection, and uterine perforation may occur. Although perforation of the uterus by an IUD is not uncommon, bladder perforation is a rare complication. A regular follow-up of patients with IUDs for the com...

  10. Intrauterine Devices and Reproductive Tract Infections: A Cross-sectional Study in Urban Slum

    OpenAIRE

    2015-01-01

    "Introduction: The concern that intrauterine devices (IUDs) might cause or facilitate reproductive tract infection has limited its use. Objectives: The study aims to explore the relationship between reproductive tract infections & IUD use. Materials and Methods: A hospital based cross sectional study conducted in STI/RTI Clinic located in urban slums of Mumbai, involving total 169 married females of reproductive age group who presented with symptoms of RTI and using atleast o...

  11. Intrauterine device infection causing concomitant streptococcal toxic shock syndrome and pelvic abscess with Actinomyces odontolyticus bacteraemia.

    Science.gov (United States)

    Wu, Carolyn M Yu; Noska, Amanda

    2016-03-10

    Intrauterine devices (IUDs) are rarely associated with serious infections. We report an unusual concomitant infection of group A Streptococcus (GAS) causing toxic shock syndrome and pelvic abscess with Actinomyces odontolyticus associated with an IUD in a healthy 50-year-old patient. The IUD was subsequently removed and the patient recovered on the appropriate antibiotics. This case highlights the importance of clinicians' high index of suspicion of an IUD infection and prompt removal of the infected foreign body to obtain source control.

  12. The prognosis of pregnancy conceived despite the presence of an intrauterine device (IUD)

    OpenAIRE

    2010-01-01

    Objective: Intrauterine devices (IUDs) are used for contraception worldwide; however, the management of pregnancies with an IUD poses a clinical challenge. The purpose of this study was to determine the outcome of pregnancy in patients with an IUD. Study design: A retrospective cohort study (December 1997–June 2007) was conducted. The cohort consisted of 12,297 pregnancies, of which 196 had an IUD. Only singleton pregnancies were included. Logistic regression analysis was used to adjust for ...

  13. Ureteric erosion and obstruction: A rare but dreaded complication of intrauterine contraceptive device

    Directory of Open Access Journals (Sweden)

    Vinod Priyadarshi

    2017-01-01

    Full Text Available Though intrauterine contraceptive device (IUCD is a safe and most frequently used long-term contraceptive method, it has some complications. Uterine perforation and intra-abdominal migration have been reported often, but a retroperitoneal migration is exceptional. Here, we are reporting an IUCD which perforated the uterus and migrated to the retroperitoneum; impinging into and obstructing left ureter causing severe hydroureteronephrosis due to the development of the left lower ureteric stricture.

  14. Translocation of an Intrauterine Contraceptive Device: Incidental Finding in the Rectosigmoid Colon

    Directory of Open Access Journals (Sweden)

    R. Vilallonga

    2010-01-01

    Full Text Available The presence of an intrauterine device (IUD within the colon is rare. Complications have been reported with IUDs among which uterine perforation. Translocation of IUDs to the uterine cavity, to the bladder and also through the wall of the bowel, and sigmoid colon has been reported. We believe there may be a case that surgeons should know the result of despite being a priori gynaecological complication. This paper reports on a case of colon perforation by an IUD.

  15. Chest wall actinomycosis in association with the use of an intra-uterine device.

    Science.gov (United States)

    McBride, W J; Hill, D R; Gordon, D L

    1995-02-01

    A 31 year old woman presented with a chest wall abscess due to Actinomyces israellii and Porphyromonas asaccharolytica (previously Bacteroides asaccharolyticus). She was a long-term user of an intra-uterine device (IUD) and, although asymptomatic, had radiological evidence of pelvic infection. Actinomyces-like organisms were seen on cervico-vaginal smears. The abscess was surgically drained, the IUD removed, and a prolonged course of amoxycillin/clavulanic acid given.

  16. Actinomyces-like organisms in the cervical Papanicolaou-stained smears of intrauterine device (IUD) users

    OpenAIRE

    2004-01-01

    p. 159 - 164 The prevalence of Actinomyces-like organisms in cervicovaginal smears of 2,347 Brazilian women, including 151 (6.4%) intrauterine devices (IUD) users for at least six months and as controls 2,196 (93.6%) non-wearers of similar age using hormonal, barrier, or other contraceptive methods or none, living in Salvador, Bahia, has been investigated. Cervical smears were stained by the Papanicolaou method for the microscopic examination of Actinomyces-like organisms. The ...

  17. Some aspects of oxidative metabolism in human endometrium after long time of applying the intrauterine contraceptive device.

    Science.gov (United States)

    Bausic, V; Ionescu, N

    1996-01-01

    The paper intends to study the variation of oxidative metabolism of human endometrium (all the components) after applying the intrauterine contraceptive device for a long period of time. The results of the study show that modifications "in situ" of the oxidative enzymes vary according to the: type of the enzymes (NADH2-cytochrome-c-reductase, Lactatdehydrogenase), the hormonal cyclic stage (proliferative phase, or luteal phase), epithelial or connective tissue structures, time of resting the intrauterine contraceptive device (DIU) in uterus.

  18. Apparent rarity of asymptomatic herpes cervicitis in a woman with intra-uterine contraceptive device

    Directory of Open Access Journals (Sweden)

    Adeola Fowotade

    2013-12-01

    Full Text Available Infection with genital herpes simplex virus (HSV remains a common viral sexually transmitted disease, often subclinical and a major worldwide problem of women of reproductive age group. Herpes cervicitis is an unusual presentation of Herpes simplex virus infection in females. The finding of herpes cervicitis on routine pap smear of an asymptomatic woman on Intrauterine contraceptive device still further supports the need for increased awareness on the possibility of Herpes simplex virus infection among women, particularly those on Intrauterine contraceptive device. The index case is a 28 years old Nigerian female who was referred to our Special Treatment Clinic on account of an abnormal pap smear cytology which was in keeping with Herpes cervicitis. There was no history of genital ulcer in this patient; however ELISA for HSV 2 IgM was positive in her. We therefore describe a case of herpes cervicitis in an asymptomatic woman on intrauterine contraceptive device. This case highlights to clinicians the need to be aware of the possibility of this association and to carry out relevant investigations so as to identify and treat these patients appropriately. Therefore, there is a need to put in place adequate public health intervention strategy to prevent genital herpes in women of reproductive age group with a view to preventing the possibility of congenital herpes in subsequent pregnancy.

  19. Apparent Rarity of Asymptomatic Herpes Cervicitis in a Woman with Intra-Uterine Contraceptive Device

    Science.gov (United States)

    Okolo, Abu Clement; Manga, Mohammed Mohammed; Anaedobe, Chinenye Gloria; Salami, Ayodeji Akeem; Akang, Effiong Essien Udo

    2013-01-01

    Infection with genital herpes simplex virus (HSV) remains a common viral sexually transmitted disease, often subclinical and a major worldwide problem of women of reproductive age group. Herpes cervicitis is an unusual presentation of Herpes simplex virus infection in females. The finding of herpes cervicitis on routine pap smear of an asymptomatic woman on Intrauterine contraceptive device still further supports the need for increased awareness on the possibility of Herpes simplex virus infection among women, particularly those on Intrauterine contraceptive device. The index case is a 28 years old Nigerian female who was referred to our Special Treatment Clinic on account of an abnormal pap smear cytology which was in keeping with Herpes cervicitis. There was no history of genital ulcer in this patient; however ELISA for HSV 2 IgM was positive in her. We therefore describe a case of herpes cervicitis in an asymptomatic woman on intrauterine contraceptive device. This case highlights to clinicians the need to be aware of the possibility of this association and to carry out relevant investigations so as to identify and treat these patients appropriately. Therefore, there is a need to put in place adequate public health intervention strategy to prevent genital herpes in women of reproductive age group with a view to preventing the possibility of congenital herpes in subsequent pregnancy. PMID:28299103

  20. [Management of abnormal bleeding in an intrauterine device user].

    Science.gov (United States)

    Desmons, F; Adam-steen, C

    1985-01-01

    Abnormal uterine bleeding is the most common complication of IUD use. Minor metrorrhagia during the insertion and the initial 2 or 3 cycles is common and has no pathological significance. The true complications are menorrhagia, or augmentation of the volume of blood, and metrorrhagia, or repeated intermenstrual bleeding. Inert IUDs increase the volume of menstrual blood loss by 100-140% and copper devices by 50-60%. Blood loss is directly related to the size and form of the IUD; copper devices cause less bleeding primarily because of their reduced surface area. Anemia secondary to menstrual problems is a serious problem in developing countries. Metrorrhagia in IUD users is often associated with pain and may lead to removal of the device. It may result from the same array of morphological and functional modifications of the endometrium as menorrhagia, but more often it signals a true complication, either utero-adnexal infection, an intra- or extrauterine pregnancy or spontaneous abortion, or an inadaptation to the uterine cavity or a displacement of the IUD, perhaps with perforation. Metrorrhagia may also result from appearance of a calcium deposit on the surface of an IUD in place for over 2 years, or it may reveal a pathology unrelated to the IUD, such as a myoma, polyp, endometrial hyperplasia, or adenomyosis. Menorrhagia is an almost inevitable consequence of IUD use, but metrorrhagia requires close surveillance. A clinical examination aided by diagnostic tests is needed to distinguish between complications requiring immediate treatment and simple intolerances that may spontaneously resolve. Sonography is indispensable, to confirm good placement of the IUD or to rule out uterine anomalies or pregnancy. Hysteroscopy can be performed with the IUD in place or not, to diagnose localized endometrial hyperplasias, polyps, poorly positioned IUDs, or partial or complete perforations. Hysterography after infection and pregnancy have been ruled out can reveal endocavity

  1. Complications associated with the unsuspected presence of intrauterine contraceptive devices.

    Science.gov (United States)

    Porges, R F

    1973-06-15

    This paper presents three case reports of women whose gynecologic difficulties centered around the unsuspected presence of an IUD. A 42-year-old black woman complained of menorrhagia of 1-year duration following IUD insertion at the local Planned Parenthood Clinic. She also had fibroid tumors of 10-years duration. Examination revealed no loop thread. A uterine sound detected an IUD in place. X-ray showed both a plastic and a metallic IUD in the uterus. Under general anesthesia a Saf-T-coil and Majzlin spring were removed. Her menarrhagia continued and back pain developed. X-ray showed another IUD present. A Lippes loop, size D, was removed and symptoms subsided. Review of her history revealed that she had returned to the Planned Parenthood clinic on 2 occasions where it was assumed the previously inserted IUD had been expelled and without x-ray confirmation another and different device was inserted. A 35-year-old woman, para 1-0- 3-1, complained of infertility of 18 months. She had become pregnant 5 years previously while using a Birnberg bow. After abortion she had used oral contraceptives until 18 months previously. Hysterosalpingogram revealed a Birnberg bow in the uterus. After removal, pregnancy promptly followed. It is believed the Birnberg loop had not been removed at the time of abortion or had been replaced while the patient was under general anesthesia without informing her. A 26-year-old woman complained of infertility for 8-9 months. An abortion had been performed 4 years previously. Later she had used an IUD and then foam contraceptives. A metallic IUD in the uterine cavity was shown by hysterosalpingography, A Hall-Stone ring was deeply imbedded in the uterine wall and removed with difficulty. Her physician stated he had inserted a Hall-Stone ring after the abortion 4 years previously and later was unable to confirm its presence with a uterine probe. He therefore inserted another similar device. No x-rays were taken. He removed 1 device later. It is

  2. Intrauterine contraceptive devices. Complications associated with their use.

    Science.gov (United States)

    Nagel, T C

    1983-03-01

    Uterine perforation is the most serious complication of IUD insertion; the risk is less than 1/1000 insertions for currently available IUDs. Most perforations occur at the time of insertion and the risk is increased in the 4-8 weeks postpartum. It is important to choose an IUD appropriate to the size of the endometrial cavity and to clean the area with an antiseptic solution. When the string is found to be missing, pregnancy must be excluded, and the endometrial cavity explored. Ultrasonography can often determine if the IUD is in the uterus; most IUDs that perforate the uterus are often found in the pelvis. Alterations in vital signs that occur at the time of insertion have been documented in 35-60% of patients; these generally require no therapy. If there are severe vasovagal reactions, treatment with intravenous atropine sulfate 0.4 mg, may be required. Bleeding is the most common reason for IUD removal, but its cause is not extremely clear. Blood loss is greatest with the large inert devices, less with small copper-containing devices, and least with a progesterone-containing IUD. The addition of supplementary iron to the diet and periodic hemoglobin determinations are recommended for IUD users. The risk of pelvic inflammatory disease (PID) is increased in IUD users, ranging from 1.6-10.5 compared with other forms of contraception. Risk is greatest during the 1st few months after insertion but continues to be higher than normal as long as the IUD is used. Studies have shown that women using hormonal or barrier contraceptives have a decreased incidence of PID. For mild infection, tetracycline 500 mg orally 4 times daily suffices; in more severe cases a regimen consisting of an animoglycoside plus penicillin is adequate. The pregnancy rate in IUD users varies between 1.6-5.3/100 women/year. Pregnancy in an IUD-wearer must be considered ectopic until proven otherwise, although the rate of ectopic pregnancy in this group is extremely low. The IUD's protective effect

  3. 左炔诺孕酮宫内缓释系统预防子宫内膜息肉复发的临床观察%The clinical observation of levonorgestrel intrauterine system in preventing recurrence of endometrial polyp

    Institute of Scientific and Technical Information of China (English)

    宋芷霜; 郭宝芝; 刘爱珍

    2015-01-01

    目的:探讨子宫内膜息肉( endometrial polyps ,EP)电切术后宫内放置左炔诺孕酮宫内缓释系统( levonorgestrel intrauterine system , LNG-IUS,又称曼月乐)预防息肉复发的临床疗效。方法收集整理2010年1月至2012年5月郑州市妇幼保健院收治的120例EP电切术后患者的临床资料,根据不同处理方法分为对照组45例、黄体酮组40例、曼月乐组35例。比较3组术后出血情况、术后2年EP复发情况。结果术后出血患者比例由高到低依次为:曼月乐组45.7%(16/35)、对照组33.3%(15/45)、黄体酮组22.5%(9/40)。术后2年曼月乐组复发率2.9%(1/35),低于对照组8.9%(4/45)及黄体酮组5.0%(2/40)(P<0.05)。结论 EP电切术后宫内放置LNG-IUS预防息肉复发的疗效显著。%Objective To investigate the clinical efficacy of levonorgestrel intrauterine system ( LNG -IUS ) in preventing recurrence of endometrial polyp ( EP ) after endometrial polyp resection .Methods Data of 120 patients with endometrial polyp resection in Zhengzhou Maternal and Child Health Hospital from Jan 2010 to May 2012 were collected , all cases were divided into the control group (n=45), progesterone group (n=40), the Mirena group (n=35).The postoperative bleeding, recurrence rate of EP after 2 years between three groups were compared .Results The rate of postoperative bleeding from high to low were Mirena group 45.7%(16/35), control group 33.3% (15/45), progesterone group 22.5% (9/40).The recurrence rate of EP after 2 years in Mirena group was 2.9%(1/35), which was lower than the control group 8.9%(4/45) and progesterone group 5.0%(2/40) (P<0.05).Conclusion The effect of LNG-IUS in preventing recurrence of EP is remarkable after endometrial polyp resection .

  4. Expulsions and adverse events following immediate and later insertion of a levonorgestrel-releasing intrauterine system after medical termination of late first- and second-trimester pregnancy: a randomised controlled trial.

    Science.gov (United States)

    Korjamo, R; Mentula, M; Heikinheimo, O

    2017-07-10

    To compare expulsions and adverse events (AEs) between immediate and delayed insertion of a levonorgestrel-releasing intrauterine system (LNG-IUS) following medical termination of pregnancy (MTOP). Randomised controlled trial. Helsinki University Hospital, Finland, January 2013-December 2014. Cohorts of 102 (gestational age 64-84 days, late first trimester) and 57 (gestational age 85-140 days, second trimester) women requesting MTOP and LNG-IUS contraception. LNG-IUS insertion occurred immediately (same day) or 2-4 weeks following MTOP. Follow-up visits were at 2-4 weeks, 3 months, and 1 year. LNG-IUS expulsion by 3 months and 1 year. AEs and bleeding profiles within 3 months. Following late first-trimester MTOP the LNG-IUS expulsion rates by 3 months were 14 (27.5%) in the immediate-insertion group and two (4.0%) in the delayed-insertion group (risk ratio, RR 6.86; 95% confidence interval, 95% CI 1.64-28.66). By 1 year the expulsion rates were 17 (33.3%) and six (12.0%) (RR 2.78, 95% CI 1.19-6.47). Following second-trimester MTOP LNG-IUS expulsion rates by 3 months and 1 year were five (18.5%) in the immediate-insertion group and one (3.6%) in the delayed-insertion group (RR 5.19, 95% CI 0.65-41.54). No differences in AEs and bleeding profiles emerged between the groups. Immediate LNG-IUS insertion after late first- or second-trimester MTOP is feasible, does not increase the complication rate, or alter the uterine bleeding patterns; however, immediate insertion increased the expulsion rate, which may limit the cost-effectiveness. Immediate insertion of LNG-IUS following MTOP at 9-20 weeks of gestation is feasible and safe. © 2017 Royal College of Obstetricians and Gynaecologists.

  5. An unusual cause of dyspareunia: secondary cervical perforation by post placental intrauterine contraceptive device

    Directory of Open Access Journals (Sweden)

    Monica Chauhan

    2015-06-01

    Full Text Available Postpartum contraception using intrauterine device Copper T 380 A is considered a valuable option to tackle high rate of unintended pregnancy. This case is presented to highlight the importance of follow up and a vigilant examination on patient reporting with any complaint on follow up, even in the presence of a normally placed thread which is crucial to identify problem and manage complication before this reliable, cost effective and long term postpartum contraceptive solution fails to see its rise. [Int J Reprod Contracept Obstet Gynecol 2015; 4(3.000: 881-883

  6. Pelvic actinomycosis associated with use of intrauterine device: a new challenge for the surgeon.

    Science.gov (United States)

    Doberneck, R C

    1982-01-01

    Pelvic actinomycosis associated with the use of an intrauterine device (IUD) is a recently recognized combination. The usual manifestation of the disease are those of mild pelvic inflammatory disease (PID) in a woman who uses an IUD. The disease is easily recognized on Papanicolaou-stained cervicovaginal smears. Early treatment involves removal of the IUD and administration of penicillin. Rarely, the disease may be serious and may require drainage of intra-abdominal abscesses, hysterectomy with salpingo-oophorectomy, or both. The second known death from pelvic actinomycosis associated with use of an IUD is reported.

  7. Actinomyces in the vaginas of women with and without intrauterine contraceptive devices.

    Science.gov (United States)

    Curtis, E M; Pine, L

    1981-08-15

    Either Actinomyces israeli, A. naeslundii, or Arachnia propionica was found, by immunofluorescence studies, in cervicovaginal mucus from 36% of 50 women. One or more of these organisms were found in a surprising 27% of those with neither intrauterine contraceptive devices (IUDs) nor intravaginal foreign bodies. The only common finding was abundant vaginal mucus, and no clinical features were more serious than vaginal itching, odor, or vague discomfort. Among those women who harbored actinomycetes, the average duration of continuous IUD use was 5.3 years; the comparable figure for those with no infection was 2.1 years.

  8. Paracervical block with 1% lidocaine for pain control during intrauterine device insertion: a prospective, single-blinded, controlled study

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    Derya Akdag Cirik

    2013-06-01

    Full Text Available In this prospective controlled study we aimed to investigate efficacy of paracervical block with 1% Lidocaine for pain control and demographic variables which may affect pain perception during intrauterine device insertion in Turkish women. Data from 95 women assigned to paracervical block (n=34, placebo (n=30 and no treatment (n=31 arms and asked to grade the pain level they felt during tenaculum placement, intrauterine device insertion and 5 minutes after the procedure using a visual pain scale. Demographic variables were also recorded. Pain scores were found to be lower in paracervical block group when compared to other 2 groups during tenaculum placement (p=0.00, intrauterine device insertion (p=0.00 and 5 minutes after the procedure (p=0.00. Level of pain was unrelated to mode of previous deliveries and current breastfeeding. Paracervical block is an easy, safe and effective way of pain control during intrauterine device insertion. Lack of vaginal birth history is not a reason to draw back from intrauterine device use. [Int J Reprod Contracept Obstet Gynecol 2013; 2(3.000: 263-267

  9. Biofilm formation on intrauterine devices in patients with recurrent vulvovaginal candidiasis.

    Science.gov (United States)

    Auler, Marcos E; Morreira, Debora; Rodrigues, Fabio F O; Abr Ao, Mauricio S; Margarido, Paulo F R; Matsumoto, Flavia E; Silva, Eriques G; Silva, Bosco C M; Schneider, René P; Paula, Claudete R

    2010-02-01

    A biofilm is a complex community of surface-associated cells enclosed in a polymer matrix. They attach to solid surfaces and their formation can be affected by growth conditions and co-infection with other pathogens. The presence of biofilm may protect the microorganisms from host defenses, as well as significantly reduce their susceptibility to antifungal agents. Pathogenic microbes can form biofilms on the inert surfaces of implanted devices such as catheters, prosthetic cardiac valves and intrauterine devices (IUDs). The present study was carried out to analyze the presence of biofilm on the surface of intrauterine devices in patients with recurrent vulvovaginal candidiasis, and to determine the susceptibility profile of the isolated yeasts to amphotericin B and fluconazole. Candida albicans was recovered from the IUDs and it was found to be susceptible to the antifungal agents when tested under planktonic growing conditions. These findings indicate the presence of the biofilm on the surface of the IUD as an important risk factor for recurrent vulvovaginal candidiasis.

  10. Role of uterine forces in intrauterine device embedment, perforation, and expulsion

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    Goldstuck ND

    2014-08-01

    Full Text Available Norman D Goldstuck,1 Dirk Wildemeersch2 1Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Western Cape, South Africa; 2Gynecological Outpatient Clinic and IUD Training Center, Ghent, Belgium Background: The purpose of this study was to examine factors that could help reduce primary perforation during insertion of a framed intrauterine device (IUD and to determine factors that contribute in generating enough uterine muscle force to cause embedment and secondary perforation of an IUD. The objective was also to evaluate the main underlying mechanism of IUD expulsion. Methods: We compared known IUD insertion forces for “framed” devices with known perforation forces in vitro (hysterectomy specimens and known IUD removal forces and calculated a range of possible intrauterine forces using pressure and surface area. These were compared with known perforation forces. Results: IUD insertion forces range from 1.5 N to 6.5 N. Removal forces range from 1 N to 5.8 N and fracture forces from 8.7 N to 30 N depending upon device. Measured perforation forces are from 20 N to 54 N, and calculations show the uterus is capable of generating up to 50 N of myometrial force depending on internal pressure and surface area. Conclusion: Primary perforation with conventional framed IUDs may occur if the insertion pressure exceeds the perforation resistance of the uterine fundus. This is more likely to occur if the front end of the inserter/IUD is narrow, the passage through the cervix is difficult, and the procedure is complex. IUD embedment and secondary perforation and IUD expulsion may be due to imbalance between the size of the IUD and that of the uterine cavity, causing production of asymmetrical uterine forces. The uterine muscle seems capable of generating enough force to cause an IUD to perforate the myometrium provided it is applied asymmetrically. A physical theory for IUD

  11. Long-acting reversible contraceptives: intrauterine devices and the contraceptive implant.

    Science.gov (United States)

    Espey, Eve; Ogburn, Tony

    2011-03-01

    The provision of effective contraception is fundamental to the practice of women's health care. The most effective methods of reversible contraception are the so-called long-acting reversible contraceptives, intrauterine devices and implants. These methods have multiple advantages over other reversible methods. Most importantly, once in place, they do not require maintenance and their duration of action is long, ranging from 3 to 10 years. Despite the advantages of long-acting reversible contraceptive methods, they are infrequently used in the United States. Short-acting methods, specifically oral contraceptives and condoms, are by far the most commonly used reversible methods. A shift from the use of short-acting methods to long-acting reversible contraceptive methods could help reduce the high rate of unintended pregnancy in the United States. In this review of long-acting reversible contraceptive methods, we discuss the intrauterine devices and the contraceptive implant available in the United States, and we describe candidates for each method, noncontraceptive benefits, and management of complications.

  12. An Intrauterine Device Detected in Ovary during Cesarean Section: A Case Report

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    Fazil Avci

    2015-01-01

    Full Text Available The copper T Intrauterine Device is a common method of contraception used throughout the world. Intrauterine or ectopic pregnancies may be caused by complications with an IUD. The aim of this study was to present an ongoing term pregnancy with a copper T extrauterine device localized in the ovary. Assessment of the clinical features of a term pregnancy complicated by an IUD. A 32-year-old female was fitted with a copper T IUD in October 2009. She was hospitalized due to a term pregnancy with recurrent cesarean history and had the IUD where was not known. Laboratory values and fetal biometry were normal. A viable normal 3750 g male infant with 8/9 Apgar score was delivered by cesarean section without any abnormalities. In pelvic exploration, the IUD was localized in the left ovary and removed. Mother and infant were discharged without any complications after 24 hours. Counselling should be provided about the potential risks of an ongoing pregnancy for all patients with the complication of copper T in place. It is rare to have a successful delivery of a term normal pregnancy complicated with an IUD.

  13. Biological evaluation of the copper/low-density polyethylene nanocomposite intrauterine device.

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    Li-Xia Hu

    Full Text Available Devices and materials intended for clinical applications as medical and implant devices should be evaluated to determine their biocompatibility in physiological systems. This article presents results from cytotoxicity assay of L929 mouse fibroblasts culture, tests for skin irritation, intracutaneous reactivity and sensitization, and material implantation tests for the novel copper/low-density polyethylene nanocomposite intrauterine device (nano-Cu/LDPE IUD with potential for future clinical utilization. Cytotoxicity test in vitro was conducted to evaluate the change in morphology, growth and proliferation of cultured L929 mouse fibroblasts, which in vivo examination for skin irritation (n = 6 and intracutaneous reactivity (n = 6 were carried out to explore the irritant behavior in New Zealand White rabbits. Skin sensitization was implemented to evaluate the potential skin sensitizing in Hartley guinea pigs (n = 35. The materials were implanted into the spinal muscle of rabbits (n = 9. The cytotoxicity grade of the nano-Cu/LDPE IUD was 0-1, suggested that the composite was nontoxic or mildly cytotoxic; no irritation reaction and skin sensitization were identified in any animals of specific extracts prepared from the material under test; similarly to the control sides, the inflammatory reaction was observed in the rabbits living tissue of the implanted material in intramuscular implantation assay. They indicated that the novel composite intrauterine device presented potential for this type of application because they meet the requirements of the standard practices recommended for evaluating the biological reactivity. The nano-Cu/LDPE IUD has good biocompatibility, which is biologically safe for the clinical research as a novel contraceptive device.

  14. Satisfaction and health-related quality of life in women with heavy menstrual bleeding; results from a non-interventional trial of the levonorgestrel-releasing intrauterine system or conventional medical therapy

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    Xu L

    2014-05-01

    Full Text Available Ling Xu,1 Byung Seok Lee,2 Shaheena Asif,3 Peter Kraemer,4 Pirjo Inki51Department of Gynecology and Obstetrics, Peking Union Medical College Hospital, Beijing, People’s Republic of China; 2Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Korea; 3Department of Gynaecology and Obstetrics, Surgimed Hospital, Lahore, Pakistan; 4Global Medical Affairs Excellence and Operations, 5Global Medical Affairs Women's Healthcare, Bayer HealthCare, Berlin, GermanyPurpose: To evaluate the patient satisfaction and health related quality of life (HRQoL for levonorgestrel-releasing intrauterine system (LNG-IUS versus conventional medical treatments ([CMTs] combined oral contraceptives, oral progestins, and antifibrinolytics, alone or in combination in Asian women with heavy menstrual bleeding (HMB.Patients and methods: A total of 647 patients diagnosed with HMB were recruited to this non-interventional study from the eight participating countries in Asia. Patient satisfaction was recorded at the last visit (at 12 months or premature discontinuation. At each visit (at 3, 6, and 12 months, patients completed the menorrhagia multi-attribute scale (MMAS to assess HRQoL.Results: A total of 83.5% of patients on the LNG-IUS were “very satisfied” or at least “satisfied” with the therapeutic effect of HMB treatment, compared with 59.2% of patients with CMTs (P<0.05. The mean (± standard deviation MMAS score increased from 41.4±24.5 to 87.7±21.4 in the LNG-IUS arm, and from 44.1±24.9 to 73.1±25.3 in the CMTs arm. This increase was significantly higher in patients on the LNG-IUS, as compared with those on CMTs (P<0.05. The improvement in HRQoL in both treatment groups correlated with the body mass index of the patient, with larger improvement obtained in women with a higher body mass index.Conclusion: The majority of women using the LNG-IUS or CMTs for HMB were satisfied with their treatment

  15. A single-arm phase III study exploring the efficacy and safety of LNG-IUS 8, a low-dose levonorgestrel intrauterine contraceptive system (total content 13.5 mg), in an Asia-Pacific population.

    Science.gov (United States)

    Fan, Guangsheng; Kang, Sukho; Ren, Mulan; Weisberg, Edith; Lukkari-Lax, Eeva; Roth, Katrin; Shin, SoYoung

    2017-04-01

    The objective was to evaluate the efficacy and safety of a low-dose levonorgestrel intrauterine system with total content 13.5 mg (average approximately 8 μg/24 h over the first year; LNG-IUS 8; Jaydess®) in an Asia-Pacific population. An open-label, single-arm phase III study conducted at 25 centers in China, Australia and Korea assessed LNG-IUS 8 use over 3 years in nulliparous and parous women (N=1114) aged 18-40 years with regular menstrual cycles (21-35 days). Primary outcome was pregnancy rate, expressed as the Pearl Index. Secondary outcomes included 3-year cumulative failure rate, treatment-emergent adverse events (TEAEs), discontinuation rate, bleeding profile and placement pain. The full analysis set comprised 925 women (mean age 31.6 years, 6.4% nulliparous). Overall unadjusted Pearl Index was 0.35 (95% confidence interval 0.15-0.70); the 3-year cumulative failure rate was 0.9% (95% confidence interval 0.4-1.9). TEAEs and study drug-related TEAEs were reported in 70.1% and 31.2% of women, respectively. Overall, 27.9% of women discontinued the study, 16.9% due to adverse events. Frequent or prolonged bleeding (World Health Organization criteria) decreased from the first to the twelfth 90-day reference intervals (from 5.0% to 0.7% and from 44.1% to 3.0%, respectively), and the percentage of women with amenorrhea increased over time (from 0.4% to 10.8%). Pain on placement was reported as "none" or "mild" in 91.9% of women. LNG-IUS 8 was an effective and well-tolerated contraceptive method, providing another option for women in the Asia-Pacific region. In this phase III study, LNG-IUS 8 was shown to be highly effective and well tolerated in an Asia-Pacific population and was not associated with any new or unexpected safety events. LNG-IUS 8 provides another contraceptive option for women in the Asia-Pacific region. Copyright © 2016. Published by Elsevier Inc.

  16. The Effect of Age, Parity and Body Mass Index on the Efficacy, Safety, Placement and User Satisfaction Associated With Two Low-Dose Levonorgestrel Intrauterine Contraceptive Systems: Subgroup Analyses of Data From a Phase III Trial.

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    Kristina Gemzell-Danielsson

    Full Text Available Two low-dose levonorgestrel intrauterine contraceptive systems (LNG-IUSs; total content 13.5 mg [average approx. 8 μg/24 hours over the first year; LNG-IUS 8] and total content 19.5 mg [average approx. 13 μg/24 hours over the first year; LNG-IUS 13] have previously been shown to be highly effective (3-year Pearl Indices: 0.33 and 0.31, respectively, safe and well tolerated. The present subgroup analyses evaluated whether or not outcomes were affected by parity, age (18-25 vs 26-35 years, or body mass index (BMI, <30 vs ≥30 kg/m2.Nulliparous and parous women aged 18‒35 years with regular menstrual cycles (21‒35 days requesting contraception were randomized to 3 years of LNG-IUS 8 or LNG-IUS 13 use.In the LNG-IUS 8 and LNG-IUS 13 groups, 1432 and 1452 women, respectively, had a placement attempted and were included in the full analysis set; 39.2%, 39.2% and 17.1% were 18-25 years old, nulliparous and had a BMI ≥30 kg/m2, respectively. Both systems were similarly effective regardless of age, parity or BMI; the subgroup Pearl Indices had widely overlapping 95% confidence intervals. Placement of LNG-IUS 8 and LNG-IUS 13 was easier (p < 0.0001 and less painful (p < 0.0001 in women who had delivered vaginally than in women who had not. The complete/partial expulsion rate was 2.2-4.2% across all age and parity subgroups and higher in parous than in nulliparous women (p = 0.004. The incidence of pelvic inflammatory disease was 0.1-0.6% across all age and parity subgroups: nulliparous and younger women were not at higher risk than parous and older women, respectively. The ectopic pregnancy rate was 0.3-0.4% across all age and parity subgroups. Across all age and parity subgroups, the 3-year completion rate was 50.9-61.3% for LNG-IUS 8 and 57.9-61.1% for LNG-IUS 13, and was higher (p = 0.0001 among older than younger women in the LNG-IUS 8 group only.LNG-IUS 8 and LNG-IUS 13 were highly effective, safe and well tolerated regardless of age or

  17. Clinical efficiency of Levonorgestrel-releasing intrauterine system in the treatment of 69 cases with adenomyosis%左炔诺孕酮宫内节育系统治疗子宫腺肌病的临床观察

    Institute of Scientific and Technical Information of China (English)

    居蓉

    2014-01-01

    Objective To evaluate the clinical efficiency of Levonorgestrel-releasing intrauterine system(LNG-IUS) in the treatment of adenomyosis. Methods Sixty-nine patients with adenomyosis were treated with LNG-IUS during March 2011 to June 2013. The menstrual quality,menstrual period,VAS and VRS score were carried out before treatment and at one,three and six months after treatment. The amount and period of menstruation were valued by test. Results Among 69 patients, menstrual quality were reduced, dysmenorrhea and chronic pelvic pain were alleviated, which were significantly different from those before treatment(P<0.05).Conclusion LNG-IUS inserting inside uterine cavity can significantly alleviate the clinical symptoms of adenomyosis and improve the patients quality.%目的:观察左炔诺孕酮宫内节育系统(LNG-IUS)治疗子宫腺肌病所致痛经、月经过多及慢性盆腔痛的临床疗效。方法选取2011年3月~2013年6月门诊确诊子宫腺肌病患者69例,排除禁忌证后给予放置左炔诺孕酮宫内节育系统治疗,随访6个月,观察患者的月经量、月经期、痛经及慢性盆腔痛的改善情况。结果与放置左炔诺孕酮宫内节育系统前相比,放置后患者月经量明显减少,痛经程度、慢性盆腔痛明显改善,差异均具有统计学意义(P<0.05)。结论左炔诺孕酮宫内节育系统可以有效缓解子宫腺肌病临床症状,提高患者生活质量。

  18. Microbial colonization of tailed and tailless intrauterine contraceptive devices: influence of the mode of insertion in the rabbit.

    Science.gov (United States)

    Jacques, M; Olson, M E; Costerton, J W

    1986-03-01

    An experimental rabbit model was developed to study the microbial colonization of intrauterine contraceptive devices. Tailed and tailless devices were surgically inserted into into the uterus by two different routes: surgically, directly into the uterine horn, thus avoiding contact with the vaginal and cervical microfloras, or via the vagina and cervix. After 1 to 8 weeks the devices were recovered and prepared for scanning electron microscopy. The surfaces of surgically inserted devices remained uncolonized all through the experiment whereas in those inserted via the cervix microorganisms colonized the core surface as early as 2 weeks after insertion. Our data suggest that in our experimental conditions the mode of insertion appears to be the major factor influencing the microbial colonization of intrauterine contraceptive devices and that the presence of a tail does not seem to play a significant role.

  19. Pre-Clinical Experimental Studies of Indomethacin-Releasing Copper Intrauterine Device

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Effects of two types of intrauterine device (IUD) on the prostaglandins and endothelin (ET) in uterus and on the endometrial morphology in rats and rabbits, and Cu2+ releasing amounts of both IUDs in vitro were observed. The results showed that the inhibiting action of the indomethacin-releasing copper IUD (FICu-IUD) on the PGI2 was stronger than that on the TXA2, the ratio of 6-keto-PGF1α/TXB2 was reduced with the increase of the doses. There were significant differences between the groups. The FICu-IUD could inhibit the rising of the ET level and lighten the endometrial impairment caused by the FCu-IUD, and promote copper ion release. It was suggested that indomethacin released by FICu-IUD could effectively reduce abnormal uterine bleeding.

  20. Medical student intrauterine device knowledge and attitudes: an assessment of clerkship training.

    Science.gov (United States)

    Bartz, Deborah; Tang, Jennifer; Maurer, Rie; Janiak, Elizabeth

    2013-08-01

    Studies demonstrate that many clinician populations have poor knowledge of and harbor negative attitudes towards intrauterine devices (IUDs). We set out to assess the impact of the clinical clerkship in obstetrics and gynecology on medical student IUD knowledge and attitudes. In this prospective cohort study, students at seven diverse US medical schools were surveyed at the start and completion of their obstetrics and gynecology clinical clerkships regarding IUD exposure, knowledge and attitudes. Subject responses were compared pre- and postclerkship. One hundred six students returned completed paired surveys (response rate 82%). The preclerkship mean knowledge percent correct (54%, SD 17%) increased significantly at postclerkship assessment (72%, SD 18%) (p<.0001). The mean attitudes score also increased significantly from pre- (34%, SD 31%) to postclerkship (59%, SD 26%) (p<.0001). US medical student IUD knowledge and attitudes are significantly improved through the obstetrics and gynecology clerkship. However, significant gaps in knowledge persist postclerkship. Copyright © 2013 Elsevier Inc. All rights reserved.

  1. Spontaneous Fracture and Vaginal Expulsion of the Arm of Intra-Uterine Device: Case Report

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    Ižlknur Mutlu

    2016-04-01

    Full Text Available Intrauterine device (IUD is an effective and safe contraceptive method which is commonly used worldwide. However, spontaneous or iatrogenic IUD fracture was rarely occurred during usage. We present the case about spontaneous fracture of one arm of copper IUD and the spontaneous expulsion of the broken piece in a 30-year-old woman 2 years after insertion. The patient recoursed to our clinic due to finding of a foreign body at vaginal outlet. Copper IUD was dislocated in transvaginal ultrasonographic (TVUSG examination and echogenicity of left transverse arm was not identified in transvers section.Although IUD fracture seems rarely, it must be born in mind especially when dislocation exists. Distance to fundus and its location, besides the continuity of its echogenicity and integrity should be observed during routine controls.

  2. Preparation and characterization of silicone rubber/nano-copper nanocomposites for use in intrauterine devices.

    Science.gov (United States)

    Chen, Yongjun; Luo, Yuanfang; Jia, Zhixin; Jia, Demin; Chen, Juan

    2014-01-01

    In this work, a novel silicone rubber/nano-copper nanocomposite for use in intrauterine devices (IUDs) was developed. Moreover, the release rate of Cu2+ ions and the water absorption of the prepared nanocomposite were investigated in detail. The results indicate that the release rate of Cu2+ ions and water absorption capability of the silicone rubber/nanocopper nanocomposite increase as the nano-copper content increases. SEM analysis suggested there is a uniform dispersion of nano-copper in the silicone matrix. Further, systematic analysis indicated that the release rate of Cu2+ ions in the prepared nanocomposite-based IUD can be stabilized for months, which is not possible in the case of traditional IUDs.

  3. Intrauterine device may trigger typical attacks of familial Mediterranean fever: a case report.

    Science.gov (United States)

    Kurultak, Ilhan; Kinalp, Can; Ceri, Mevlut; Evrenkaya, Tevfik Rıfkı

    2015-01-01

    Familial Mediterranean fever (FMF) is an autosomal recessive disorder characterized by episodic, recurrent, self-limited attacks of fever and serositis (sterile peritonitis, pleuritis, arthritis, etc). The insufficiency in restriction of mild inflammation contributes this consequence in FMF.Intrauterine devices (IUDs) have been widely used in the world for contraception by gynecologists as an effective and safe method. Herein, we present a woman with FMF as the first case, whose attacks were triggered by copper-containing IUD. Our hypothesis in the present case was that sterile mild inflammation in the uterus caused by copper-containing IUD may be the initial source of systemic inflammatory response.In our opinion, clinicians should consider that the copper-containing IUDs may be another cause of FMF attacks in women using this contraceptive method.

  4. Intravesical Migration and Calcification of Intrauterin Device: A Case Report and Review of the Literature

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    Levent Verim

    2015-12-01

    Full Text Available Intrauterine device (IUD is widely used for the long duration of protection, cost-effectiveness and for being a reversible contraceptive method as well as having low complication rates. Despite low complication rates, various IUD-related complications, such as spontaneous aborts, bleeding, infection, and uterine perforation may occur. Although perforation of the uterus by an IUD is not uncommon, bladder perforation is a rare complication. A regular follow-up of patients with IUDs for the complications and training of clinicians for insertion and removal are mandatory to provide better and safe family planning services. Here, we report a case of a patient with uterine perforation with a calcified IUD migration into the the bladder.

  5. Knowledge and attitudes about intrauterine devices among women's health care providers in El Salvador.

    Science.gov (United States)

    Hohmann, Heather Lyn; Cremer, Miriam L; Gonzalez, Enrique; Maza, Mauricio

    2011-03-01

    In order to gain an understanding of Salvadoran health care providers' clinical knowledge, attitudes, and practice toward the intrauterine device (IUD), Ministry of Health providers completed a self-administered, anonymous survey. Surveys were completed by 135 participants. The majority (94.7% and 97.0%) agreed the IUD is a safe and effective form of contraception. Only 46.6% of participants had ever received training in IUD placement, and 32.0% of them had ever inserted more than 10 IUDs. The majority of providers (54.2%) believed that the IUD was associated with a higher rate of infection than is described in the literature. Lack of formal training and knowledge about persistent infection rates associated with IUDs may contribute to low IUD placement by Salvadoran providers. Health care providers surveyed are open to learning more about the IUD and sharing the information with their patients.

  6. [Abdominal-pelvic actinomycosis with urinary tract involvement, secondary to gynecologic infection caused by intrauterine device].

    Science.gov (United States)

    Pérez García, M D; Rodríguez Alonso, A; Núñez López, A; Ojea Calvo, A; Alonso Rodrigo, A; Rodríguez Iglesias, B; Barros Rodríguez, M; Benavente Delgado, J; González-Carreró Fojón, J; Nogueira March, J L

    2000-02-01

    Abdomino-pelvic actinomycosis is a condition caused by Actinomyces israelii, a Gram-positive opportunistic bacteria that triggers and develops the infection only in previously injured tissues, and then slowly progresses and spreads until it extrinsically affects the urinary tract. Use of an intrauterine device is a known risk factor to suffer from this disease. Relative risk in IUD users is two- to four-fold higher compared to IUD non-users. Risk increased with prolonged IUD use. Treatment is by removal of the causative agent, surgical resection of necrotic tissues and administration of intravenous Penicillin G, 4 million units every 4 hours for 30 days, followed by Amoxicillin 500 mg every 8 hours for 12 months. This paper contributes two cases of abdomino-pelvic actinomycosis with urinary tract involvement in IUD users. Standard treatment was employed with good evolution.

  7. Intrauterine device--associated pelvic actinomycosis: a rare disease mimicking advanced ovarian cancer: a case report.

    Science.gov (United States)

    Kirova, Y M; Feuilhade, F; Belda-Lefrère, M A; Le Bourgeois, J P

    1997-01-01

    A case report of intrauterine device (IUD)-associated tubo-ovarian actinomycosis is presented. The patient was a 37-year-old nulliparous woman with IUD usage for the last four years. She presented anemia and weight lost of 8 kg. Ultrasound and computed tomography showed an unilateral large mass in the right adnexum adherent to the uterus and compressing the urinary bladder. Preoperative diagnosis of ovarian cancer with liver metastases was made. Bilateral salpingoophorectomy and total abdominal hysterectomy were performed. After pathological and biological analyses, actinomycosis was diagnosed and the patient was treated postoperatively with penicillin. The purpose of this article is to add to the literature a new case of this rare disease which clinically mimics ovarian cancer.

  8. [Intrauterine device and pelvic tumor: two case reports of pelvic actinomycosis with pseudotumor from tropical zones].

    Science.gov (United States)

    Abid, M; Ben Amar, M; Damak, Z; Feriani, N; Guirat, A; Khebir, A; Mzali, R; Frikha, M F; Beyrouti, M I

    2010-06-01

    Pelvic actinomycosis is a rare chronic disease caused by actinomycete species. The pseudotumorous form is the most common and often leads to misdiagnosis. The purpose of this report is to describe two cases of pelvic actinomycosis involving women with a history of intrauterine contraceptive device (IUD) use. Diagnosis was based on pelvic mass and the findings of surgery undertaken for suspicion of an advanced ovarian tumor with hepatic metastasis in one case and for a tumor of the right ovary in the other case. Diagnosis was confirmed by histological examination of a biopsy specimen in the first case and of the surgical specimen (right ovariectomy) in the second case. Long-term antibiotic therapy was effective in both patients. Based on these two cases and review of the literature, discussion focuses on diagnostic pitfalls, natural course, and therapeutic options for this particular infection.

  9. Ureteral obstruction associated with pelvic inflammatory disease in a long-term intrauterine contraceptive device user.

    Science.gov (United States)

    Yonemura, Shigenori; Moriya, Mitsuhiko; Hori, Yasuhide; Arima, Kiminobu; Toyoda, Nagayasu; Sugimura, Yoshiki

    2006-03-01

    We report herein a case of ureteral obstruction associated with pelvic inflammatory disease in a long-term intrauterine contraceptive device (IUD) user. A 62-year-old woman presented with a 2-week history of left flank pain and high fever, but no abdominal pain. She had forgotten the use of an IUD. Retrograde pyelography showed a stricture in the lower third of the left ureter. Magnetic resonance showed swelling of the uterus wall and left parametria, but did not reveal the presence of an IUD. Subtotal hysterectomy, bilateral salpingo-oophorectomy and left nephronureterectomy was performed. The IUD was then found in the uterine cavity. The results of pathological and bacteriological findings for Actinomyces infection were negative. Therefore we diagnosed this case as ureteral obstruction associated with pelvic inflammatory disease. Ureteral obstruction associated with pelvic inflammatory disease in a long-term IUD user is extremely rare.

  10. The Observation of Clinical Effect of Levonorgestrel-releasing Intrauterine System in the Treatment of Endometrial Hyperplasia%左炔诺孕酮宫内节育系统治疗子宫内膜单纯性增生过长的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    胡树群; 张海艳; 栾继红; 李晓红

    2015-01-01

    目的:对左炔诺孕酮宫内节育系统治疗子宫内膜单纯性增生过长的临床价值进行探究。方法于2013年4月7日~2014年12月7日,随机选取我院接诊的60例子宫内膜单纯性增生过长患者,采用抽签方法将其平均分为实验组(n=30)和对照组(n=30),实验组患者实行左炔诺孕酮宫内节育系统治疗,对照组患者实行孕激素治疗,对实验组和对照组两组患者的生活质量状况、不良事件发生率以及临床效果等进行分析和统计。结果经过对两组患者临床疗效分析对比来看,实验组患者其临床效果优于对照组患者(P<0.05),差异具有统计学意义。结论左炔诺孕酮宫内节育系统治疗子宫内膜单纯性增生效果显著。%Objective To explore the clinical value of Levonorgestrel-releasing intrauterine system in the treatment of endometrial hyperplasia. Methods Randomly selected 60 cases of endometrial hyperplasia patients in our hospital from April 7,2013 to December 7,2014. The patients were divided into experimental group (n=30)and control group(n=30)by lottery. The patients of experimental group are treated with Levonorgestrel-releasing intrauterine system while that of control group were treated with progesterone. The patient's life quality,incidence of adverse events and clinical ef ect were analysed. Results By comparing the clinical ef icacy of two groups of patients,the clinical ef ect of experimental group was better than that of control group(P<0.05),the result had significant dif erence. Conclusion Levonorgestrel-releasing intrauterine system has a remarkable ef ect in the treatment of simple endometrial hyperplasia.

  11. Observation of the curative effect of mifepristone combined with infertility caused left levonorgestrel releasing intrauterine system in acetone in treatment of adenomyosis%米非司酮联合左炔诺孕丙酮宫内缓释系统治疗子宫腺肌病导致不孕症疗效观察

    Institute of Scientific and Technical Information of China (English)

    施振娥

    2013-01-01

    目的:观察米非司酮联合左炔诺孕丙酮缓释系统(LNG-IUS)治疗子宫腺肌病导致不孕症的临床疗效。方法将本院2010年5月~2011年8月收治的子宫腺肌病导致的不孕症患者60例,随机分成治疗组和对照组两组。治疗组:予以米非司酮25mg,每日一次口服,连服3个月。并且所有患者均在签署知情同意书后自愿使用左炔孕丙酮宫内缓释系统。经彩超检查后,由专人于月经第3~7天在用药同时放置左炔诺孕丙酮宫内缓释系统。6个月后取出。对照组:单独给予米非司酮25mg,每日一次口服,连服3个月。观察停药后1、3、6、12个月的怀孕成功率。结果随访至12个月时统计,治疗组平均受孕率79%,对照组平均受孕率57%,治疗组总有效率明显高于对照组(P<0.05)。结论使用米非司酮联合左炔诺孕丙酮宫内缓释系统治疗子宫腺肌病可以明显提高患者的受孕率,对于子宫腺肌病导致的不孕症疗效好于其他方法,而且经济、安全,便于患者接受。%Objective To observe the curative effect of mifepristone combined with infertility caused left levonorgestrel releasing intrauterine system in acetone in treatment of adenomyosis. Methods 60 infertility patients in our hospital from 2010 May to 2011 August were adenomyosis in patients, randomly divided into treatment group and control group two groups.Treatment group was given mifepristone 25mg orally, once a day, and even served three months. And all the patients after informed consent voluntary use of levonorgestrel releasing intrauterine system in acetone, by color Doppler ultrasound examination, by hand in 3-7 days in the menstrual medication at the same time, place left levonorgestrel releasing intrauterine system in acetone, removed after 6 months. Control group was given mifepristone 25mg orally, once a day, and even served three months. The pregnancy, 3, 6, 1 and 12 months were

  12. Wandering intrauterine contraceptive device: An unusual travel to the sigmoid colon.

    Science.gov (United States)

    Kumarappan, A L; Karthikeyan, M; Gunaseelan, D; Ros'aini, P

    2015-10-01

    Intrauterine contraceptive device (IUCD) is common choice for contraception. Migration of IUCD is one of the complications that are encountered. Here we report a case of IUCD migration to the sigmoid colon. A 39-year-old Malay lady carrying a copper T type of IUCD presented with missing thread then underwent examination under anaesthesia, proceeded to hysteroscopy but failed removal. Abdominal ultrasound detected it in the left lower quadrant of abdomen. She then underwent diagnostic laparoscopy where the device was found to be embedded in the sigmoid colon. Technical difficulty necessitated conversion to mini laparotomy and sigmoidotomy to remove the IUCD and the bowel closed primarily. IUCD is a relatively simple and safe contraceptive procedure but possible complications are bleeding and pain that usually co-exist, pelvic infection, expulsion and perforation. Investigations should be based on clinical suspicion and migrated IUCD in symptomatic patients should be surgically removed whereas, asymptomatic patients can be managed conservatively under certain circumstances. However in the presence of a concurrent pathology that requires exploration then retrieval of the migrated IUCD should be undertaken.

  13. 左炔诺孕酮宫内缓释系统治疗子宫内膜单纯性增生过长的研究%Study of Levonorgestrel Intrauterine System in the Treatment of Simple Endometrial Hyperplasia

    Institute of Scientific and Technical Information of China (English)

    奚滕滕; 崔秀娟; 孙燕娜

    2014-01-01

    目的:探讨左炔诺孕酮宫内缓释系统(曼月乐)治疗子宫内膜单纯性增生过长的疗效及可能作用机制。方法:选取2011年11月—2012年2月门诊应用曼月乐治疗子宫内膜单纯性增生过长的患者60例,观察放置曼月乐6个月后的子宫内膜活检病理变化及经阴道超声测量子宫内膜厚度、子宫动脉血流[阻力指数(RI)、搏动指数(PI)]及月经模式的改变。结果:2例由于阴道持续性点滴出血提前取出,58例子宫内膜转归正常。放置曼月乐前后子宫内膜厚度、RI分别为(1.52±0.33) cm、(0.62±0.14)cm和0.64±0.07、0.79±0.08,差异均有统计学意义(P<0.05或P<0.01),PI分别为1.98±0.51、1.96±0.04,差异无统计学意义(P>0.05)。放置曼月乐后经量明显减少,24例表现为月经稀发,32例表现为闭经。结论:曼月乐是治疗子宫内膜单纯性增生过长的简单有效方法,对子宫动脉血流的影响是其可能的作用机制。%Objective:To study the efficancy and long possible mechanism of Mirena (levonorgestrel intrauterine system ) in the treatment of simple endometrial hyperplasia. Methods:Select sixty cases of simple endometrial hyperplasia in outpatient between 2011.11 and 2012.2,we observed the menstrual patterns,the endometrial thickness and uterine arterial blood flow [resistance index (RI),pulsatility index (PI)] by transvaginal ultrasound,pathologic changes of endometrial by endometrial biopsy in 6 months after insertion of mirena. Results:2 patients were removed Mirena due to colporrhagia. Pathological examinations of 58 patients performed 6 months after the insertion showed that endometrial hyperplasia had reversed. The endometrial thickness,RI of uterine artery in 6 months after the insertion were statistically significant,respectively (1.52±0.33) cm,(0.62±0.14) cm (P0.05). After placing Mirena significantly reduced by the amount,24 cases showed

  14. Effect of levonorgestrel releasing intrauterine system on endometrial polyp recurrence%左炔诺孕酮宫内缓释系统预防子宫内膜息肉术后复发的研究

    Institute of Scientific and Technical Information of China (English)

    蔡惠兰; 丁香翠; 钱蓉蓉; 虞如芬; 孙利敏; 李强

    2011-01-01

    Objective: To explore the clinical effect of a levonorgestrel intrauterine system ( LNG - IUS) on prevention of en-dometrial polyp recurrence after endometrial polyp resection by hysteroscopy. Methods: Three hundred and three women after endometrial polyp resection by hysteroscopy were randomly divided into two groups. Women in the treatment group (n = 152) had a LNG - IUS insertion immediately after hysteroscopy. There were 103 cases of solitary endometrial polyp and 49 cases of multiple endometrial polyps in the treatment group, and 111 cases of solitary endometrial polyp and 40 cases of multiple endometrial polyps in the control group. Women were followed up for 3 years. Results: No endometrial polyp recurrence were found in the treatment group. In the control group, the endometrial polyp recurrence was found in 31 women (20.5% ) , 17 cases of solitary endometrial polyp and 14 cases of multiple endometrial polyps. There was statistically significant difference in the incidence of endometrial polyp recurrence between the two groups (P<0. 05). No hypoestrogenic symptoms, acne, hirsutism, and abnormal liver and renal functions as well as lipid metabolism were found throughout the following - up period. Conclusion ; A LNG - IUS could prevent the endometrial polyp recurrence after hysteroscopy.%目的:探讨左炔诺孕酮宫内缓释系统( LNG - IUS)预防宫腔镜子宫内膜息肉切除术后复发的临床疗效.方法:采用前瞻性随机对照研究,将303例宫腔镜子宫内膜息肉切除术(TCRP)后妇女分为两组,治疗组152例,TCRP术后立即放置LNG - IUS,其中单发性息肉103例,多发性息肉49例;对照组151例,TCRP术后无任何处理措施,其中单发性息肉111例,多发性息肉40例,门诊随访3年.结果:治疗组中无一例复发,对照组中单发性息肉有17例复发,多发性息肉有14例复发,总复发率为20.5% (31/151),两组复发率差异有统计学意义(P<0.05).在随访期间,治疗组无一例患者出

  15. Clinical effects of Levonorgestrel-Releasing Intrauterine System in 98 women%98例左诀诺孕酮宫内缓释系统临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    刘田雨; 柯珮琪; 梁明懿; 耿慧珍; 黄佳明

    2014-01-01

    目的 探讨子宫内膜异位症、功能失调性子宫出血(功血)及单纯避孕妇女放置左诀诺孕酮宫内缓释系统(LNG-IUS)后的临床疗效.方法 随访我院计生门诊98例子宫内膜异位症、功血及单纯避孕患者,分别于放置LNG-IUS后3、6、12个月观察其月经、副反应及患者满意度情况;同时采用口诉评分(VRS)法对47例子宫内膜异位症患者痛经程度进行评估.结果 34例功血患者放环后3、6、12个月月经量较放环前减少,差异有统计学意义(P<0.001);47例子宫内膜异位症患者放环后3、6、12个月VRS评分较放环前减小,差异有统计学意义(P<0.001).治疗12个月,无一例发生妊娠,59例(64.9%,59/91)患者对治疗的综合效果表示非常满意或满意.结论 LNG-IUS是一种治疗子宫内膜异位症、功血及避孕的安全有效方法.%Objective To evaluate the safety and efficacy of levonorgestrel-releasing intrauterine system (LNG-IUS) for the women who are suffered from endometriosis (EM),dysfunctional uterine bleeding (DUB) or simply intended to contraception.Methods Ninety-eight cases of EM,DUB or simply intending contraception were enrolled from the Department of Family Planning Clinics.The primary endpoints were defined as controlling menstruation,side effects and satisfaction after placing LNG-IUS for 3,6 and 12 months.Meanwhile,the visual analogue scale (VAS) score was used to assess the degree of dysmenorrhea.Results For the 34 DUB patients,their menstrual quantity after placing LNGIUS for 3,6 and 12 months decreased significantly compared with the levels of their baseline(P<0.001).The VAS scores of the 47 EM patients of the baseline levels were significantly different from those of the follow-up levels (P<0.001).Overall,no woman was pregnant in cases of intended to contraception.And 59 women (64.9%,59/91) were very satisfied or satisfied with the one-year treatment.Conclusion LNG-IUS is a safe and efficient method for the

  16. A multicenter randomized clinical trial of one-rod etonogestrel and two-rod levonorgestrel contraceptive implants with nonrandomized copper-IUD controls: methodology and insertion data.

    Science.gov (United States)

    Meirik, Olav; Brache, Vivian; Orawan, Kiriwat; Habib, Ndema Abu; Schmidt, Johannes; Ortayli, Nuriye; Culwell, Kelly; Jackson, Emily; Ali, Moazzam

    2013-01-01

    Comparative data on etonogestrel and two-rod levonorgestrel contraceptive implants are lacking. A multicenter, open, parallel-group trial with random allocation of implants was performed. For every second implant user, an age-matched woman choosing an intrauterine device (IUD) (TCu380A) was admitted. Methods and data on implant/IUD insertion and 6-week follow-up are reported. A total of 2008 women were randomized to an implant, and 974 women were enrolled in the IUD group. Results from 997 etonogestrel implant users, 997 levonorgestrel implant users and 971 IUD users were analyzed. In the etonogestrel and levonorgestrel groups, respectively, mean insertion durations were 51 (SD 50.2) s and 88 (SD 60.8) s; complication rates at insertion were 0.8% and 0.2%; and at follow-up, 27.2% and 26.7% of women, respectively, had signs or symptoms at the insertion site. At follow-up within 6 weeks after insertion, all implants were in situ, while 2.1% of IUDs were expelled. Performance of etonogestrel and levonorgestrel implants at insertion and within the first 6 weeks is similar. Short-term (6 weeks) continuation rates appear higher for implants than TCu380A. Copyright © 2013 Elsevier Inc. All rights reserved.

  17. ACOG Committee Opinion no. 450: Increasing use of contraceptive implants and intrauterine devices to reduce unintended pregnancy.

    Science.gov (United States)

    2009-12-01

    High unintended pregnancy rates in the United States may in part be the result of relatively low use of long-acting reversible contraceptive (LARC) methods, specifically the contraceptive implant and intrauterine devices. Top-tier reversible methods share the characteristic of requiring a single act of motivation for long-term use, eliminating adherence and user-dependence from the effectiveness equation. According to the World Health Organization's evidence-based Medical Eligibility Criteria for contraceptive use, LARC methods have few contraindications, and almost all women are eligible for implants and intrauterine devices. Because of these advantages and the potential to reduce unintended pregnancy rates, LARC methods should be offered as first-line contraceptive methods and encouraged as options for most women. To increase use of LARC methods, barriers such as lack of health care provider knowledge or skills, low patient awareness, and high upfront costs must be addressed.

  18. Recurrent extended-spectrum beta-lactamase-producing Escherichia coli urinary tract infection due to an infected intrauterine device

    OpenAIRE

    2014-01-01

    The use of intrauterine devices (IUDs) have been widespread since the 1960s. In 2002, the World Health Organization estimated that approximately 160 million women worldwide use IUDs. However, IUDs are associated with short-term complications such as vaginal bleeding, pelvic discomfort, dyspareunia and pelvic infection. Herein, we report the case of a woman who had recurrent urinary tract infection (UTI) due to the use of an IUD, even after treatment. The patient developed four episodes of UTI...

  19. Performance of the polypropylene fiber tailstring on the Copper 7 intrauterine device.

    Science.gov (United States)

    Warner, M S; Matsuno, S J; Virgin, C J; Masterson, K B; Schneider, G A; Wright, T E; Robertson, C R; Fives-Taylor, P

    1991-01-01

    New and used polypropylene tailstrings from the Copper 7 (Cu-7) intrauterine device were examined by a combination of analytical techniques. Optical microscopy, scanning acoustic and electron microscopy, x-ray diffraction, energy dispersive x-ray analysis, and chemical etching were employed to elucidate both the surface and interior morphology of new Cu-7 tailstrings. Tailstrings removed from women following varying periods of use were investigated with optical microscopy, scanning and transmission electron microscopy. In addition, a subset of the used tailstrings were cultured to identify the types of microorganisms associated with them. Our findings show that unused Cu-7 tailstrings are in various stages of degradation owing to a combination of factors which include the high-draw ratio employed during manufacturing, the method of packaging, and the use of a particulate colourant. Furthermore, it is evident that used Cu-7 tailstrings undergo major deterioration while in situ because of the unfavorable interactions between the highly drawn polypropylene and the physiological environment. These results indicate that the polypropylene tailstrings as manufactured for use with the Cu-7 IUD fail to meet accepted design criteria for biomedical implants.

  20. [Infections associated with the use of indwelling urinary catheters. Infections related to intrauterine devices].

    Science.gov (United States)

    Pigrau, Carlos; Rodríguez-Pardo, M Dolores

    2008-05-01

    Hospital-acquired urinary tract infections (UTI) are mainly associated with indwelling urinary catheter use. In this chapter, the pathogenesis of hospital-acquired UTI in catheterized patients, the mechanisms by which microorganisms reach the urinary tract and are able to adhere and form biofilms, and the influence of other risk factors, such as time since catheter insertion and catheter composition, are reviewed. A wide variety of infecting microorganisms can affect patients with urinary catheters, making the choice of an adequate empirical antimicrobial course complex, particularly in cases of suspected multiresistant microorganisms. Moreover, the clinical symptoms are less characteristic in catheter infection and the diagnosis may be difficult. Treatment should be stratified according to the clinical features, which can vary from asymptomatic bacteriuria that may not require treatment, to severe septic episodes that need wide antibiotic coverage. The prevention measures for UTI in permanently catheterized patients are reviewed. Infections of the female genital tract associated with foreign bodies are mainly related to the use of intrauterine devices (IUDs). The epidemiology, microbiology profile, antimicrobial treatment, and prophylaxis of pelvic inflammatory disease related to IUD use in women are also reviewed.

  1. Intrauterine Devices and Reproductive Tract Infections: A Cross-sectional Study in Urban Slum

    Directory of Open Access Journals (Sweden)

    Poonam P Shingade, Naveen C Khargekar

    2015-01-01

    Full Text Available "Introduction: The concern that intrauterine devices (IUDs might cause or facilitate reproductive tract infection has limited its use. Objectives: The study aims to explore the relationship between reproductive tract infections & IUD use. Materials and Methods: A hospital based cross sectional study conducted in STI/RTI Clinic located in urban slums of Mumbai, involving total 169 married females of reproductive age group who presented with symptoms of RTI and using atleast one type of contraceptive method, who attended OPD from January to March 2012. Tool for interview was the questionnaire about sociodemographic profile, contraceptive practices, and symptoms of the participants. Disease specific laboratory methods were used to confirm diagnosis of RTI. Results: 47(27.81% females were using IUD as contraceptive method in this study. Proportion of the symptoms was more among IUD users than non IUD users. 33(70.2% had suffered from STI / RTI who were using IUDs as compared to 63 (51.6% non-IUD users showing statistically significant association. Conclusion: There is a statistically significant association between use of IUD and RTI. "

  2. Determinants of Method Switching among Social Franchise Clients Who Discontinued the Use of Intrauterine Contraceptive Device.

    Science.gov (United States)

    Hameed, Waqas; Azmat, Syed Khurram; Ali, Moazzam; Hussain, Wajahat; Mustafa, Ghulam; Ishaque, Muhammad; Ali, Safdar; Ahmed, Aftab; Temmerman, Marleen

    2015-01-01

    Introduction. Women who do not switch to alternate methods after contraceptive discontinuation, for reasons other than the desire to get pregnant or not needing it, are at obvious risk for unplanned pregnancies or unwanted births. This paper examines the factors that influence women to switch from Intrauterine Contraceptive Device (IUCD) to other methods instead of terminating contraceptive usage altogether. Methods. The data used for this study comes from a larger cross-sectional survey conducted in nine (9) randomly selected districts of Sindh and Punjab provinces of Pakistan, during January 2011. Using Stata 11.2, we analyzed data on 333 women, who reported the removal of IUCDs due to reasons other than the desire to get pregnant. Results. We found that 39.9% of the women do not switch to another method of contraception within one month after IUCD discontinuation. Use of contraception before IUCD insertion increases the odds for method switching by 2.26 times after removal. Similarly, postremoval follow-up by community health worker doubles (OR = 2.0) the chances of method switching. Compared with women who received free IUCD service (via voucher scheme), the method switching is 2.01 times higher among women who had paid for IUCD insertion. Conclusion. To increase the likelihood of method switching among IUCD discontinuers this study emphasizes the need for postremoval client counseling, follow-up by healthcare provider, improved choices to a wider range of contraceptives for poor clients, and user satisfaction.

  3. Intrauterine device knowledge and practices: a national survey of obstetrics and gynecology residents.

    Science.gov (United States)

    Tang, Jennifer; Maurer, Rie; Bartz, Deborah

    2013-09-01

    The primary objective of this study was to assess the current intrauterine device (IUD) knowledge and counseling practices of US obstetrics and gynecology chief residents. The secondary objective was to evaluate the current IUD experience of obstetrics and gynecology residents. A Web-based survey about IUD knowledge and practices was sent to US obstetrics and gynecology residents in January 2010. An analysis of responses by postgraduate year was completed using descriptive statistics. We received 699 surveys (36%) from a pool of 1922 residents in 96 different residency programs. A total of 654 respondents (94%) had placed an IUD during residency and 88% had received formal teaching about IUDs during residency. Only 53% of respondents knew that the copper IUD could be used for emergency contraception. Less than 65% of respondents would routinely recommend the IUD to adolescents or immediately after first trimester abortion. Many US obstetrics and gynecology residents lack knowledge about IUD benefits and do not counsel all eligible women to use IUDs. We should continue to evaluate our training and educational programs to ensure that women's health providers do not act as a barrier to IUD use.

  4. Uptake and continuous use of copper intrauterine device in a cohort of HIV-positive women.

    Science.gov (United States)

    Landolt, Nadia Kancheva; Phanuphak, Nittaya; Teeratakulpisarn, Nipat; Kriengsinyot, Rosalin; Ahluwalia, Jennisa; Pinyakorn, Suteeraporn; Chaithongwongwatthana, Surasith; Ananworanich, Jintanat

    2013-01-01

    Copper intrauterine device (IUD) is not commonly used in many countries, though it provides effective reversible contraception with no or minimal primary systemic side effects. We assessed its uptake and continuation of use among HIV-positive Thai women. Sixty-six of 322 women of reproductive age, whom we approached for the study, met the eligibility criteria. Sterilization (62%) was the main reason for failure to enroll. Twenty-nine of them (44%) underwent IUD insertion. Considering condom use sufficient for pregnancy prevention (12%) was the main reason among eligible women for the refusal to participate in the study. At six months, 54% of enrolled participants reported one or more side effects such as increased menstrual flow (43%), spotting (21%) and dysmenorrhea (11%). The continuation rate of IUD use was high (93%), in spite of the persistent non-systemic side effects. The study showed that copper IUD could be an acceptable contraceptive choice for Thai HIV-positive women. Easy access to the method in a setting linked with the HIV service, and education on IUD risks and benefits is needed to promote the use of IUD in addition to condoms as an effective contraceptive option in HIV-infected women.

  5. Determinants of Method Switching among Social Franchise Clients Who Discontinued the Use of Intrauterine Contraceptive Device

    Science.gov (United States)

    Hameed, Waqas; Azmat, Syed Khurram; Ali, Moazzam; Hussain, Wajahat; Mustafa, Ghulam; Ishaque, Muhammad; Ali, Safdar; Ahmed, Aftab; Temmerman, Marleen

    2015-01-01

    Introduction. Women who do not switch to alternate methods after contraceptive discontinuation, for reasons other than the desire to get pregnant or not needing it, are at obvious risk for unplanned pregnancies or unwanted births. This paper examines the factors that influence women to switch from Intrauterine Contraceptive Device (IUCD) to other methods instead of terminating contraceptive usage altogether. Methods. The data used for this study comes from a larger cross-sectional survey conducted in nine (9) randomly selected districts of Sindh and Punjab provinces of Pakistan, during January 2011. Using Stata 11.2, we analyzed data on 333 women, who reported the removal of IUCDs due to reasons other than the desire to get pregnant. Results. We found that 39.9% of the women do not switch to another method of contraception within one month after IUCD discontinuation. Use of contraception before IUCD insertion increases the odds for method switching by 2.26 times after removal. Similarly, postremoval follow-up by community health worker doubles (OR = 2.0) the chances of method switching. Compared with women who received free IUCD service (via voucher scheme), the method switching is 2.01 times higher among women who had paid for IUCD insertion. Conclusion. To increase the likelihood of method switching among IUCD discontinuers this study emphasizes the need for postremoval client counseling, follow-up by healthcare provider, improved choices to a wider range of contraceptives for poor clients, and user satisfaction. PMID:26576454

  6. Clinical Comparative Study of GyneFix IN and ML Cu375 Intrauterine Devices

    Institute of Scientific and Technical Information of China (English)

    窦金铃; 张颖; 张春云; 辛秀芳; 王吉英; 王荣梅; 王佩贞

    2001-01-01

    Objective To observe the effectiveness and side effects of GyneFix IN intrauterine device (IUD) in clinical useMaterials & methods The present study is a randomized clinical control trial, 1 956healthy parous women were randomly allocated into GyneFix IN group (n= 980) and ML Cu375 group (n= 976). Follow-up was arranged at 1, 3, 6 and 12 months after insertion. The discontinuation rates were calculated by using life table method.Results At the end of the first year, the pregnancy rate with IUDs and expulsion rate were 0. 4% and 2. 3% respectively in GyneFix IN group. It was the same as in ML Cu375 group (0. 4%, 2. 0%, P> 0. 05). The removal rate for medical reasons and the use-related discontinuation rate were 0. 4% and 3.1% respectively in GyneFix IN group, which were significantly lower than that in ML Cu375 group (1. 5%,4. 2%, P< 0. 01).Conclusion GyneFix IN IUD has high effectiveness, low expulsion rate and can significantly reduce the occurrence of side effects of bleeding and pain.

  7. Group B-beta haemolytic streptococcal colonization in women using intrauterine contraceptive devices.

    Science.gov (United States)

    Farrag, O A; Gawad, A A; Antar, S

    1985-06-01

    Two-hundred-and-eighteen gynaecological patients were screened for group B-beta haemolytic streptococci (GBS) colonization of the vagina, cervix, urethra and rectum. The overall colonization rate was 17%. There is no relation between the rate of colonization and the patient's age or parity. The colonization rate among the intrauterine contraceptive device (IUCD) users (31%) is significantly higher than the non-users (14.5%). The IUCD does not cause GBS vaginal colonization. Nevertheless, its presence helps the microorganisms' vertical spread through the cervical canal. The short duration of IUCD use among the Saudi patients may have provided a protective mechanisms against the development of PID. All the four sites were colonized in the IUCD users and only in 8.1% of the non-users. The urethra was the most common site involved in both groups (83.8%). A higher incidence of GBS colonization was found among patients presenting with excessive vaginal discharge as the main complaint. The presence of excessive vaginal discharge is a significant factor towards the spread of the microorganism to the cervix and urethra. Therefore, an IUCD user with excessive vaginal discharge has a higher chance of getting cervical and urethral colonization.

  8. Hip prosthesis infection related to an unchecked intrauterine contraceptive device: a case report.

    Science.gov (United States)

    Ducharne, G; Girard, J; Pasquier, G; Migaud, H; Senneville, E

    2013-02-01

    Intrauterine devices (IUD) used for contraception can be the source of local infections or can migrate, which justifies regular checking recommendations and limitations around the implantation period. To our knowledge, bone and joint infections related to an infected IUD have not been described in the scientific literature. This paper reports on a case of the repeated infection of a total hip prosthesis related to an infected IUD that had been forgotten after being implanted 34years previously. The arthroplasty infection revealed itself through dislocation of a dual mobility cup. Commensal bacteria that colonize the female genital tract (Streptococcus agalactiae) were identified at the site of hip arthroplasty. This led to the discovery of the IUD that was infected by the same bacterium. Despite lavage of the non-loosened arthroplasty, removal of the IUD and 2months of antibiotic treatment, the dislocation recurred and the prosthesis was again infected with the same microorganism 4months later. This recurrence of the infection, with persistence of a uterine abscess containing the same bacterium, was treated with repeated lavage of the joint, total hysterectomy and antibiotics treatment. The infection had resolved when followed-up 3years later. The occurrence of a bone and joint infection with this type of bacterium should trigger the evaluation of a possible IUD infection.

  9. Tuboovarian abscess mimicking intraligamentar uterine myoma and a intrauterine device: a case report.

    Science.gov (United States)

    Habek, D; Has, B; Habek, J Cerkez

    2005-09-01

    A case study is presented of tubo-ovarian abscess (pathohystological-verified actinomycosis) in a 41-year-old woman with an intrauterine device (IUD), which on US was found to be imposed upon an intraligamentary degenerated myoma (pyomyoma). The patient was afebrile, with normal vital functions (diuresis, blood pressure and pulse). Exposure of the abdominal cavity by lower transverse laparotomy performed under general endotracheal anaesthesia revealed slight uterus enlargement with normal left adnexa, whereas right adnexa were not exposed due to the soft tumour in the region of the right ligamentum latum, which displaced the urinary bladder and uterus leftward. The peritoneum fold was incised and deprepared, revealing a tumorous formation imposed onto the myoma or onto the 'cold' tubo-ovarian abscess. Total hysterectomy was then performed. Left adnexa showed a normal finding. Hemalaun-eosin staining of the preparation of the tumour capsule and tumour content showed colonies of threads extending radially to the surrounding tissues (drusen), surrounded by pus corpuscles, polymorphonuclears and macrophages containing lipids (sulfur granules). The patient was free from disease relapse at 2 years after the procedure. Thus, total abdominal hysterectomy and salpingoophorectomy, along with antibiotic therapy, were the definite mode of treatment for pelvic actinomycosis.

  10. Factors associated with actinomyces-like organisms on Papanicolaou smear in users of intrauterine contraceptive devices.

    Science.gov (United States)

    Petitti, D B; Yamamoto, D; Morgenstern, N

    1983-02-01

    To determine the factors associated with the presence of actinomyces-like organisms on cervicovaginal Papanicolaou smears in users of the intrauterine contraceptive device (IUD), we carried out a case-control study. Among about 80,000 Papanicolaou smears examined in one year in a large cytology laboratory, actinomyces-like organisms were identified on 107 smears; all but three smears were from IUD users. Compared with IUD users who did not have actinomyces-like organisms on Papanicolaou smears, those with actinomyces-like organisms had used the IUD for more years. An increased risk of actinomyces-like organisms on Papanicolaou smear was not apparent until 7 years of IUD use, however. No significant association of actinomyces-like organisms with the type of IUD was found after controlling for differences in duration of use between users of various IUDs. The percentage of women reporting gynecologic symptoms (vaginal discharge, pelvic pain, abnormal bleeding) also did not differ significantly between IUD users with and without actinomyces-like organisms on Papanicolaou smear (p = 0.5).

  11. Clinic observation of a levonorgestrel-releasing intrauterine system inserted immediately after artificial abortion%人工流产后即时放置曼月乐的临床观察

    Institute of Scientific and Technical Information of China (English)

    陈静; 王娴静; 梁艳; 金勤

    2011-01-01

    Objective To compare the contraceptive efficacies and side effects of Mirena (levonorgestrel-releasing intrauterine system,LNG-IUS)inserted immediately after artificial abortion and in the period of regular menstruation.Methods A total of 166 female subjects volunteered for the insertion of LNG-IUS.They were divided into 2 groups.Eighty-six female subjects inserted right after artificial abortion were selected as the observation group and 80 female subjects inserted during the period of regular menstruation as the control group.Follow-up was performed at one year after insertion.Contraceptive efficacies and side effects were compared between two groups.Results No pregnancy was found in both groups.No mirena expulsion occurred in neither groups.The continuation rates were 100% and 95% in the observation and control groups respectively(P >0.05).The rates of abnormal hemorrhage were 27.5% and 36.2% in observation and control groups respectively during the first three months(P <0.05).And 22.7% and 23.3% subjects suffered amenorrhea respectively in the first year.No significant difference was found in such side effects as amenorrhea,weight gain,acne and swollen breasts between two groups(P > 0.05).Conclusion Mirena is proved to be an excellent choice for contraception after artificial abortion.Secondary intrauterine surgery may be avoided.And its insertions immediately after artificial abortion or during the period of regular menstruation share the same efficacies.%目的 观察早孕人工流产后即时放置与月经后期放置左炔诺孕酮宫内缓释系统(曼月乐)的避孕效果、不良反应比较.方法 166例自愿选择放置曼月乐的已生育女性,分人工流产术后即时放置组(观察组)86例和月经后期放置组(对照组)80例,随访12个月,对其避孕效果、续用率及不良反应进行观察比较.结果 观察组与对照组的妊娠率均为0,脱环率均为0,续用率分别为100%、95%,两组比

  12. An observation of effect of levonorgestrel-releasing intrauterine system for inhibiting recurrence of endometriosis focus after resecting ovarian endometrial implantation cyst%卵巢子宫内膜异位囊肿剥除术后放置曼月乐的观察

    Institute of Scientific and Technical Information of China (English)

    林素霞; 何华

    2011-01-01

    目的 探讨卵巢子宫内膜异位囊肿行剥除术后放置左炔诺孕酮宫内缓释系统抑制病灶复发的有效性.方法 回顾性地分析46例卵巢子宫内膜异位囊肿患者行腹腔镜剥除术后放置左炔诺孕酮宫内缓释系统对卵巢子宫内膜异位囊肿复发的控制情况,并完成2年至2年11个月的随访,观察复发情况.随机对照同期住院行腹腔镜卵巢子宫内膜异位囊肿剥除术,且术后予口服孕三烯酮治疗6个月的患者38例.结果 随访发现5例复发,复发率为10.87%;对照组复发11例,复发率为28.95%.两组复发率比较差异有统计学意义(χ2=4.41,P<0.05).结论 左炔诺孕酮宫内缓释系统作为卵巢子宫内膜异位囊肿剥除术术后针对控制复发的后续治疗,相比较传统以孕三烯酮为代表的全身激素抑制治疗,其远期观察具有较好地控制复发的结果.%Objective To observe effect of placement of levonorgestrel-releasing intrauterine system for inhibiting recurrence of endometriosis focus after resecting ovarian endometrial implantation cyst. Methods The recurrence control situations of 46 women with ovarian endometrial implantation cyst who received laparoscopic cystectomy after placing levonorgestrel-releasing intrauterine system in a period from Oct. , 2007 to Sep. , 2008 in Quanzhou Municipal Maternal and Child Health of Fujian Province were retrospectively analyzed.All 46 patients were followed-up for 24 months to 35 months to observe their recurrence situations ( observation group). The therapeutic effects of 46 patients were compared with those of 38 women with ovarian endometrial cyst who were given orally gestrinone for 6 months after cystectomy (control group). Results 5 of 46 patients with ovarian endometrial implantation cyst who were placed levonorgestrelreleasing intrauterine system recurred after laparoscopic cystectomy, the recurrence rate was 10.87% at follow-up after 24 months to 35 months. In the control group

  13. Comparing the Effect of Mefenamic Acid and Vitex Agnus on Intrauterine Device Induced Bleeding

    Directory of Open Access Journals (Sweden)

    Parisa Yavarikia

    2013-08-01

    Full Text Available Introduction: Increased bleeding is the most common cause of intrauterine device (IUD removal. The use of alternative therapies to treat bleeding has increased due to the complications of medications. But most alternative therapies are not accepted by women. Therefore, conducting studies to find the right treatment with fewer complications and being acceptable is necessary. This study aimed to compare the effect of mefenamic acid and vitex agnus castus on IUD induced bleeding.Methods: This was a double blinded randomized controlled clinical trial. It was conducted on 84 women with random allocation in to two groups of 42 treated with mefenamic acid and vitex agnus capsules taking three times a day during menstruation for four months. Data were collected by demographic questionnaire and Higham 5 stage chart (1 month before the treatment and 4 months during the treatment., Paired t-test, independent t-test, chi-square test, analysis of variance (ANOVA with repeated measurements, and SPSS software were used to determine the results.Results: Mefenamic acid and vitex agnus significantly decreased bleeding. This decrease in month 4 was 52% in the mefenamic acid group and 47.6% in the vitex agnus group. The mean bleeding score changes was statistically significant between the two groups in the first three months and before the intervention. In the mefenamic acid group, the decreased bleeding was significantly more than the vitex agnus group. However, during the 4th month, the mean change was not statistically significant. Conclusion: Mefenamic acid and vitex agnus were both effective on IUD induced bleeding; however, mefenamic acid was more effective.

  14. Inhaled Lavender Effect on Anxiety and Pain Caused From Intrauterine Device Insertion

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    Mahnaz Shahnazi

    2012-11-01

    Full Text Available Introduction: Intrauterine device (IUD is the most common reliable, effective and reversible contraceptive method used worldwide and in areas with high growth rate is of particular importance. IUD insertion is associated with high anxiety in most people that causes pain and discomfort. The aim of this study was to determine the effects of aromatherapy on anxiety and pain caused by IUD insertion. Methods: This study was conducted on 106 women in a health care center located in Ardebil, Iran. Participants were divided into two groups by randomized blocks of 4 and 6. In the experimental group lavender scent was inhaled and in the control group the placebo was inhaled 30 minutes before IUD insertion. The anxiety of the participants was measured by Spielberger questionnaire, and the pain of IUD insertion was measured immediately after the insertion using visual analog scale (range 0-10. Results: The mean score (standard deviation of anxiety before intervention was 43.2 (9.2 in the experimental group that decreased after intervention to 39.0 (10.5 (p < 0.001, while this score was 42.2 (9.0 and 41.5 (8.4 before and after the intervention in the control group (p = 0.21. Mean differences of anxiety in both groups was statistically significant (p < 0.001. The pain score after intervention did not show significant difference between two groups (p = 0.51. Conclusion: Aromatherapy with lavender inhalation was effective in decreasing anxiety in IUD procedure, and this method can be used in health care centers as complementary treatments.

  15. Influences on women's decision making about intrauterine device use in Madagascar.

    Science.gov (United States)

    Gottert, Ann; Jacquin, Karin; Rahaivondrafahitra, Bakoly; Moracco, Kathryn; Maman, Suzanne

    2015-04-01

    We explored influences on decision making about intrauterine device (IUD) use among women in the Women's Health Project (WHP), managed by Population Services International in Madagascar. We conducted six small group photonarrative discussions (n=18 individuals) and 12 individual in-depth interviews with women who were IUD users and nonusers. All participants had had contact with WHP counselors in three sites in Madagascar. Data analysis involved creating summaries of each transcript, coding in Atlas.ti and then synthesizing findings in a conceptual model. We identified three stages of women's decision making about IUD use, and specific forms of social support that seemed helpful at each stage. During the first stage, receiving correct information from a trusted source such as a counselor conveys IUD benefits and corrects misinformation, but lingering fears about the method often appeared to delay method adoption among interested women. During the second stage, hearing testimony from satisfied users and receiving ongoing emotional support appeared to help alleviate these fears. During the third stage, accompaniment by a counselor or peer seemed to help some women gain confidence to go to the clinic to receive the IUD. Identifying and supplying the types of social support women find helpful at different stages of the decision-making process could help program managers better respond to women's staged decision-making process about IUD use. This qualitative study suggests that women in Madagascar perceive multiple IUD benefits but also fear the method even after misinformation is corrected, leading to a staged decision-making process about IUD use. Programs should identify and supply the types of social support that women find helpful at each stage of decision making. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Motivations for Interest, Disinterest and Uncertainty in Intrauterine Device Use Among Young Women.

    Science.gov (United States)

    Gomez, Anu Manchikanti; Freihart, Bridget

    2017-06-19

    Objective To elucidate salient contraceptive preferences and priorities as they relate to young women's interest or lack thereof in intrauterine device (IUD) use. Methods Qualitative data were drawn from a 2012 survey on contraceptive preferences and IUD interest. Among 413 young (ages 18-29) women, open-ended responses describing reasons for interest, disinterest or uncertainty in future IUD use were examined using a thematic analysis approach. Results Most participants were unsure about (49.2%) or not interested in (30.0%) future IUD use. Themes regarding IUD interest related to specific facets of IUD use (e.g., risks and side effects, ease of use), as well as broader influences on contraceptive decision-making (e.g., social influences, alignment with pregnancy intentions). For interested participants, a sense of empowerment pervaded the responses, with many references to the ease of use and lack of requisite maintenance. Uninterested participants were concerned about the internal nature of the IUD, with many describing "horror stories" and fears that the IUD would cause injury or infertility. Unsure participants provided more detailed and complex responses, carefully weighing the advantages and disadvantages of IUD use. Uncertainty was often driven by an acknowledged need for specific information, rather than overall lack of knowledge. Conclusions for Practice In this analysis, many women had a clear sense of their contraceptive preferences, which frequently did not align with IUDs. While continuing to remove barriers to IUD access is critical, patient-centered counseling approaches offer the opportunity to support women in best matching with a method that aligns with their preferences.

  17. Patient knowledge and intension to use the intrauterine contraceptive device (IUCD at a tertiary level hospital.

    Directory of Open Access Journals (Sweden)

    Nadia van der Westhuizen

    2016-11-01

    Full Text Available Background: The intrauterine device (IUCD is a highly effective and safe method of contraception. Prevention of unwanted pregnancies has made its use a matter of national priority in certain countries.Despite numerous advantages and suitability the uptake of the IUCD is poor. Patients in South Africa seem to lack knowledge regarding this contraceptive. Objectives: The aim of this study was to determine the quantity and quality of knowledge of the IUCD, and to evaluate its acceptability for future use. Methods: A prospective cross-sectional study was conducted at Pelonomi Tertiary Hospital. 201 consecutive patients were interviewed using structured questionnaires. Results: Awareness of the IUCD was found in almost half (49%, n=95 of our patients. Its use was very low, with only one patient having used it before. Overall qualitative knowledge was poor, even among those that were aware of the IUCD. There was a significant association between level of education and knowledge, with patients having passed Grade 12 or higher significantly more likely to have knowledge of the IUCD than those at lower levels (RR 1.57, 95% CI 1.18-2.08. Forty-five percent (n=86 of patients indicated a desire for future IUCD use. Conclusion: Despite the availability of the IUCD in South African clinics and hospitals, its uptake is still poor. Awareness of this method seemed to have improved over the past few years, but the qualitative knowledge still lacks considerably. Education plays a major role in the knowledge of contraception and better educational aids in all facilities will increase its use and reduce unwanted pregnancies.

  18. Is There Any Impact of Copper Intrauterine Device on Female Sexual Functioning?

    Science.gov (United States)

    Deveer, Ruya; Akin, Melike Nur; Gurbuz, Ali Sami; Kasap, Burcu; Guvey, Huri

    2016-01-01

    Introduction Intrauterine Device (IUD) is the most preferred modern contraceptive method in Turkey. Female Sexual Dysfunction (FSD) is defined as lack of one or more of the components in the sexual response cycle which includes sexual desire, impaired arousal and inability achieving an orgasm or pain with intercourse. FSD has multi-factorial aetiology. Advanced age and menopause, fatigue and stress, psychiatric and neurologic disease, childbirth, pelvic floor or bladder dysfunction, endometriosis, uterine fibroids, hypertension obesity, medication and substances, hormonal contraceptives, relationship factors are known risk factors for FSD. Aim To investigate if IUD has any impact on female sexual functioning. Materials and Methods In this cross-sectional study subjects were divided into two groups. Study group consisted of 92 IUD-users (mean 5.1±1.2 years) and the control group consisted of 83 women with no contraception. Female Sexual Function Index (FSFI) questionnaire was performed to both two groups. Women with a total score lower than 26.5 were considered as having sexual dysfunction. Results The prevalence of FSD was 57.1% among participants. IUD users had a lower total FSFI score comparing to control group but the difference was not statistically different (p=0.983). A positive correlation was found between total FSFI score and duration of IUD (p=0.003). Conclusion No difference was found in terms of sexual dysfunction between IUD users and women with no contraception. The prevalence of FSD was very high in both groups which may be attributed to the socio-cultural factors such as embarrassment of women due to conservatism. PMID:27891404

  19. Lack of Association between Cu T-380A Intrauterine Device and Secondary Infertility in Iran

    Science.gov (United States)

    Abdinasab, Mahnaz; Dehghani Firouzabadi, Razieh; Farajkhoda, Tahmineh; Abdoli, Ali Mohammad

    2017-01-01

    Background The appropriate choice of a contraceptive method has been a major issue in reproductive health research. Cu T intrauterine device (Cu T IUD) has been introduced as one of the most effective contraceptive methods in the world, however, the relationship between prior use of Cu T IUD and secondary infertility has not been evaluated in Iran. To examine the association of Cu T-380A IUD and secondary infertility in Iran. Materials and Methods A retrospective cohort study was conducted from December 2010 to September 2011 in the Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. A total of 750 married women (15-49 years old) with at least one parity, whom were referred to four educational healthcare centers of Shahid Sadoughi University of Medical Sciences, were selected as participants. They were divided into two groups (case and control) based on previous history of using Cu T-380A IUD. Data were gathered using a standard reliable questionnaire along with a face-to-face interview and were analyzed with descriptive and analytical (χ²) tests. Results Mean period of Cu T-380A IUD usage in the case group was 57.46 ± 47.74 months and mean time length from Cu T-380A IUD removal to pregnancy was 14.87 ± 5.18 months in this group. We observed no relationship between the use of Cu T-380A IUD and frequency of secondary infertility (3.5% in the case group versus 2.7% in the control group, P=0.52). Conclusion Given the relatively large sample size studied here, it is unlikely that Cu T-380A IUD results in secondary infertility and may be used by Iranian women as a safe contraceptive method. PMID:28042414

  20. Lack of Association between Cu T-380A Intrauterine Device and Secondary Infertility in Iran

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    Mahnaz Abdinasab

    2016-11-01

    Full Text Available Background: The appropriate choice of a contraceptive method has been a major issue in reproductive health research. Cu T intrauterine device (Cu T IUD has been introduced as one of the most effective contraceptive methods in the world, however, the relationship between prior use of Cu T IUD and secondary infertility has not been evaluated in Iran. To examine the association of Cu T-380A IUD and secondary infertility in Iran. Materials and Methods: A retrospective cohort study was conducted from December 2010 to September 2011 in the Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. A total of 750 married women (15-49 years old with at least one parity, whom were referred to four educational healthcare centers of Shahid Sadoughi University of Medical Sciences, were selected as participants. They were divided into two groups (case and control based on previous history of using Cu T-380A IUD. Data were gathered using a standard reliable questionnaire along with a face-to-face interview and were analyzed with descriptive and analytical (χ² tests. Results: Mean period of Cu T-380A IUD usage in the case group was 57.46 ± 47.74 months and mean time length from Cu T-380A IUD removal to pregnancy was 14.87 ± 5.18 months in this group. We observed no relationship between the use of Cu T-380A IUD and frequency of secondary infertility (3.5% in the case group versus 2.7% in the control group, P=0.52. Conclusion: Given the relatively large sample size studied here, it is unlikely that Cu T-380A IUD results in secondary infertility and may be used by Iranian women as a safe contraceptive method.

  1. Primary tubal infertility in relation to the use of an intrauterine device.

    Science.gov (United States)

    Daling, J R; Weiss, N S; Metch, B J; Chow, W H; Soderstrom, R M; Moore, D E; Spadoni, L R; Stadel, B V

    1985-04-11

    Women who use an intrauterine device (IUD) are at increased risk of acute pelvic inflammatory disease, but the relation of the IUD to subsequent infertility is not established. We interviewed 159 nulligravid women with tubal infertility to determine their prior use of an IUD. Their responses were compared with those of a matched group who conceived their first child at the time the infertile women started trying to become pregnant. The risk of primary tubal infertility in women who had ever used an IUD was 2.6 times that in women who had never used one (95 per cent confidence interval, 1.3 to 5.2). The observed difference between cases and controls was not uniform for different types of IUD. The relative risk associated with use of a Dalkon Shield was 6.8 (1.8 to 25.2), and that associated with use of either a Lippes Loop or Saf-T Coil IUD was 3.2 (0.9 to 12.0). The smallest elevation in risk was found among users of copper-containing IUDs (relative risk, 1.9 [0.9 to 4.0] for all women who had ever used a copper-containing IUD). The relative risk for women who used only a copper-containing IUD was 1.3 (0.6 to 3.0). We conclude that use of the Dalkon Shield (and possibly of plastic IUDs other than those that contain copper) can lead to infertility in nulligravid women.

  2. Intrauterine Device Placement During Cesarean Delivery and Continued Use 6 Months Postpartum: A Randomized Controlled Trial

    Science.gov (United States)

    Levi, Erika E; Stuart, Gretchen S; Zerden, Matthew L; Garrett, Joanne M; Bryant, Amy G

    2017-01-01

    Objective To compare intrauterine device (IUD) use at 6 months postpartum among women who underwent intracesarean delivery (during cesarean delivery) IUD placement versus women who planned for interval IUD placement 6 or more weeks postpartum. Methods In this non-blinded randomized trial women who were undergoing a cesarean and desired an IUD were randomized to intracesarean cesarean delivery or interval IUD placement. The primary outcome was IUD use at 6 months postpartum. A sample size of 112 (56 in each group) was planned to detect a 15% difference in IUD use at 6 months postpartum between groups. Results From March 2012 to June 2014, 172 women were screened and 112 women were randomized into the trial. Baseline characteristics were similar between groups. Data regarding IUD use at 6 months postpartum was available for 98 women, 48 and 50 women in the intracesarean and interval groups, respectively. A larger proportion of the women in the intracesarean group were using an IUD at 6 months postpartum ((40/48), 83%) compared to those in the interval group ((32/50) 64%, relative risk [RR]=1.3, 95% confidence interval [CI]: 1.02, 1.66). Among the 56 women randomized to interval IUD insertion, 22 (39%) of them never received an IUD; 14 (25%) never returned for IUD placement, five (9%) women declined an IUD, and three (5%) had a failed IUD placement. Conclusion IUD placement at the time of cesarean delivery leads to a higher proportion of IUD use at 6 months postpartum when compared to interval IUD placement. PMID:26241250

  3. Self-Administered Lidocaine Gel for Intrauterine Device Insertion in Nulliparous Women: A Randomized Controlled Trial.

    Science.gov (United States)

    Rapkin, Rachel B; Achilles, Sharon L; Schwarz, E Bimla; Meyn, Leslie; Cremer, Miriam; Boraas, Christy M; Chen, Beatrice A

    2016-09-01

    To evaluate self-administration of vaginal lidocaine gel to decrease pain with intrauterine device (IUD) insertion in nulliparous women. In this randomized, double-blind, placebo-controlled trial, women self-administered 2% lidocaine or placebo vaginal gel 5 minutes before IUD insertion. The primary outcome was change in pain from baseline to IUD insertion on a 100-mm visual analog scale. We also assessed pain after speculum insertion, tenaculum placement, uterine sounding, and 5 minutes after IUD insertion. Secondary outcomes included patient acceptability, ease of IUD insertion, and need for pain medication for up to 7 days. From July 2012 to May 2013, 59 women were randomized; 30 received lidocaine gel and 29 placebo. Baseline demographics, including age, race, and body mass index, were similar. There was no difference in median change in pain during IUD insertion in women receiving lidocaine (61 mm [interquartile range 53-71]) compared with placebo (69 mm [interquartile range 63-80], P=.06). Women receiving lidocaine experienced less pain with tenaculum placement (32 mm [interquartile range 18-54]) compared with placebo (56 mm [interquartile range 26-75], P=.02). Most (76%) women were satisfied with their IUD insertion experience and 86% would probably or definitely recommend an IUD to a friend. Thirty-four percent of women required pain medication for at least 3 days after IUD insertion. For nulliparous women, self-administered vaginal lidocaine gel does not reduce pain with IUD insertion, but does decrease pain with tenaculum placement. ClinicalTrials.gov, http://clinicaltrials.gov, NCT01534520.

  4. Application Comparison of Uterine Cavity Fixed Intrauterine Device and Traditional Intrauterine Device%宫腔固定式节育器与传统节育器的使用比较

    Institute of Scientific and Technical Information of China (English)

    周峰

    2016-01-01

    Objective To discuss the effect of uterine cavity fixed intrauterine device and traditional intrauterine device. Methods 80 cases of women of childbearing age with intrauterine device placed in our hospital from June 2014 to June 2015 were selected and divided into two groups according to different IUDs, the control group adopted traditional intrauterine device, the experimental group adopted uterine cavity fixed intrauterine device, and the contraception effective rate and adverse reactions of the two groups were observed. Results The operation time and lochia duration time in the observation group were respectively (35.82±11.32) min and (3.22±1.42) d, which were better than those in the control group, and the comparisons between groups had statistical significance(P<0.05), the contraception effective rate in the experimental group was obviously higher than that in the control group (P<0.05), and the difference was obvious, at the same time, the contraception failed, so, the removal rate was obviously lower than that in the control group(P<0.05), and the difference was obvious, the total incidence rate of adverse reactions during the application of IUD in the experimental group was obviously lower than that in the control group, and the difference was obvious (P<0.05). Conclusion The contraception effect of fixed intrauterine device is obvious with few adverse reactions after application, which is an effective and safe contraception method for women of childbearing age, and it is worth promotion.%目的:探讨传统节育器与宫腔固定式节育器的效果。方法选取80例于2014年6月—2015年6月期间在该院放置节育器的育龄妇女,根据IUD的不同分对照组与实验组,分别采取传统节育器及宫腔固定式节育器,观察两组避孕有效率及不良反应。结果观察组手术时间为(35.82±11.32)min、恶露持续时间(3.22±1.42)d均优于对照组,组间对比,差异有统计学意义(P<0.05);实验组

  5. The Intrauterine Device in Women with Diabetes Mellitus Type I and II: A Systematic Review.

    Science.gov (United States)

    Goldstuck, Norman D; Steyn, Petrus S

    2013-12-11

    Background. Women with diabetes mellitus type I and type II need effective contraception for personal and medical reasons. Long acting reversible contraceptive (LARC) methods are among the most efficient and cost-effective methods. Study Design. We searched the Popline, PubMed, and clinicaltrials.gov databases from 1961 to March 2013 for studies on the efficacy of the IUD in diabetic women and the possible changes it may produce in laboratory parameters. Studies of at least 30 subjects with DM1 or DM2 who were studied for 6 to 12 months depending on the method of analysis were eligible. Results. The search produced seven articles which gave event rate efficacy evaluable results and three which evaluated the effect of the IUD on laboratory parameters. One of the earlier efficacy studies showed an abnormally high pregnancy rate which sparked a controversy which is discussed in the Introduction section. The remaining 6 studies produced acceptable pregnancy rates. The three laboratory studies showed that the copper and levonorgestrel releasing IUD/IUS do not affect the diabetic state in any way. Conclusions. The copper bearing and levonorgestrel releasing IUDs are safe and effective in women with diabetes type I and diabetes type II although the evidence in the latter is limited.

  6. Effects of levonorgestrel intrauterine system on the expressions of estrogen receptor, progesterone receptor and insulin-like growth factor-1%左炔诺孕酮宫内释放系统对雌激素受体、孕激素受体及胰岛素样生长因子-1的影响

    Institute of Scientific and Technical Information of China (English)

    吴晓杰; 刘霞; 金小英; 徐兴云

    2014-01-01

    Objective To explore the effects of levonorgestrel intrauterine system on estrogen receptor (ER) and progesterone receptor (PR),insulin-like growth factor-1 (IGF-1) of endometrial polyps and surrounding endometrial tissue.Methods A total of 250 cases of hysteroscopic resection for endometrial polyps were divided into study group (n =125) with placement of levonorgestrel intrauterine system after hysteroscopic electroresection and control group (n =125) without placement.The intraoperative and postoperative expressions of ER,PR and IGF-1 in endometrial biopsy specimens were measured by immunohistochemistry.They were followed up for 2 years to analyze the recurrence of endometrial polyp.Results All patients had successful surgery.When intraoperative and postoperative specimens were compared with regards to the expressions of ER,PR and IGF-1,significant differences existed between two groups.During a 2-year follow-up,the recurrence of endometrial polyp was 10.89% in control group versus 0 in study group.Conclusion Levonorgestrel intrauterine system may inhibit the recurrence and formation of endometrial polyp through lowering the expressions of ER,PR and IGF-1.%目的 研究左炔诺孕酮宫内释放系统对子宫内膜息肉局部及周围内膜组织雌激素受体(ER)、孕激素受体(PR)、胰岛素样生长因子(IGF)的影响.方法 选取2010至2011年在浙江省嘉兴市妇幼保健院行宫腔镜下子宫内膜息肉切除术患者,共250例.随机分组为研究组(106例)和对照组(125例).研究组术后子宫内即时放置左炔诺孕酮宫内释放系统,而对照组不予放置.分别对术中内膜组织及术后6个月子宫内膜活体组织检查,通过免疫组化方法对ER、PR、IGF-1的表达情况进行对比,且追踪随访2年,了解患者子宫内膜息肉复发情况.结果 所有患者均手术成功,研究组内膜组织对比发现ER、PR、IGF-1表达术后明显低于术中,差异有统计学意义.对照组术中及术

  7. The study of effect of levonorgestrel intrauterine system on the expres-sions of insulin-like growth factor-1 with endometrial polyps%子宫内膜息肉术后放置左炔诺孕酮宫内释放系统对IGF-1的影响研究

    Institute of Scientific and Technical Information of China (English)

    陶跃平; 吴晓杰

    2015-01-01

    目的:研究左炔诺孕酮宫内释放系统对子宫内膜息肉患者子宫内膜组织胰岛素样生长因子-1(IGF-1)表达的影响。方法选取2010年1月~2011年12月期间行宫腔镜下子宫内膜息肉切除术182例患者为研究对象,将其随机分为对照组(常规治疗组)94例和研究组(宫内放置左炔诺孕酮宫内释放系统)88例。后通过免疫组化法将术中内膜组织及术后6个月子宫内膜活检IGF-1的表达情况进行对比,且追踪随访2年,观察患者子宫内膜息肉复发情况。结果研究组内膜组织IGF-1表达研究组术后明显低于术中,差异有统计学意义,对照组IGF-1的表达变化无差异性。随访2年对照组87例患者中7例子宫内膜息肉复发,复发率为8.05%,而研究组无一例复发,差异有统计学意义。结论左炔诺孕酮宫内释放系统可能通过抑制子宫内膜的IGF-1来降低子宫内膜息肉复发。%Objective To study levonorgestrel intrauterine system on insulin-like growth factor-1 (IGF-1) in endometri-um tissue for patients with endometrial polyps. Methods All 182 patients with endometrial polyps in our hospital from January 2010 to December 2011 were selected as research object, and randomly divided into control group(routine treatment group)94 cases and observation group(levonorgestrel intrauterine system in uterus group)88 cases. The IGF-1 expression of endometrial biopsy specimens during intraoperative and rechected after 6 months were measurd by im-munohistochemistry. Patients were followed up for 2 years to analyse endometrial polyp recurrence. Results The ex-pressions of IGF-1 decreased significant in endometrium tissue of observation group with operation. But there were no significant differences in control group. Followed up for 2 years, the endometrial polyp recurrence was 8.05% in control group and without recurrence in study group. Conclusion Levonorgestrel intrauterine system may be involved in

  8. 左炔诺孕酮宫内缓释系统对子宫腺肌病患者月经模式的影响%Effects of Levonorgestrel-Releasing Intrauterine System on Menstrual Patterns of Patients with Adenomyosis

    Institute of Scientific and Technical Information of China (English)

    段志珍; 洪莉; 程艳香

    2013-01-01

    Objective To explore the variation of menstrual patterns of patients who suffered from adenomyosis after the treatment with levonorgestrel via intrauterine releasing system.Methods Seventy patients with adenomyosis who were inserted with levonorgestrel-releasing intrauterine system were selected.The variation of menstrual patterns was assessed through menstrual blood loss method and dysmenorrhea scoring at beginning and 1,3, 6, 9 months after insertion.Results Sixty-five patients completed follow-up, which accounted for 92.9%.Menstrual blood volume of baseline and 1 ,3,6,9 months after therapy was (193.03±134.79), (21.08±32.13),(5.56±7.16), (2.13±4.28), (1.51 ±2.89),respectively.Compared to the baseline, the menstrual blood volume and blood clot of the patients were significantly decreased at 1,3,6,9 months after treatment.The dysmenorrhea score of 27 patients at the same time point was 1.85 ±0.82 (prior-insertion),0.48 ±0.51 (one month post-insertion),0.13 ±0.34 (three months post-insertion), 0 (six months post-insertion), respectively, and the dysmenorrheal normally occurred after vaginal ring operation was obviously relieved after insertion.Conclusion Levonorgestrel-releasing intrauterine system displays good therapeutic effect on improving the menstrual patterns of patients with adenomyosis.%目的 探讨左炔诺孕酮宫内缓释系统对子宫腺肌病患者月经模式的影响.方法 选择因子宫腺肌病放置左炔诺孕酮宫内缓释系统的患者70例.采用月经失血法、痛经评分法评价患者放置前,放置后1,3,6,9个月月经模式.结果 65例患者完成随访,随访率为92.9%.月经量评分:放置前(193.03±134.79)分,放置后1个月(21.08±32.13)分,放置后3个月(5.56±7.16)分,放置后6个月(2.13±4.28)分,放置后9个月(1.51±2.89)分,与放置前比较,放置后1,3,6,9个月患者,月经量、血块均明显减少;其中27例痛经患者痛经评分:放置前(1.85±0.82)分,放置后1个月(0.48±0.51)

  9. Clinical study of levonorgestrel-releasing intrauterine system in the treatment of perimenopausal uterine bleeding.%左旋炔诺酮宫内缓释系统治疗围绝经期功血的90例疗效观察

    Institute of Scientific and Technical Information of China (English)

    李红

    2012-01-01

    Objective To observe the clinical efficacy of levonorgestrel-releasing intrauterine system in the treatment of perimenopausal uterine bleeding. Methods 90 patients with perimenopausal uterine bleeding were treated with levonorgestrel-releasing intrauterine system, and all the patients were followed up 3-7 days after menstrual for 6 months. The menstrual flow, endometrial thickness, uterine size, ovaries size, and hemoglobin changes before and after treatment were recorded. Results There were no statistically significant differences in the uterine size, ovarian volume before and after treatment (P>0.05). The endometrial thickness was (13.69±0.35) mm before treatment and (7.36±1.29) mm after treatment (P<0.05), showing statistically significant difference. The hemoglobin content was (53.66±3.22) g/L before the treatment, significantly lower than (102.96±4.62) g/L after treatment (P<0.05). Conclusion Levonorgestrel-releasing intrauterine system for treatment of perimenopausal uterine bleeding can effectively reduce the menstrual flow, control the endometrial hyperplasia, and increase hemoglobin levels, with satisfactory clinical result, which is worthy to be promoted in clinical practice.%目的 观察左炔诺孕酮宫内缓释系统治疗围绝经期功血的临床疗效.方法 对90例围绝经期功血患者采用左炔诺孕酮宫内缓释系统治疗,全部病例均于每次月经后3 ~7d内随访,共随访6个月.记录服药前后月经出血情况、子宫内膜厚度、子宫大小、双侧卵巢大小、血红蛋白含量的变化.结果 患者用药前后的子宫大小、卵巢体积比较差异无统计学意义(P>0.05);患者在用药前的子宫内膜厚度为(13.69±0.35) mm,用药后为(7.36±1.29) mm,治疗前后的子宫内膜厚度改变比较差异有统计学意义(P<0.05);患者用药前的血红蛋白含量为(53.66±3.22) g/L,治疗后为(102.96±4.62) g/L,治疗前后的血红蛋白含量改变比

  10. Pyometra caused by carrying of an intrauterine device for a period of forty years and chronic endometritis

    Directory of Open Access Journals (Sweden)

    Todorović Nada 1

    2002-01-01

    Full Text Available Pyometra is the accumulation of pus in the uterine cavity, thus streaching its walls and thinning and enlarging the uterus. This change is characteristic of the senium period of life, when the uterus is atrophie with a stenotic cervical canal. It most frequently occurs as a result of secondary infection of the cancerogenic tissue of the uterus and additional stenosation and clogging up of cervical canal by a malignant process. Apart from carcinomas of the body and uterus cervix, pyometra less often can occur in other illnesses such as senile endometritis and senile colpitis. As pyometra most frequently occurs in uterine carcinomas, in detection of this state, we must think of malignancy and direct our examination to this direction. In this paper we present a patient in whom pyometra developed because she carried an intrauterine device for forty years that resulted in chronic endometritis. The main symptoms for which the patient was admited to hospital were abdominal pain and intensive suppurative vaginal excretion a month after removal of intrauterine device. The diagnosis of pyometra was made by gynaecological and ultrasound examinations, and also on the basis of gynecological and ultrasound examinations one month after chronic endometritis was confirmed. On the basis of this finding we suspected that chronic endometritis was caused by this state. By cytological, PAP and histopathological examinations of samples obtained by explorative curettage and biopsy of the uterine cervix, malignant changes were eliminated a possible cause. By laboratory analysis and bacteriological examination of the uterine cavity and vaginal excretion, inflammatory changes of the uterine mocous membrane were confirmed as a cause of the pyometra. This conditions was due to carrying the intrauterine device for more decades. The therapy consisted of dilatation of the cervical canal and evacuation of accumulated suppurative contents and irrigation of uterine cavity with 3

  11. Forgotten intrauterine contraceptive device - A threat to total hip prosthesis: A case report with review of the literature.

    Science.gov (United States)

    Sharma, Sonam; Sharma, Sansar Chand

    2016-01-01

    Primary total hip replacement has become a routine procedure these days. With improvement in surgical techniques and implant designs, the survival rate of prosthesis has increased significantly but unfortunately, prosthetic infections though uncommon continue to be a threatening complication. We present a detailed review of the literature along with a case report of infected total hip prosthesis in a 36-year-old female who had been operated 6 years back. The causative organism was found to be Actinomyces israelii which was related to an infected intrauterine device used for contraception that had been forgotten after being implanted 8 years earlier.

  12. Invading of intrauterine contraceptive device into the sigmoid colon through uterine perforation caused by a blunt trauma

    Institute of Scientific and Technical Information of China (English)

    Abdoulhossein Davoodabadi; Mahdi Mohammadzadeh; Mahdieh Amirbeigi; Hoda Jazayeri

    2015-01-01

    Intrauterine contraceptive device (IUCD) is relatively safe but still with some serious risks.Uterus perforation is rare and would be fatal.A case of Cu-7 IUCD invading into the sigmoid colon through uterine perforation caused by a pelvic blunt trauma was presented.Our case showed that uterus perforation by an IUCD could induce utero-sigmoid fistula which is likely to be missed.Imaging is required when the patients with IUCD present abdominal pain,particularly with a history of trauma.

  13. Bladder stone caused by an ectopic intrauterine contraceptive device: case report

    Energy Technology Data Exchange (ETDEWEB)

    Atasoy, C.; Fitoz, S.; Akyar, S. [Ankara Univ. School of Medicine, Dept. of Radiology, Ibn-i Sina Hospital, Ankara (Turkey)

    2001-02-01

    Perforation of the uterus is a recognized complication associated with the use of an intrauterine contraceptive (IUCD). However, migration of an IUCD into the bladder, with or without stone formation, is exceptionally rare. We report the case of a patient with a displaced IUCD that acted as a nidus for bladder lithiasis. (author)

  14. Clinicians' knowledge and practices regarding family planning and intrauterine devices in China, Kazakhstan, Laos and Mexico.

    Science.gov (United States)

    Hoffman, Steven J; Guindon, G Emmanuel; Lavis, John N; Randhawa, Harkanwal; Becerra-Posada, Francisco; Boupha, Boungnong; Shi, Guang; Turdaliyeva, Botagoz S

    2016-06-10

    It is widely agreed that the practices of clinicians should be based on the best available research evidence, but too often this evidence is not reliably disseminated to people who can make use of it. This "know-do" gap leads to ineffective resource use and suboptimal provision of services, which is especially problematic in low- and middle-income countries (LMICs) which face greater resource limitations. Family planning, including intrauterine device (IUD) use, represents an important area to evaluate clinicians' knowledge and practices in order to make improvements. A questionnaire was developed, tested and administered to 438 individuals in China (n = 115), Kazakhstan (n = 110), Laos (n = 105), and Mexico (n = 108). The participants responded to ten questions assessing knowledge and practices relating to contraception and IUDs, and a series of questions used to determine their individual characteristics and working context. Ordinal logistic regressions were conducted with knowledge and practices as dependent variables. Overall, a 96 % response rate was achieved (n = 438/458). Only 2.8 % of respondents were able to correctly answer all five knowledge-testing questions, and only 0.9 % self-reported "often" undertaking all four recommended clinical practices and "never" performing the one practice that was contrary to recommendation. Statistically significant factors associated with knowledge scores included: 1) having a masters or doctorate degree; and 2) often reading scientific journals from high-income countries. Significant factors associated with recommended practices included: 1) training in critically appraising systematic reviews; 2) training in the care of patients with IUDs; 3) believing that research performed in their own country is above average or excellent in quality; 4) being based in a facility operated by an NGO; and 5) having the view that higher quality available research is important to improving their work. This

  15. Efficacy of levonorgestrel releasing intrauterine system on menorrhagia induced by anticoagulant therapy in women after cardiac valve replacement%左炔诺孕酮宫内缓释系统用于治疗心脏瓣膜置换术后抗凝药物所致月经过多的疗效观察

    Institute of Scientific and Technical Information of China (English)

    莫小亮; 蒋晓莉; 郑晓宇; 孙燕

    2013-01-01

    目的:探讨左炔诺孕酮宫内缓释系统(levonorgestrel releasing intrauterine system,LNG-IUS)用于治疗心脏换瓣术后抗凝药物所致月经过多的有效性和安全性.方法:32例月经过多妇女,曾接受换瓣术,术后口服抗凝药物.将这32例患者随机分为观察组16例,月经1 ~5d放置LNG-IUS;对照组16例,未采取任何干预措施.记录活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、国际标准化比值(INR)、纤维蛋白原、血红蛋白(Hb)、铁蛋白水平及月经改变.结果:观察组放置3个月后,月经量显著减少,子宫内膜显著变薄,Hb、铁蛋白升高(P<0.05),凝血指标两组比较差异无统计学意义(P>0.05).结论:LNG-IUS是治疗换瓣术后抗凝药物所致月经过多的有效方法.%Objective To evaluate the efficacy and safety of levonorgestrel releasing intrauterine system (LNG-IUS) on menorrhagia induced by anticoagulant therapy in women after cardiac valve replacement. Methods 32 women with menorrhagia induced by anticoagulant therapy after cardiac valve replacement were randomly divided into 2 groups: 16 patients in observation group received LNG-IUS replacement, 16 patients in control group received no intervention. APTT, PT, INR, Hb, ferritin levels and menstrual quantity in both groups were recorded. Results Menstrual blood volume was decreased, the endometrium became thinner, the levels of Hb and ferritin were increased in observation group 3 months after therapy (P < 0.05). Conclusion LNG-IUS was an effective method for menorrhagia induced by anticoagulant therapy in women after cardiac valve replacement.

  16. Clinical efficacy on levonorgestrel intrauterine system in treating dysfunctional uterine bleeding during peri-menopausal period%左炔诺孕酮宫内缓释系统治疗围绝经期功血的临床观察

    Institute of Scientific and Technical Information of China (English)

    何丽霞; 陈正勤

    2016-01-01

    目的:观察围绝经期功能失调性子宫出血(功血)患者宫腔内放置左炔诺孕酮宫内缓释系统(商品名:曼月乐)的临床疗效。方法:选取曼月乐治疗围绝经期功血患者72例,比较放置曼月乐前后患者月经情况、子宫内膜厚度及血红蛋白、血脂、性激素水平变化。结果:放置曼月乐后月经量减少,子宫内膜变薄,血红蛋白升高,结果均有明显差异(P <0.05),而血脂及性激素水平无明显改变,差异无统计学意义(P >0.05)。结论:曼月乐治疗围绝经期功血减少经量和纠正贫血效果确切,不影响血脂代谢和卵巢功能。%Objective To investigate the clinical efficacy on dysfunctional uterine bleeding during peri -menopausal period of levonorgestrel intrauterine system.Method Seventy -two cases of patients who were diagnosed dysfunctional uterine bleeding during peri -menopausal period were placed with mirenas during menstrual period.The menstrual conditions,endometrium width, hemoglobin,blood lipid,sex hormone level changes of these cases were measured before and after the insertion of mirena.Results After the insertion of mirena the menstrual quantity decreases,thinning of the endometrium,hemoglobin was increased.These were statistically significant(P 0.05).Conclusion Levonorgestrel intrauterine system can efficiently reduce the amount of blood and correct a-nemia but does not affect blood lipid metabolism and ovarian function.

  17. 宫腔镜电切术后置环加人工周期预防宫腔粘连的疗效%The effect of intrauterine device and artificial menstrual cycle to prevent intrauterine adhesion after hysteroscopic electrosurgery

    Institute of Scientific and Technical Information of China (English)

    叶可君; 蔡珠华; 曹华妹; 夏秋霞

    2012-01-01

    Objective: To compare the using of artificial menstrual cycle or intrauterine device to treat and prevent intrauterine adhesion (IUA) . Methods: All of 90 cases with IUA whom underwent TCRA, TCRM and TCRP him March 2008 to March 2011 were divided into non -treated group (Group A), intrauterine device group (Group B) and intrauterine device + artificial menstrual cycle group (Group C) . The change of menstrual quantity and uterine cavity and pregnancy were observed. Results; The cases of sterility and mild menses, pure mild menses, amenorrhea in group A were more than that in group B and group C, and those in group C were the least, the differences were significant (P <0. 05); The rates of adhesion in group B and C were less than that in group A, and it in group C was the least, the differences were significant (P < 0.05 ) ; The pregnancy rate was the highest in group C, higher in group B than in group A (P < 0.05) . Conclusion: Combination of artificial menstrual cycle and intrauterine device is effective for intrauterine adhesion.%目的:比较人工周期或节育器留置治疗及预防宫腔粘连(intrauterine adhesion,IUA)的疗效.方法:选择2008年3月~2011年3月做宫腔粘连电切术(TCRA)、子宫黏膜下肌瘤电切术(TCRM)和子宫内膜多发性息肉电切术(TCRP)的患者,比较无处理组(A组)、置环组(B组)及置环加人工周期组(C组)的月经量恢复及宫腔镜下宫腔情况和妊娠情况.结果:置环及置环加人工周期A组出现不孕及月经量过少、单纯月经过少和闭经以及周期性腹痛的患者多于B组和C组,而C组最少(P<0.05);B组、C组宫腔粘连的发生率小于A组(P<0.05),而C组更低(P<D.05);术后半年随访A组妊娠率低于B组和C组(P<0.05),而C组高于B组(P<0.05).结论:置环加人工周期对宫腔电切术后宫腔粘连治疗效果明显.

  18. [Use of modified intrauterine device (IUD) TCu 380 with chromium filaments in the immediate postpartum].

    Science.gov (United States)

    Hernández Valencia, M; Becerril Flores, L C

    2000-02-01

    Postpartum insertion of the intrauterine device (IUD) can provide an effective and convenient means of contraception. As a result, the use of IUD's has steadily increased, and the Family Planning Program recommends it because it offers many advantages. However, a major risk associated with the use of IUD's is the possibility of its expulsion, which ranges from 4 to 60%. Furthermore, 20% of women who expelled IUD's were unaware that it occurred, thus increasing their susceptibility to unwanted pregnancies. IUD's modified by the addition of biodegradable strands of chromic suture at time of implantation are thought to be less likely to be expelled, as the sutures anchor the IUD more firmly to the endometrium, and it is possible that the use of these sutures may decrease the risk of expulsion. Therefore we determined if the chromic extension to IUD enhance retention and decreased the rate of expulsion. In one year of study, 150 women received a modified IUD (TCu 380) with chromic catgut number 0 (ccO) in the transversal arm within 10 minutes of delivery of the placenta. However, only 84 women completed the follow-up study. To evaluate IUD expulsion, exploratory examinations were conducted during the immediate postpartum, at 7 days postpartum and at 6 weeks after delivery. We determined the presence or expulsion of the IUD in these three periods postpartum. Other parameters such as parity, age and marital status were also considered. A total of 14 modified IUD's (16.6%) were expelled. This represents a similar frequency of expulsion both during the immediate postpartum and the 7 days postpartum period. There was no significant difference in the rate of expulsion between the two periods. Moreover, there was no expulsion at 6 weeks postpartum. The primiparity women had the highest percentage of expulsion (22.8%). Single mothers either living with or without their sexual partner had expulsion rates of 20.6 and 20.5%, respectively. The highest rate of expulsion when we

  19. An introduce on the health education of levonorgestrel-releasing intrauterine system in the treatment of adenomyosis and its effect evaluation%曼月乐治疗子宫腺肌病患者的健康教育及效果评价

    Institute of Scientific and Technical Information of China (English)

    何淑明; 黄少兰

    2006-01-01

    目的:探讨健康教育程序在左旋-18甲基炔诺酮宫内缓释系统(levonorgestrel-releasing intrauterine system,LNG-IUS;商品名为"曼月乐")在治疗子宫腺肌病中的作用.方法:对48例子宫腺肌病的患者宫内放置曼月乐治疗,进行健康教育评估、诊断、制订实施健康教育计划和效果评价.结果:48例患者中有43例术前均有不同程度焦虑情绪,经教育后仅有3例存在轻度焦虑心理,无一例并发感染或有不遵医行为.结论:运用健康教育程序对曼月乐治疗子宫腺肌病进行健康教育可以增长患者知识,改变患者行为,提高患者的依从性.

  20. Effect of Levonorgestrel-releasing Intrauterine System in the Treatment of Adenomyosis:Analysis of 120 Cases%左炔诺孕酮宫内缓释系统治疗子宫腺肌症120例疗效分析

    Institute of Scientific and Technical Information of China (English)

    王莉; 王彩霞

    2013-01-01

    Objective:To observe the effect of levonorgestrel-releasing intrauterine system in treatment of adenomyosis. Methods:The changes of menstruation, uterine volume, hemoglobin and hormone levels before and after LNG-IUS placement were performed in 120 patients with AM. Results:The menstrual quantity obvious reduction;reduction of uterine volume and increased hemoglobin were observed after the placement of LNG-IUS 4,8 months in patients with anemia(P0.05). Conclusion:LNG-IUS had significant effect in the treatment of AM, had no t effect on ovarian function, worthy of clinical application.%目的:观察左炔诺孕酮宫内缓释系统(LNG-IUS,曼月乐)治疗子宫腺肌病(AM)的疗效。方法:对120例AM患者放置LNG-IUS前后月经量、子宫体积、血红蛋白和激素水平的变化进行观察。结果:放置LNG-IUS4、8个月后月经量明显减少;子宫体积缩小及贫血患者血红蛋白上升(P0.05)。结论:LNG-IUS治疗AM疗效显著,对卵巢功能无明显影响,值得临床应用推广。

  1. Analyses the intrauterine device failure causes and prevention countermeasures%浅析宫内节育器的失败原因及预防对策

    Institute of Scientific and Technical Information of China (English)

    林红

    2014-01-01

    目的:分析放置宫内节育器(intrauterine device,IUD)的并发症及失败原因,探讨相关的预防对策。方法对2010年10月-2011年9月在我院放置宫内节育器健康育龄妇女676例的病历资料进行回顾性分析。结果676例妇女中,脱落6例(0.89%),宫内节育器下移取器14例(2.07%),因症取器25例(3.70%),带器妊娠13例(1.92%)。结论育龄妇女放置节育环后应定期随访,要根据妇女不同生理状况,合理选择适宜的宫内节育器,及时发现并处理节育器异常情况,减少宫内节育器严重并发症发生。%Objective Through the analysis of prevention by placing intrauterine device (intrauterine device, IUD)complications,to find the cause of failure and do some relevant prevention measures. Methods Collected 676 patients were placed intrauterine device IUD in our hospital in October 2010 to September 2011,and the medical records were retrospectively analyzed.Results All of 676 cases,fall off for 6 cases (0.89%),device down in the intrauterine for 14 cases(2.07%),apparatus were taken off because of the disease for 35 cases(5.18%),with pregnancy for 13 cases (1.92%). Conclusion Women of child-bearing age should be regular follow-up after place intrauterine device,according to the women of different physiological condition,reasonable choice of appropriate intrauterine device, timely discover and deal with synthetic anomaly,reduce serious complications occurred in the intrauterine device.

  2. Contraceptive failure with Copper T380A intrauterine device (IUD): A single tertiary center experience

    OpenAIRE

    Ekiz, Ali; Ozkose, Burak; Yucel, Burak; Avci, Muhittin Eftal; Adanur, Ahmet; Yildirim, Gokhan

    2016-01-01

    Objective: The objective of this study was to assess the risk factors of pregnancy with Copper (Cu)T380A IUD and pregnancy outcomes. Methods: A retrospective study evaluating the risk factors and pregnancy outcomes of 81 patients who conceived with CuT380A IUD in situ. Results: Four ectopic pregnancies and 77 intrauterine pregnancies were detected. Twenty-six pregnancies (33.76%, 26/77) were terminated according to maternal desire. Twenty-five patients (32.46%, 25/77) whose IUDs were removed ...

  3. Comparison of the Efficacy and Safety of Levonorgestrel Intrauterine System and Mifepristone in the Treatment of Perimenopausal Dysfunctional Uterine Bleeding%左炔诺孕酮宫内节育系统与米非司酮治疗围绝经期功能失调性子宫出血的疗效和安全性比较

    Institute of Scientific and Technical Information of China (English)

    姜欣; 曾银花

    2016-01-01

    目的:比较左炔诺孕酮宫内节育系统与米非司酮治疗围绝经期功能失调性子宫出血的疗效和安全性。方法:200例围绝经期功能失调性子宫出血患者随机分为观察组(100例)和对照组(100例)。观察组患者放置左炔诺孕酮宫内节育系统(含左炔诺孕酮52 mg),对照组患者口服米非司酮胶囊10 mg/d。两组疗程均为3个月。观察两组患者的临床疗效和治疗前后子宫内膜厚度、月经量[根据图示应用出血评分法(PBAC)评估]、血红蛋白水平及不良反应发生情况。结果:治疗后,观察组患者总有效率显著高于对照组,不良反应发生率显著低于对照组,差异均有统计学意义(P<0.01)。治疗前,两组患者子宫内膜厚度、PBAC评分、血红蛋白水平比较差异无统计学意义(P>0.05);治疗后,两组患者子宫内膜厚度、PBAC评分显著低于同组治疗前,且观察组低于对照组,而血红蛋白水平显著高于同组治疗前,且观察组高于对照组,差异均有统计学意义(P<0.01或P<0.05)。结论:左炔诺孕酮宫内节育系统治疗围绝经期功能失调性子宫出血的疗效和安全性显著优于米非司酮。%OBJECTIVE:To compare the efficacy and safety of levonorgestrel intrauterine system and mifepristone in the treat-ment of perimenopausal dysfunctional uterine bleeding. METHODS:200 patients with perimenopausal dysfunctional uterine bleed-ing were randomly divided into observation group (100 cases) and control group (100 cases). Patients in the observation group placed levonorgestrel intrauterine system (containing levonorgestrel 52 mg),patients in control group received Mifepristone cap-sule 10 mg/d,oral,the treatment course for 2 groups were 3 months. Clinical efficacy,endometrial thickness,menstruation(PBAC score),hemoglobin level before and after treatment and incidence of adverse reaction in 2 groups were observed

  4. Recurrent extended-spectrum beta-lactamase-producing Escherichia coli urinary tract infection due to an infected intrauterine device.

    Science.gov (United States)

    Hui, Chee-Kin

    2014-02-01

    The use of intrauterine devices (IUDs) have been widespread since the 1960s. In 2002, the World Health Organization estimated that approximately 160 million women worldwide use IUDs. However, IUDs are associated with short-term complications such as vaginal bleeding, pelvic discomfort, dyspareunia and pelvic infection. Herein, we report the case of a woman who had recurrent urinary tract infection (UTI) due to the use of an IUD, even after treatment. The patient developed four episodes of UTI within a seven-month period after IUD insertion. During each episode of UTI, extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli (E. coli) was cultured from the patient’s midstream urine. The IUD was finally removed, and culture of the removed IUD was positive for ESBL-producing E. coli. An infected IUD as a source of recurrent UTI should be considered in women with IUD in situ who develop recurrent UTI even after treatment.

  5. Isolated Abdominal Wall Actinomycosis Associated with an Intrauterine Contraceptive Device: A Case Report and Review of the Relevant Literature

    Directory of Open Access Journals (Sweden)

    Sinan Carkman

    2010-01-01

    Full Text Available Isolated abdominal wall actinomycosis in the presence of an intrauterine contraceptive device (IUCD is extremely rare and only six such cases have been reported in the literature. We report a case where clinical and radiological examinations revealed a pseudotumor within the anterior abdominal wall. After being lost to follow-up, the patient presented two years later with the enlargement of the mass. The mass including the affected anterior abdominal wall was completely excised. The diagnosis of actinomycosis was established postoperatively by histopathological examination. Further questioning concerning her gynecological history revealed long-term use of the same IUCD. Surgical excision of the actinomycotic pseudotumour and removal of the IUCD followed by antibiotic therapy resulted in the full recovery of the patient.

  6. In vitro release of cupric ion from intrauterine devices: influence of frame, shape, copper surface area and indomethacin.

    Science.gov (United States)

    Zhang, Shuangshuang; Li, Ying; Yu, Panpan; Chen, Tong; Zhou, Weisai; Zhang, Wenli; Liu, Jianping

    2015-02-01

    The release of cupric ion from copper intrauterine device (Cu-IUD) in human uterus is essential for contraception. However, excessive cupric ion will cause cytotoxic effect. In this paper, we investigated the influence of device characteristics (frame, copper surface area, shape, copper type and indomethacin) on copper release for the efficacy and adverse effects vary with IUD types which may correlate to their different release behaviors. Nine types of Cu-IUDs were selected and incubated in simulated uterine fluid. They were paired for comparison based on the device properties and the release of cupric ion was determined by flame atomic absorption spectrometer for about 160 days. The result showed that there was a burst release during the first month and the release rate tends to slow down and become steady afterwards. In addition, the copper release was mainly influenced by frame, indomethacin and copper type (copper wire and copper sleeve) while the shape variation had little effect on copper release throughout the experiment. Moreover, the influence of copper surface area was only noticeable during the first month. These findings were seldom reported before and may provide some useful information for the design of Cu-IUDs.

  7. Best practices to minimize risk of infection with intrauterine device insertion.

    Science.gov (United States)

    Caddy, Sheila; Yudin, Mark H; Hakim, Julie; Money, Deborah M

    2014-03-01

    Contexte : Les dispositifs intra-utérins constituent un moyen de contraception à long terme extrêmement efficace qui compte l’avantage d’être réversible. Historiquement, l’utilisation de certains dispositifs intra-utérins a été associée à une hausse du risque de syndrome inflammatoire pelvien. Des données plus récentes laissent entendre que cette association ne s’applique pas aux nouveaux dispositifs; toutefois, certains facteurs de risque peuvent accroître la possibilité d’infection. Objectifs : Analyser le risque d’infection associé à l’insertion de dispositifs intra-utérins et recommander des stratégies visant la prévention de l’infection. Issues : Les issues prises en considération ont été le risque de syndrome inflammatoire pelvien, les effets du dépistage de la vaginose bactérienne et des infections transmissibles sexuellement (dont la chlamydiose et la gonorrhée), et le rôle de l’antibioprophylaxie. Résultats : La littérature publiée a été récupérée par l’intermédiaire de recherches menées, le 21 juillet 2011, dans PubMed, Embase et The Cochrane Library au moyen d’un vocabulaire contrôlé (p. ex. « intrauterine devices », « pelvic inflammatory disease ») et de mots clés (p. ex. « adnexitis », « endometritis », « IUD ») appropriés. Un filtre étiologique a été appliqué dans PubMed. Les recherches ont été limitées à la période débutant en l’an 2000. Aucune restriction n’a été appliquée en matière de langue. La littérature grise (non publiée) a été identifiée par l’intermédiaire de recherches menées dans les sites Web de sociétés de spécialité médicale nationales et internationales. Valeurs : La qualité des résultats est évaluée au moyen des critères décrits dans le rapport du Groupe d’étude canadien sur les soins de santé préventifs (Tableau). Recommandations 1. Toutes les femmes demandant l’insertion d’un dispositif intra

  8. Effect of the levonorgestrel intrauterine slow-releasing system on cytokines of uterine fluid after endometrial polyps resection by hysteroscopy%子宫内膜息肉术后放置左炔诺孕酮宫内缓释系统对宫腔灌洗液中细胞因子的影响

    Institute of Scientific and Technical Information of China (English)

    蔡惠兰; 丁香翠; 钱蓉蓉; 虞如芬; 孙利敏; 李强

    2012-01-01

    目的:研究子宫内膜息肉术后放置左炔诺孕酮宫内缓释系统(the levonorgestrel intrauterine system,LNGIUS)后宫腔灌洗液中细胞因子含量的改变.方法:22例子宫内膜息肉手术患者,术后采用LNG--IUS预防息肉复发,收集手术前及随访1年后宫腔灌洗液,采用ELISA法检测IL-1β、IL-6、IFN-γ、TGF-β1等细胞因子的变化情况.结果:子宫内膜息肉患者宫腔镜手术后采用LNG-IUS治疗1年后,其宫腔灌洗液中IL- 1β、IFN-γ含量较术前明显降低,其差异具有统计学意义(P<0.01);术前22例标本灌洗液中均未检出TGF-β1,术后IL-6、TGF-β1含量明显增高,其差异具有统计学意义(IL-6,P<0.05; TGF-β1,P<0.01).结论:LNG-IUS可诱导子宫内膜蜕膜样改变且局部炎症反应较轻,可能是预防子宫内膜息肉术后复发的原因之一.%OBJECTIVE To detect the changes of cytokines levels of uterine fluid after endometrial polyps resection by hyst-eroscopy LNG-IUS placement. METHODS 22 patients with LNG-IUS placement after endometrial polyps resection by hyste-roscopy was recruited,the uterine fluid collected before endometrial polyps resection by hysteroscopy and follow-up 1 years, detected the IL-1β, IL-6, IFN-γ, TGF-β1 levels detected by ELISA. RESULTS Follow-up 1 years, IL-11β, IFN-γ levels of the uterine lavage fluid were significantly lower than the preoperative levels, the difference was statistically significant (P<0. 01) ; the TGF-β1 was not detected before endometrial polyps resection by hysteroscopy, IL-6, TGF-fil were significantly increased follow-up 1 years , the difference was statistically significant (IL-6, P<0. 05; TGF-β11, P<0. 01). CONCLUSION Levonorgestrel intrauterine slow-releasing system can induce endometrial decidual-like changes and mild local inflammatory reaction, it may be reason to prevent recurrence of endometrial polyps.

  9. 宫内节育器盆腹腔异位的临床研究%Clinic analysis of the intrauterine contraceptive device abdominal ectopia

    Institute of Scientific and Technical Information of China (English)

    唐艳; 乔林; 徐克惠

    2011-01-01

    目的 探讨宫内节育器(intrauterine contraceptive device,IUD)盆腹腔异位的预防及诊断.方法 回顾性分析华西第二医院2006~2010年住院治疗的15例IUD盆腹腔异位患者的病历资料.结果 15例中有13例在分娩后一年内放置;金属圆形环10例,T型环3例;异位于膀胱1例,肠壁3例,大网膜2例,直肠子宫陷凹3例,阔韧带1例,盆壁1例,子宫表面4例.结论 接受宫内节育器避孕患者随访意识差,育龄妇女置环应定期随访及时发现节育器异常情况,及时处理,减少宫内节育器严重并发症的发生,重视围绝经期及绝经后妇女的取环问题,应加强对采取宫内节育器避孕育龄妇女的随访宣教,加强对计划生育技术人员的培训是减少宫内节育器并发症的关键.%Objective To investigate the prevention,Diagnosis and therapy of intrauterine contraceptive device (IUD) abdominal ectopia. Methods The clinical materials of 15 cases with intrauterine contraceptive device abdominal ec-topia treated in the hospital were analyzed retrospectively. Results Among the 15 cases with intrauterine contraceptive device abdominal ectopia. 13 cases were insert in a year after delivery, 10 cases were round metal IUD, 3 cases were T shape IUD,1 case was ectopic at bladder,3 were at bowel,2 were at caul,3 were at pouch of Douglas, 1 was at broad ligament, 1 was at pelvic wall,and 4 was at the surface of uterus. Conclusion The follow-up of intrauterine contraceptive device is poor. It need to follow up termly after intrauterine contraceptive device insert. The abnormal status can be found and dealt in time. It is important to pay attention to perimenopausal and postmenopausal removing intrauterine contraceptive device. It needs to enhance the intrauterine contraceptive device follow-up and the skill-training of the birth control medical workers, which is crucial for lessening intrauterine contraceptive device complications.

  10. Efficacy of Oral Contraceptive or Levonorgestrel-releasing Intrauterine System after Hysteroscopic Endometrial Polypectomy in Preventing Recurrence%宫腔镜子宫内膜息肉切除术后口服避孕药或放置左炔诺孕酮宫内缓释系统对预防复发的作用

    Institute of Scientific and Technical Information of China (English)

    王威; 王晓晔

    2013-01-01

    Objective To investigate the recurrence-prevention effect of oral contraceptive or levonorgestrel-releasing intrauterine system ( Mirena) after hysteroscopic endometrial polypectomy. Methods Totally 116 patients, who received hysteroscopic endometrial polypectomy and were confirmed with endometrial polyp by postoperative pathological examination during January 2009 and October 2011 in our hospital, were enrolled into this study. The patients were divided into three groups; oral contraceptive group (n =34) was given combined oral contraceptive since one month until 12 months after the operation; Mirena group ( n = 39) received levonorgestrel-releasing intrauterine system since one month after the operation; and control group ( n = 43 ) received no treatment after hysteroscopic endometrial polypectomy. The three groups were followed up at 3, 6, and 12 months after the procedure, and the recurrence rate, menstruation, and level of hemoglobin were compared among the groups. Results No patients were lost during a 12-month follow-up. The control group showed significantly higher recurrence rate, lower proportion of low menstruation volume and lower level of hemoglobin than the oral contraceptive and Mirena groups [18.6% (8/43) vs. 2.9% (1/34) and 2.6% (1/39) , χ2 - 8. 649, P = 0. 013; P = 0. 000; and P < 0. 05, respectively]. Conclusion Oral contraceptive or levonorgestrel-releasing intrauterine system after hysteroscopy for endometrial polyps significantly decreases recurrence rate and adverse reaction, and we recommend it to be widely used.%目的 探讨子宫内膜息肉宫腔镜手术后口服避孕药或放置左炔诺孕酮宫内缓释系统(曼月乐)对预防复发的效果. 方法 2009年1月~2011年10月门诊宫腔镜子宫内膜息肉切除术且病理证实为子宫内膜息肉116例,由患者知情选择术后处理方法.34例宫腔镜手术后1个月开始应用复方短效口服避孕药12个月(避孕药组),39例宫腔镜术后1个

  11. Scanning electron microscopy, x-ray diffraction, and electron microprobe analysis of calcific deposits on intrauterine contraceptive devices

    Energy Technology Data Exchange (ETDEWEB)

    Khan, S.R.; Wilkinson, E.J.

    1985-07-01

    Deposits found on intrauterine contraceptive devices (IUDs) were studied by scanning electron microscopy, x-ray diffraction, and energy dispersive x-ray microanalysis. All seven devices, including five plastic and two copper IUDs, were coated with a crust containing cellular, acellular, and fibrillar material. The cellular material was composed of erythrocytes, leukocytes, cells of epithelial origin, sperm, and bacteria. Some of the bacteria were filamentous, with acute-angle branching. The fibrillar material appeared to be fibrin. Most of the acellular material was amorphous; calcite was identified by x-ray diffraction, and x-ray microanalysis showed only calcium. Some of the acellular material, particularly that on the IUD side of the crust, was organized in spherulitic crystals and was identified as calcium phosphate by x-ray microanalysis. The crust was joined to the IUD surface by a layer of fibrillar and amorphous material. It is suggested that the initial event in the formation of calcific deposits on IUD surfaces is the deposition of an amorphous and fibrillar layer. Various types of cells present in the endometrial environment adhere to this layer and then calcify. Thus, the deposition of calcific material on the IUDs is a calcification phenomenon, not unlike the formation of plaque on teeth.

  12. Changes in copper and zinc serum levels in women wearing a copper TCu-380A intrauterine device.

    Science.gov (United States)

    Imani, Somaieh; Moghaddam-Banaem, Lida; Roudbar-Mohammadi, Shahla; Asghari-Jafarabadi, Mohammad

    2014-02-01

    OBJECTIVE To assess the effects of the copper intrauterine device (IUD) TCu-380A, on copper and zinc serum levels. MATERIAL AND METHODS This longitudinal study enrolled 121 women attending Health Centres in Tehran between November 2011 and August 2012. A blood sample was obtained before use and three months after insertion of a TCu-380A IUD. Serum levels of copper and zinc were measured for the 101 women who had completed three months with the device in situ. Analyses of change included paired t-tests, McNemar tests and linear regression. RESULTS Significant elevations in mean serum levels were found for both copper (170.22 μg/dl at three months vs.160.40 μg/dl at baseline, p = 0.034) and zinc (107.67 μg/dl at three months vs. 94.61 μg/dl at baseline, p IUD insertion. CONCLUSIONS A slight, but significant increase in copper serum levels, not reaching toxic levels, was observed three months after TCu-380A IUD insertion. Zinc levels too had risen significantly, which was quite unexpected, and warrants further investigation.

  13. Five-year review of copper T intrauterine device use at the University of Calabar Teaching Hospital, Calabar

    Directory of Open Access Journals (Sweden)

    Iklaki CU

    2015-10-01

    Full Text Available Christopher U Iklaki, Anthony U Agbakwuru, Atim E Udo, Sylvester E Abeshi Department of Obstetrics and Gynaecology, University of Calabar, Calabar, Nigeria Background: The intrauterine devices (IUDs are widely used contraceptive methods all over the world today. They are effective and recommended for use up to 10 years. They are not without side effects, which often prompt the users to request for removal. Objective: To determine the utilization rate of copper T intrauterine contraceptive device (IUCD, side effects, and request for removal at the University of Calabar Teaching Hospital, Calabar. Methods: The data on usage of the various forms of temporary contraception provided by the Family Planning Clinic of this center from January 1, 2006 to December 31, 2010 were collated. The records of usage of IUCD during same period were carefully studied. Results: During this period, a total of 10,880 users were provided with various forms of contraceptives. Copper T IUD was the commonest form of contraception used at the University of Calabar Teaching Hospital Family Planning Unit over the period under review (2006–2010 with a rate of 4,069 (37.40%. There was a yearly higher request for IUCD over other forms of contraceptives over the period. Of a total of 4,069 users of the copper T IUD method over the period, 1,410 (34.65% belonged to the age group of 25–29 years. Eleven (4.61% of the users requested for its removal due to abnormal vaginal bleeding, while five (2.08% removed theirs due to abnormal vaginal discharge. The major reason for removal was the desire for pregnancy that accounted for 165 (70.26%, while one (0.51% was removed due to dysmenorrhea. Conclusion: The copper T380A was very effective, safe with fewer side effects, and easily available in this study. The request for removal is also low in our environment. Keywords: copper T380A, contraception, request for removal

  14. Conservative management of postmenopausal woman with prolonged use of the dislocated intrauterine device which was also unnoticed while hysterectomy

    Directory of Open Access Journals (Sweden)

    Mustafa Gazi Ucar

    2015-10-01

    Full Text Available The objectives of this study are to identify and compare the treatment options of woman with uterine perforation caused by intrauterine device (IUD. A 74-years-old woman presented with irritable voiding symptoms and a dislocated IUD into the peritoneal cavity was discovered incidentally during radiologic imaging. While a Lippes loop IUD had been inserted 35 years previously, she had a history of hysterectomy 10 years after an IUD insertion. Not only the patient had forgotten the presence of the IUD, but also it was unnoticed during hysterectomy. Patient has remained asymptomatic for over the 25 years, with the prolonged use of dislocated IUD. The patient managed conservatively and no need for surgical intervention. Once a gynaecologist is faced with the dilemma of whether it is necessary to remove a dislocated IUD or not, patients should undergo an individualized management, balancing both risks and benefits of surgical intervention. Asymptomatic elderly patients with comorbidities may benefit from conservative management with close monitoring. [Int J Reprod Contracept Obstet Gynecol 2015; 4(5.000: 1565-1567

  15. Magnetic Field Interactions of Copper-Containing Intrauterine Devices in 3.0-Tesla Magnetic Resonance Imaging: In Vivo Study

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    Berger-Kulemann, Vanessa; Einspieler, Henrik [Department of Radiology, Medical University of Vienna, Vienna 1090 (Austria); Hachemian, Nilouparak [Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna 1090 (Austria); Prayer, Daniela; Trattnig, Siegfried; Weber, Michael; Ba-Ssalamah, Ahmed [Department of Radiology, Medical University of Vienna, Vienna 1090 (Austria)

    2013-07-01

    An ex vivo study found a copper-containing intrauterine device (IUD) to be safe for women undergoing an MRI examination at a 3.0-T field. No significant artifacts caused by the metallic implant were detected. However, there are still no in vivo data about these concerns. The aim of this study was to evaluate 3.0-T magnetic field interactions of copper-containing IUDs in vivo. Magnetic field interactions and potential adverse events were evaluated in 33 women using a questionnaire-based telephone survey. Two experienced radiologists performed artifact evaluation on MR images of the pelvis. Eighteen patients were eligible for the survey. One patient reported a dislocation of the IUD after the MR examination. All other patients had no signs of field interactions. No IUD-related artifacts were found. MRI at 3.0-T is possible for women with copper-containing IUDs. However, consulting a gynecologist to check the correct position of the IUD and exclude complications after an MR examination is highly recommended. High-quality clinical imaging of the female pelvis can be performed without a loss in image quality.

  16. Divergent endometrial inflammatory cytokine expression at peri-implantation period and after the stimulation by copper intrauterine device.

    Science.gov (United States)

    Chou, Chia-Hung; Chen, Shee-Uan; Shun, Chia-Tung; Tsao, Po-Nien; Yang, Yu-Shih; Yang, Jehn-Hsiahn

    2015-10-15

    Endometrial inflammation has contradictory effects. The one occurring at peri-implantation period is favourable for embryo implantation, whereas the other occurring after the stimulation by copper intrauterine device (Cu-IUD) prevents from embryo implantation. In this study, 8 week female ICR mice were used to investigate the endometrial inflammation, in which they were at proestrus stage (Group 1), at peri-implantation period (Group 2), and had a copper wire implanted into right uterine horn (Group 3). Cytokine array revealed that two cytokines were highly expressed in Group 2 and Group 3 as compared with Group 1, and seven cytokines, including tumour necrosis factor α (TNF-α), had selectively strong expression in Group 3. Immunohistochemistry demonstrated prominent TNF-α staining on the endometrium after Cu-IUD stimulation, and in vitro culture of human endometrial glandular cells with Cu induced TNF-α secretion. The increased TNF-α concentration enhanced in vitro THP-1 cells chemotaxis, and reduced embryo implantation rates. These results suggest that inflammatory cytokine profiles of endometrium are different between those at peri-implantation period and after Cu-IUD stimulation, and TNF-α is the one with selectively strong expression in the latter. It might account for the contradictory biological effects of endometrial inflammation.

  17. Decrease in cytotoxicity of copper-based intrauterine devices (IUD) pretreated with 6-mercaptopurine and pterin as biocompatible corrosion inhibitors.

    Science.gov (United States)

    Alvarez, Florencia; Grillo, Claudiaa; Schilardi, Patricial; Rubert, Aldo; Benítez, Guillermo; Lorente, Carolina; de Mele, Mónica Fernández Lorenzo

    2013-01-23

    The copper intrauterine device (IUD) based its contraceptive action on the release of cupric ions from a copper wire. Immediately after the insertion, a burst release of copper ions occurs, which may be associated to a variety of side effects. 6-Mercaptopurine (6-MP) and pterin (PT) have been proposed as corrosion inhibitors to reduce this harmful release. Pretreatments with 1 × 10(-4) M 6-MP and 1 × 10(-4) M PT solutions with 1h and 3h immersion times were tested. Conventional electrochemical techniques, EDX and XPS analysis, and cytotoxicity assays with HeLa cell line were employed to investigate the corrosion behavior and biocompatibility of copper with and without treatments. Results showed that copper samples treated with PT and 6-MP solutions for 3 and 1 h, respectively, are more biocompatible than those without treatment. Besides, the treatment reduces the burst release effect of copper in simulated uterine solutions during the first week after the insertion. It was concluded that PT and 6-MP treatments are promising strategies able to reduce the side effects related to the "burst release" of copper-based IUD without altering the contraceptive action.

  18. An approach to give prospective life-span of the copper/low-density-polyethylene nanocomposite intrauterine device.

    Science.gov (United States)

    Xia, Xianping; Tang, Ying; Xie, Changsheng; Wang, Yun; Cai, Shuizhou; Zhu, Changhong

    2011-07-01

    As a novel copper-containing intrauterine device (IUD), the prospective life-span of the copper/low-density-polyethylene (Cu/LDPE) nanocomposite IUD is very important for the future clinical use and should be given in advance. Here a novel approach, cupric ions accelerated release in diluted nitric acid solution and cupric ions concentration release in various volume of simulated uterine solution (SUS), is reported to verify the type of cupric ions release model of the cylindrical matrix-type nanocomposite IUD, and to obtain the minimal cupric ions release rate that need to ensure contraceptive efficacy and the thickness of copper particles exhausted layer of the cylindrical matrix-type nanocomposite IUD within two difficult immersion durations in experimental volume of SUS, respectively. Using these results, the prospective life-span of the cylindrical matrix-type nanocomposite IUD can be obtained. For instance, the prospective life-span of the novel γ-shape nanocomposite IUD with 25 wt% of copper nanoparticles and 2 mm of diameter and a total weight of 285 mg can be given in advance and it is about 5 years in the future clinical use.

  19. Alterations in copper homeostasis and oxidative stress biomarkers in women using the intrauterine device TCu380A.

    Science.gov (United States)

    Arnal, Nathalie; de Alaniz, María J T; Marra, Carlos A

    2010-02-15

    Copper ions participate in the Häber-Weiss reaction to produce ROS, which can be toxic when in excess. The purpose of this study was to measure the copper concentration (Cu) in the plasma of women using Cu-IUDs and determine (i) the effect of Cu on oxidative stress biomarkers, (ii) the levels of copper transport proteins in the plasma and (iii) the status of some liver damage markers in relation to the length of the intrauterine device use. Thirty-nine controls and 35 T380-IUD users were recruited. Various oxidative stress biomarkers, ceruloplasmin (CRP), metallothioneins (MTs), Cu and enzyme activities involved in liver function were measured in the plasma. The Cu concentration was higher in women with IUDs, concomitantly with time-dependent increases in the main oxidative stress biomarkers (TBARS, protein carbonyls, glutathione and nitrates+nitrites), hepatic enzymes (LDH and transaminases), MTs and CRP. We concluded that the use of Cu-IUDs for more than 2 consecutive years should be avoided in order to prevent oxidative damage.

  20. Long-term safety, efficacy, and patient acceptability of the intrauterine Copper T-380A contraceptive device

    Directory of Open Access Journals (Sweden)

    Bliss Kaneshiro

    2010-07-01

    Full Text Available Bliss Kaneshiro, Tod AebyDepartment of Obstetrics and Gynecology, John A Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USAAbstract: The intrauterine device (IUD, primarily in the form of the copper IUD, is used by more than 150 million women around the world, making it the most widely used reversible method of contraception. With a remarkably low failure rate of less than 1 per 100 women in the first year of use, the Copper T-380A is in the top tier of contraceptives in terms of efficacy. Risks of utilization include perforation and an increased risk of infection in the first 20 days following insertion. Overall, the number of adverse events is low, making the Copper T-380A a very safe contraceptive method. The most common reasons for the discontinuation of this method are menstrual bleeding and dysmenorrhea. However, cumulative discontinuation rates of Copper T-380A are lower than that have been reported for other methods, indicating that the Copper T-380A is highly acceptable to women. After 5 years, approximately 50% of all women, who have a Copper T-380A inserted, will continue to use this highly effective contraceptive method.Keywords: contraception, perforation, expulsion, pelvic inflammatory disease, continuation

  1. Reasons for Intrauterine Device Use, Discontinuation and Non-Use in Malawi: A Qualitative Study of Women and their Partners.

    Science.gov (United States)

    Bryant, Amy G; Hamela, Gloria; Gotter, Ann; Stuart, Gretchen S; Kamanga, Gift

    2015-12-01

    The copper intrauterine device (IUD) is a safe, long-acting, and effective method of contraception that is under-utilized in many countries, including Malawi. A unique cohort of women who had enrolled in a trial of postpartum IUD use one year earlier gave insights into reasons for using, discontinuing, or not using the IUD. We conducted in-depth interviews with 18 women one year after they participated in a pilot study of a randomized controlled trial of postpartum IUD insertion, and 10 of their male partners. Women and their partners expressed a strong desire for family planning, and perceived numerous benefits of the IUD. However, fear of the IUD was common among successful users and non-users alike. This fear arose from rumours from friends and neighbors who were non-users. How women and their partners responded to this fear affected IUD adoption and continuation. Key themes included (1) Trust in information received from health care providers versus rumours from community members; (2) Partner involvement in IUD decision-making; and (3) Experience with side effects from short-term hormonal contraceptive methods. Broad community education about the IUD's benefits and safety, and proactive counseling to address couples' specific fears, may be needed to increase uptake of the method.

  2. A facility birth can be the time to start family planning: postpartum intrauterine device experiences from six countries.

    Science.gov (United States)

    Pfitzer, Anne; Mackenzie, Devon; Blanchard, Holly; Hyjazi, Yolande; Kumar, Somesh; Lisanework Kassa, Serawit; Marinduque, Bernabe; Mateo, Marie Grace; Mukarugwiro, Beata; Ngabo, Fidele; Zaeem, Shabana; Zafar, Zonobia; Smith, Jeffrey Michael

    2015-06-01

    Initiation of family planning at the time of birth is opportune, since few women in low-resource settings who give birth in a facility return for further care. Postpartum family planning (PPFP) and postpartum intrauterine device (PPIUD) services were integrated into maternal care in six low- and middle-income countries, applying an insertion technique developed in Paraguay. Facilities with high delivery volume were selected to integrate PPFP/PPIUD services into routine care. Effective PPFP/PPIUD integration requires training and mentoring those providers assisting women at the time of birth. Ongoing monitoring generated data for advocacy. The percentages of PPIUD acceptors ranged from 2.3% of women counseled in Pakistan to 5.8% in the Philippines. Rates of complications among women returning for follow-up were low. Expulsion rates were 3.7% in Pakistan, 3.6% in Ethiopia, and 1.7% in Guinea and the Philippines. Infection rates did not exceed 1.3%, and three countries recorded no cases. Offering PPFP/PPIUD at birth improves access to contraception.

  3. Awareness and Interest in Intrauterine Contraceptive Device Use among HIV-Positive Women in Cape Town, South Africa

    Directory of Open Access Journals (Sweden)

    Catherine S. Todd

    2012-01-01

    Full Text Available Objective. To assess awareness of and interest in intrauterine contraceptive device (IUCD use among HIV-positive women in Cape Town, South Africa. Design. Cross-sectional survey. Methods. HIV-positive women aged 18 through 45 years presenting for care at a primary health care clinic in Cape Town, South Africa participated in this study. Consented participants completed a staff-administered questionnaire in a private setting. Descriptive statistics were generated. Comparisons between demographic and reproductive health-related variables and IUCD awareness and interest were performed with multiple logistic regression. Analyses for IUCD interest excluded women with prior surgical sterilization. Results. Of 277 HIV-positive women, 37% were aware of the IUCD; awareness was independently associated with greater age (adjusted odds ratio (AOR = 1.15, 95%; confidence interval (CI: 1.10–1.20 and not switching contraceptive methods in the last year (AOR = 2.45, 95% CI: 1.03–5.83. Following an IUCD information session, 86% of women (=206/240 were interested in IUCD use. IUCD interest was inversely associated with age (AOR = 0.91, 95% CI: 0.86–0.97 and marginally positively associated with current menstrual bleeding pattern complaints (AOR = 2.14, 95% CI: 0.98–4.68. Conclusions. Despite low levels of method awareness, HIV-positive women in this setting are frequently interested in IUCD use, indicating need for programming to expand method access.

  4. POST-PLACENTAL INTRAUTERINE CONTRACEPTIVE DEVICE (PPIUCD INSERTION -2 YEAR EXPERIENCE AT A GOVT. MEDICAL COLLEGE, VIMS, BELLARY, KARNATAKA

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    Asha Rani

    2015-11-01

    Full Text Available Post-partum period is one of the critical times when both woman and new-born need a special and integrated package of health services as morbidity and mortality rates are quite high during this period and also the women are vulnerable to unintended pregnancy. Studies show that pregnancies taking place within 24 months of a previous birth have a higher risk of adverse outcomes like abortions, premature labor, post-partum haemorrhage, low birth weight babies, fetal loss and maternal death. In India, 65 percent of women in the first year post-partum have an unmet need for family planning. Hence, contraception needs to be practiced in this critical period.1 Intrauterine contraceptive device is the most commonly used reversible method of contraception worldwide with about 127 million current users.2 Insertion of an IUD immediately after delivery is appealing for several reasons. The woman is not pregnant and is motivated for contraception and the setting is convenient for both woman and provider. For women with limited access to medical care, the delivery affords a unique opportunity to address the need for contraception. The evidence for post-partum IUD insertion was weak when this study was undertaken. Therefore, the present study was planned to evaluate the safety and efficacy (In terms of pain, expulsion, excessive bleeding, foul smelling vaginal discharge of insertion of immediate post-partum IUD in women delivering vaginally or by caesarean section.

  5. Medical eligibility, contraceptive choice, and intrauterine device acceptance among HIV-infected women receiving antiretroviral therapy in Lilongwe, Malawi.

    Science.gov (United States)

    Haddad, Lisa B; Feldacker, Caryl; Jamieson, Denise J; Tweya, Hannock; Cwiak, Carrie; Bryant, Amy G; Hosseinipour, Mina C; Chaweza, Thomas; Mlundira, Linly; Kachale, Fanny; Stuart, Gretchen S; Hoffman, Irving; Phiri, Sam

    2014-09-01

    To determine medical eligibility for contraceptive use, contraceptive preference, and acceptance of a copper intrauterine device (IUD) among a cohort of HIV-infected women receiving antiretroviral therapy (ART). All HIV-infected women who received ART and sought contraceptive services at the Lighthouse clinic, an integrated HIV/ART clinic in Lilongwe, Malawi, between August and December 2010 were invited to participate in a structured interview. Eligibility and preference for the following contraceptive methods were assessed: combined hormonal contraceptives, progestogen-only pills, copper IUD, injectable depot medroxyprogesterone acetate (DMPA), and contraceptive implants. The final sample included 281 women; five were pregnant. The remaining 276 women were eligible for at least three contraceptive methods, with 242 (87.7%) eligible for all five methods evaluated. After counseling, 163 (58.0%) selected DMPA and 98 (34.9%) selected an IUD as their preferred contraceptive method. Regardless of their method of choice, 222 (79.0%) women agreed to have an IUD placed on the same day. Most methods of contraception are safe for use by HIV-infected women. Approximately 80% of the women were willing to receive an IUD. Efforts must be made to increase education about, and access to, long-acting reversible methods that may be acceptable and appropriate contraceptive options for HIV-infected women. Copyright © 2014 International Federation of Gynecology and Obstetrics. All rights reserved.

  6. Eubacterium nodatum mimics Actinomyces in intrauterine device-associated infections and other settings within the female genital tract.

    Science.gov (United States)

    Hill, G B

    1992-04-01

    Eubacterium nodatum is an obligately anaerobic, gram-positive, branching rod that markedly resembles Actinomyces, particularly Actinomyces israelii, in its cellular and colonial characteristics. Its isolation from the female genital tract was examined for a study period in which use of intrauterine contraceptive devices (IUDs) was common, and additional characteristics of the organism were investigated. Fifteen genital isolates of E nodatum were all associated with the presence of a foreign body, usually an IUD (12 patients). Six of these 12 patients had presented with clinically severe pelvic inflammatory disease. The remaining six had signs and symptoms related to IUD use and/or had a report of probable Actinomyces (five patients) by a Papanicolaou smear, demonstrating that E nodatum can be mistaken for Actinomyces in a Papanicolaou-stained smear. The three other patients had different types of foreign bodies. The frequency of isolation from cultures associated with IUD use during the study period was five (6.4%) of 78 for Actinomyces versus the 12 (15.4%) of 78 for E nodatum. In vitro-prepared E nodatum was not demonstrated to cross-react with A israelii or A naeslundii antisera. Both E nodatum and A israelii were shown to adhere in vitro to an inanimate object, indicating their propensities to colonize a foreign body. The present data, with the previous reports of isolation of E nodatum from cases of lumpy jaw and severe periodontitis, suggest that it is an opportunistic pathogen very much like A israelii.

  7. Immediate Postpartum Intrauterine Contraceptive Device Insertions in Caesarean and Vaginal Deliveries: A Comparative Study of Follow-Up Outcomes

    Science.gov (United States)

    Nanda, Smiti; Gupta, Anjali; More, Hemant

    2016-01-01

    Background. Immediate postpartum intrauterine contraceptive device (IPPIUCD) is a lucrative postpartum family planning method which provides effective reversible contraception to women in the delivery setting. Our aim was to study the clinical outcomes of IPPIUCD insertions and compare them as a factor of route of insertion (vaginal versus caesarean). Methods. This is a retrospective analytical study done in a tertiary care teaching institute. A Cohort of 593 vaginal and caesarean deliveries with IPPIUCD insertions, over a two-year period, was studied and compared for follow-up results. Outcome measures were safety (perforation, irregular bleeding, unusual vaginal discharge, and infection), efficacy (pregnancy, expulsions, and discontinuations), and incidence of undescended IUCD strings. Descriptives were calculated for various outcomes and chi square tests were used for comparison in between categorical variables. Results. Overall complication rates were low. No case of perforation or pregnancy was reported. Spontaneous expulsions were present in 5.3% cases and were significantly higher in vaginal insertions (p = 0.042). The incidence of undescended strings was high (38%), with highly significant difference between both groups (p = 0.000). Conclusion. IPPIUCD is a strong weapon in the family planning armoury and should be encouraged in both vaginal and caesarean deliveries. Early follow-up should be encouraged to detect expulsions and tackle common problems. PMID:27631023

  8. Synergistic effect of amphotericin B and tyrosol on biofilm formed by Candida krusei and Candida tropicalis from intrauterine device users.

    Science.gov (United States)

    Shanmughapriya, Santhanam; Sornakumari, Haridevvenkatesan; Lency, Arumugam; Kavitha, Senthil; Natarajaseenivasan, Kalimuthusamy

    2014-11-01

    The presence of intrauterine contraceptive devices (IUDs) provides a solid surface for attachment of microorganisms and an ideal niche for the biofilm to form and flourish. Vaginal candidiasis is often associated with the use of IUDs. Treatment of vaginal candidiasis that develops in connection with IUD use requires their immediate removal. Here, we present in vitro evidence to support the use of combination therapy to inhibit Candida biofilm. Twenty-three clinical Candida isolates (10 C. krusei and 13 C. tropicalis) recovered from endocervical swabs obtained from IUD and non-IUD users were assessed for biofilm-formation ability. The rate of isolation of Candida did not differ significantly among IUD and non-IUD users (P = 0.183), but the biofilm-formation ability of isolates differed significantly (P = 0.02). An in vitro biofilm model with the obtained isolates was subjected to treatment with amphotericin B, tyrosol, and a combination of amphotericin B and tyrosol. Inhibition of biofilm by amphotericin B or tyrosol was found to be concentration dependent, with 50% reduction (P tyrosol and amphotericin B was studied. Interestingly, approximately 90% reduction in biofilm was observed with use of 80 μM tyrosol combined with 4 mg/l amphotericin B (P < 0.001). This represents a first step in establishing an appropriate antibiofilm therapy when yeasts are present.

  9. Foreign body granuloma in the anterior abdominal wall mimicking an acute appendicular lump and induced by a translocated copper-T intrauterine contraceptive device: a case report

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    Ansari Maulana Mohammed

    2009-04-01

    Full Text Available Abstract Introduction Intrauterine contraceptive devices may at times perforate and migrate to adjacent organs. Such uterine perforation usually passes unnoticed with development of potentially serious complications. Case presentation A 25-year-old woman of North Indian origin presented with an acute tender lump in the right iliac fossa. The lump was initially thought to be an appendicular lump and treated conservatively. Resolution of the lump was incomplete. On exploratory laparotomy, a hard suspicious mass was found in the anterior abdominal wall of the right iliac fossa. Wide excision and bisection of the mass revealed a copper-T embedded inside. Examination of the uterus did not show any evidence of perforation. The next day, the patient gave a history of past copper-T Intrauterine contraceptive device insertion. Conclusions Copper-T insertion is one of the simplest contraceptive methods but its neglect with inadequate follow-up may lead to uterine perforation and extra-uterine migration. Regular self-examination for the "threads" supplemented with abdominal X-ray and/or ultrasound in the follow-up may detect copper-T migration early. To the best of our knowledge, this is the first report of intrauterine contraceptive device migration to the anterior abdominal wall of the right iliac fossa.

  10. Influences of copper and design of intrauterine devices on endometrial bleeding in monkeys.

    Science.gov (United States)

    Shaw, S T; Forino, R V; Poon, C H; Moyer, D L

    1976-07-01

    Uterine bleeding in 8 rhesus monkeys was compared in response to plain vs. a specially fitted copper-wrapped IUD. All animals had utero-cutaneous surgical fistulas for accurate IUD insertion and removal. Daily observations for uterine bleeding between menstruations and quantitation of menstrual blood loss (MBL) were made. Following control periods of observation, each monkey was inserted with either a plain or a copper-wrapped IUD and then studied for 4 consecutive menstrual periods. Each IUD was especially fashioned to an estimate of individual uterine cavity size. Some were wrapped with pure copper wire of 30 sp mm surface area. In some animals the devices were later removed from the uterus, the copper wire taken off, and the plain polyethylene oval-Ts reinserted. In some animals originally wearing plain polyethylene devices, the IUDs were removed, wrapped with copper wire, and reinserted into the same monkeys. During the observed 4 consecutive preinsertion periods, MBL averaged 1.54 ml and was the same in the 4 cycles in which a plain polyethylene oval-T device was in place. No intermenstrual bleeding was observed, except slight spotting for the first 1 or 2 days. During the 4 cycles, with the copper-wound device present, mean MBL was 1.28 ml. Having individually fitted each uterine cavity with a best-fitting IUD was considered important. The addition of copper had not increased the bleeding. In humans, especially fitted contraceptive devices may minimize complications of bleeding and pain as compared with standard designs. Bleeding and pain have been the most frequent complications leading to removal of IUDs.

  11. 绝经后妇女宫内节育器取出困难原因探讨%Difficulty reason discussion of taking out intrauterine device of postmenopausal women

    Institute of Scientific and Technical Information of China (English)

    俞群亚

    2015-01-01

    目的:探析绝经后妇女宫内节育器取出困难的原因.方法:2010年2月-2014年7月接受宫内节育器取出术的绝经后妇女 510 例,回顾性分析其临床资料.结果:408 例患者一次性取环成功,102 例取出困难,取环困难率20%.结论:绝经时间和带环时间越长,取环困难率越高.妇女绝经后,应该尽快将节育器取出,从而改善患者预后生活质量.%Objective:To explore the difficult reason of taking out intrauterine device of postmenopausal women.Methods:The clinical data of 510 cases of postmenopausal women with intrauterine device taking out were analyzed retrospectively from February 2010 to July 2014.Results:408 patients had once extraction of intrauterine device,and 102 cases had difficulty in taking out,and the difficult extraction rate was 20%.Conclusion:The difficult extraction rate of intrauterine device was high as long as the menopause time and the intrauterine device time.The intrauterine device should removed as soon as possible after menopause so as to improve the patients'prognosis quality of life.

  12. [Adequacy of the device intrauterine by ultrasound evaluation: postpartum and post-abortion insertion versus insertion during the menstrual cycle].

    Science.gov (United States)

    de Holanda, Antônio Arildo Reginaldo; Pessoa, Aline de Melo; Holanda, Julita de Campos Pipolo; de Melo, Maria Helena Vieira; Maranhão, Técia Maria de Oliveira

    2013-08-01

    To compare by transvaginal ultrasound the position of the intrauterine device (IUD) inside the uterine cavity, depending on the time of insertion, postpartum and post-abortion, and during the menstrual cycle. Epidemiologic, observational and cross-sectional study carried out between February and July, 2013. A total of 290 women were included, 205 of them with insertion during the menstrual cycle and 85 during the postpartum and post-abortion periods. The independent variables were: age, parity, time of use, insertion time, number of returns to family planning, satisfaction with the method, wish to continue using the device, symptoms and complications. The dependent variable was the adequate position of the IUD inside the uterine cavity. The χ² test with Pearson's correction and the Fisher exact test were used for statistical analysis, with the level of significance set at 5%. The average age was 29.4 years and the average time of IUD use was 2.7 years; 39.3% of the women had symptoms associated with the method, the most frequent being menorrhagia (44.7%). The degree of satisfaction was 85% and 61.4% of the women returned two or more times for consultation about family planning. Age, parity and the position of the uterus in the pelvic cavity was not associated with a poor position of the IUD inside the uterine cavity (p>0.05). Insertion during the menstrual cycle was significantly more associated with a correct position of the IUD than postpartum and post-abortion insertion (pabortion insertion showed worse results regarding the adequacy of IUD position, a fact that was not observed regarding age, parity or position of the uterus in the pelvic cavity.

  13. Use of echosonography to monitor uterine placement of intrauterine devices after immediate postpartum insertions.

    Science.gov (United States)

    Ortiz Mariscal, J D; Guerrero Barrera, C; Wheeler, R G; Waszak, C S

    1987-02-01

    A study designed to monitor uterine placement of IUDs inserted immediately postpartum using echosonography was conducted at the Hospital de Gineco Obstetricia No. 23, "Dr. Ignacio Morones Prieto" in Monterrey, Mexico. TCu220 and Delta T IUDs were randomly assigned to, and inserted in women immediately following a normal vaginal delivery. Ultrasound examinations were to be performed within 60 min postinsertion, at 24 h postinsertion and at 1- and 3-month follow-up visits. There were no differences in the expulsion rates of the two device groups. Data are presented on the readings taken at the ultrasound examinations of the distance between the fundus and the upper part of the stem of the T. These differences differed significantly between the two device groups at the first ultrasound reading only (P less than or equal to 0.01). No relationship was found between the incidence of expulsion and the distance between the IUD and the fundus at any of the readings.

  14. Failure of post-coital contraception after insertion of an intrauterine device. Case report.

    Science.gov (United States)

    Kubba, A A; Guillebaud, J

    1984-06-01

    This paper reports the case of in situ failure of a postcoitally inserted IUD. The patient selected to have a Nova-T IUD inserted 69 hours after a single episode of unprotected intercourse and 19 days after her last menstrual period. 18 days after insertion, the patient had a positive urine pregnancy test. There was no evidence of partial expulsion or malposition of the device. Before this failure, 116 IUDs had been inserted at the center, primarily for postcotial contraception. Only 2 failures/1300 postcoital IUD insertions are expected to occur, and the 1300 case reports in the literature include no reports of failure. Although the failure rate is theoretically low, the effectiveness of this method should not be overstated during counseling.

  15. Prevalence of genital tract infection with Entamoeba gingivalis among copper T 380A intrauterine device users in Egypt.

    Science.gov (United States)

    Foda, Ashraf A; El-Malky, Mohamed M

    2012-01-01

    This study was performed to study the prevalence and potential pathogenicity of E. gingivalis in the genital tracts of intrauterine contraceptive device (IUD) users. A prospective study conducted at the Obstetrics and Gynecology Department and Fertility Care Unit, Mansoura University Hospital, Egypt. The study was carried out on 87 IUD users and 87 nonusers. The copper T 380A IUD was removed from each woman and washed with phosphate-buffered saline (PBS) pH 7.4; the IUD wash was centrifuged. The sediment was resuspended in 2 ml PBS and divided into two portions. One portion was used for preparation of direct and iron hematoxylin-stained smears. Direct smears and stained smears were examined for detailed morphology. The second portion of the sediment was used for DNA extraction and subsequent PCR amplification targeting the small subunit ribosomal RNA of E. gingivalis. The parasite was found in 12.64% of IUD users and in 6.9% of non users (p>.3). It was found that 90.9% of those harboring E. gingivalis in their genital tract had the parasite in their oral cavity. The percentage of genital infection in IUD users increased with low level of education, rural areas, insertion in primary health-care center and among those not washing hands before checking the strings. In the infected cases, vaginal discharge was more common (81.8%) than in noninfected cases (32.9%), such difference was statistically significant (p<.05). Also, excessive vaginal discharge is more common than backache and menorrhagia in the infected cases. Higher incidence of E. gingivalis infection in IUD users is related to oral cavity infection, residence, the facility where they inserted their IUD and washing hands attitude before checking the strings. We recommend treatment of gingival infection, proper counseling and medical education on oral and genital tract hygiene for IUD users. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. Diclofenac plus lidocaine gel for pain relief during intrauterine device insertion. A randomized, double-blinded, placebo-controlled study.

    Science.gov (United States)

    Fouda, Usama M; Salah Eldin, Noha M; Elsetohy, Khaled A; Tolba, Hoda A; Shaban, Mona M; Sobh, Sherin M

    2016-06-01

    To determine the effectiveness of diclofenac potassium combined with 2% lidocaine gel in reducing the pain of intrauterine device (IUD) insertion. We randomized 90 parous women requesting copper T380A IUD insertion in a 1:1 ratio to active or placebo treatment. Active treatment included administration of two 50-mg diclofenac potassium tablets 1h before IUD insertion, application of 3mL of 2% lidocaine gel on the anterior cervical lip 3min before IUD insertion and placement of a cotton swab soaked in 2% lidocaine gel in the cervical canal 3min before IUD insertion. Women in the placebo group received placebo tablets and gel. Participants assessed pain intensity using a 10-cm visual analog scale (VAS). We considered a 2-cm difference in VAS pain score between both groups during IUD insertion to be a clinically significant difference. Subjects receiving active treatment, as compared to placebo, experienced less pain during tenaculum placement (1.66±0.85 vs. 2.33±1.19, p=.003) and IUD insertion (3.14±0.92 vs. 3.94±1.3, p=.001). Women who delivered only by cesarean section had higher pain scores with IUD insertion compared with women with previous vaginal deliveries (4.41±1.24 vs. 3.29±1.05, p=.001). Diclofenac potassium combined with 2% lidocaine gel slightly reduced pain scores during tenaculum application and copper IUD insertion in parous women; however, the reduction in pain scores lacked clinical significance. Although we found a statistically significant lowering of pain scores with pretreatment with diclofenac potassium and lidocaine gel in parous women having copper IUD placement, the reduction is not clinically relevant. These findings may be more relevant for nulliparous women who experience more pain than parous women with IUD insertion and support studies of diclofenac potassium and lidocaine gel in this population. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. [The role of intrauterine contraceptive devices in the development of inflammatory processes in the small pelvis].

    Science.gov (United States)

    Batar, I

    1986-08-10

    The incidence of pelvic inflammatory disease (PID) attributable to IUD use has been increasing, especially after the removal of the Dalkon shield from the market, but this relationship has not been settled conclusively. In recent decades PID included a variety of infections, but lately the definition of PID has meant acute ascending infections of the female genital tract. Its most common risk factors include promiscuity of IUD use, although this can be reduced to one fourth by regular checkups and proper hygiene. The frequency of PID is estimated at 2-5% of IUD users. Microorganisms contributing to PID include Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma hominis, Escherichia coli, Proteus, Staphylococcus epidermis, Haemophilus influenzae, Bacteroides, Peptococcus, Peptostreptococcus, Clostridium, and Actinomyces israelii, The differentiation of actinomycosis (AC) and pseudoactinomycosis (PAC) is well advised. The potential of IUD use in increasing the risk of AIDS should not be discounted. The clinical picture of PID is varied, it can be mild requiring conservative drug therapy; with medium severity requiring removal of the IUD and drug therapy; severe necessitating removal, antibiotics and sulfonamide treatment and laparotomy; and very severe with potentially fatal generalized sepsis. In addition to antibiotics, e.g., penicillin, treatment can include the so called catastrophy combination of Mandokef- Metronidazol-Gentamycin. An analysis of the data of 8536 IUD fittings in Debrecen, Hungary showed 1.4% removals due to PID after 4 years, 694 patients (8.1%) had lower abdominal pain 73 of which (0.9%) had palpable resistance, and suppuration occurred in only 30 cases (0.4%). Treatment included Semicillin or Tetran, or removal of the IUD, and even surgery if no improvement resulted. Prevention of PID include elimination of risk factors, the careful selection of IUD users, regular checkups, the use of copper (Cu) T device, and strict adherence to

  18. Place, remove the intrauterine device, and medical abortion correlation analysis%放置、取出宫内节育器和药物流产相关性分析

    Institute of Scientific and Technical Information of China (English)

    杨慧(通讯作者); 朱晓琴; 季金陵; 姜璐璐

    2013-01-01

    Objective: To investigate place the intrauterine device,take out the intrauterine device and medical abortion number changes among contraception operation from 2008 to 2011 in Huaian. Methods: al the region engaged in family planning technical service work by the trained professionals to fil in the monthly number of contraception technical services, report step by step, statistics place the intrauterine device,take out the intrauterine device and medical abortion number changes among contraception operation. Results: The number of place the intrauterine device and take out the intrauterine device in 2008~2011 in Huaian were reduced year by year. The number of medical abortion number increased too. Conclusion: The number of medical abortion with highly linear negative correlation with The difference between the place and remove the intrauterine device number.%目的研究淮安市2008~2011年计划生育手术中放置与取出宫内节育器和药物流产人次数变化情况。方法本地区所有从事计划生育技术服务的工作单位由受过培训的专业人员每月填写计划生育技术服务数量情况,逐级上报,统计分析淮安市计划生育手术中放置与取出宫内节育器和药物流产人次数变化情况。结果淮安市2008~2011年放置与取出宫内节育器例数逐年减少,药物流产人次数逐年上升。结论药物流产人次数与放置、取出宫内节育器例数之差有高度线性负相关。

  19. linical Effect Observation of MCu Memory Alloy Intrauterine Device%放置MCu记忆合金宫内节育器临床效果观察

    Institute of Scientific and Technical Information of China (English)

    王玲; 张蕊

    2016-01-01

    目的:探讨观察MCu记忆合金宫内节育器临床使用情况。方法方便选择于2012年2月—2014年12月在山东省烟台市计划生育指导中心自愿放置MCu记忆合金宫内节育器的受试者400例,进行临床效果观察。结果 MCu记忆合金宫内节育器,置器18个月MCuIUD避孕率为99.75%;不良反应发生率3个月时13.5%,18个月后降至0%。累计移位率1.25%,脱落率0.25%;累计续用率为96.25%。结论 MCu记忆合金宫内节育器,避孕有效率高、因症取出及不良反应发生率低,操作便捷,在临床使用中安全高效值得推广使用。%Objective To investigate the clinical use of MCu memory alloy intrauterine device. Methods Convenient selec-tion 400 cases of MCu memory alloy intrauterine device in Yantai City, Shandong Province, family planning guidance center from February 2012 to December 2014 years old were selected, and the clinical effect was observed. Results MCu memory alloy intrauterine device, the device for 18 months MCuIUD contraceptive rate was 99.75%; the incidence of adverse reac-tions was 3 months, 18, 13.5% months after the 0%. The cumulative displacement rate was 1.25%, and the shedding rate was 0.25%. The cumulative rate was 96.25%. Conclusion MCu memory alloy intrauterine device, the effective rate of con-traception, and the incidence of adverse drug reaction rate is low, the operation is convenient, safe and effective in clinical use is worthy of popularization and use.

  20. Predicted Value of Serum Prostaglandin E2 on the Dysmenorrheal Treatment Effect in Adenomyosis Patients with Levonorgestrel-releasing Intrauterine System%血清前列腺素E2预测左炔诺孕酮缓释系统治疗子宫腺肌病痛经效果的价值探讨

    Institute of Scientific and Technical Information of China (English)

    杨丽华; 徐勤; 胡万芹

    2013-01-01

    Objective: To explore the possibility of the serum prostaglandin E2(PGE2) level predictive value on the dysmenorrheal treatment effect in the adenomyosis (ADS) patients with levonorgestrel-releas-ing intrauterine system (LNG-IUS). Methods: Forty-one ADS patients treated with LNG-IUS because of dysmenorrhea were collected. These patients were divided into effective group (n=32) and noneffective group (n=9) according to the effect of relieving dysmenorrhea. The serum PGE2 level before and after 6 months of the LNG-IUS treatment were compared by ELISA, and the influence of serum PGE2 level caused by LNG-IUS and the correlation between the serum PGE2 level and the dysmenorrheal treatment effect with LNG-IUS were analyzed. Results: The serum PGE2 concentrations were 20.95 ± 3.07 pg/ml and 5.56 ± 1.72 pg/ml in the effective group before and after 6 months with LNG-IUS treatment, there was a significant difference between them (P<0.05). The serum PGE2 concentrations were 5.74 ±1.12 pg/ml and 4.95±1.39 pg/ml in the noneffective group before and after 6 months with LNG-IUS treatment, there was no significant difference between them. The serum PGE2 concentration in the effective group was significantly higher than that in the noneffective group (P<0.05). The change of visual analogue scale (VAS) score after 6 months of LNG-IUS treatment had a positive correlation with the serum PGE2 level before LNG-IUS treatment, the higher serum PGE2 concentration was, the more obviously the VAS score decreased (r=0.845, P<0.05). Conclusion: PGE2 might be involved in the occurrence of ADS dysmenorrhea and LNG-IUS relieved dysmenorrhea through decreasing the PGE2 level. It is suggested that the patients with high PGE2 level choose LNG-IUS to treat their dysmenorrhea and the patients with low PGE2 level use other ways to treat dysmenorrhea.%目的:探讨子宫腺肌病(adenomyosis,ADS)患者血清前列腺素E2(prostaglandin E2,PGE2)水平预测左炔诺孕酮缓释系统(levonorgestrel

  1. Clinical efficacy of levonorgestrel and norethisterone for the treatment of chronic abnormal uterine bleeding.

    Science.gov (United States)

    Ashraf, Muhammad Nadeem; Habib-Ur-Rehman, Agha; Shehzad, Zahid; AlSharari, Shakir DakheelAllah; Murtaza, Ghulam

    2017-09-01

    To compare the clinical efficacy of levonorgestrel intrauterine system with oral norethisterone for the treatment of idiopathic chronic abnormal uterine bleeding. This cross-sectional study was conducted at Bahawal Victoria Hospital, Jubilee Female Hospital, Civil Hospital and private clinics of consultant gynaecologists in Bahawalpur, Pakistan, from March to August 2014, and comprised patients presenting with abnormal uterine bleeding. The patients were equally and randomly divided into two groups, i.e. intrauterine levonorgestrel administered (group A) and norethisterone administered (group B). Mean age, duration of the disease and parity were determined using a predesigned questionnaire. The primary outcomes of the treatments, i.e. reduction in menstrual blood loss assessed by the pictorial blood assessment chart score, were recorded before the initiation of therapy, at 3 months and at 6months of the study. SPSS 16 was used for data analysis. There were 76 subjects; 38(50%) in each group. In group A, the mean age and mean duration of the disease was 34.16±6.327 years and 6.18±2.415 years compared to 34.21±3.595 years and 6.21±2.418 years in group B. The reduction in menstrual blood loss did not differ significantly between the groups after 3 months (p= 0.321). However, levonorgestrel intrauterine system was found more effective in reducing menstrual blood loss in 36(94.73%) patients, compared to norethisterone-treated patients 28(73.68%) after 6 months of the treatment (p=0.041). The response of both the treatments was found independent of patient's age, parity and chronicity of the disease. The levonorgestrel intrauterine system was better than norethisterone with marked clinical benefit of profound reduction in menstrual blood loss.

  2. LNG-IUS对腺肌症子宫内膜VEGF、Ang-1、Ang-2的影响%The influence of levonorgestrel intrauterine system on endometrial VEGF/Ang-1/Ang-2 of women with adenomyosis

    Institute of Scientific and Technical Information of China (English)

    姚佳娜; 谢梅青

    2013-01-01

    Objective To determine the alteration of endometrial VEGF/Ang-1/Ang-2 expression of women with adenomyosis after using levonogestrel intrauterine system,and elucidate the possible mechanism of breakthrough bleeding in the use of LNG-IUS on angiogenesis and vascular stability.Methods Endometrial biopsies was obtained from 41 women with adenomyosis undergoing treatment with LNG-IUS by using Pipelle suction curette,determine the endometrial VEGF/Ang-1/Ang-2 expression through immunohistochemistry.We also took the endometrial tissue from patients diagnosed as adenomyosis without any treatment as control groups.Results The LNG-IUS group was divided into bleeding group (16 cases) and non-bleeding group (25 cases),according to the bleeding patterns in the last 3 months before biopsy.The staining for VEGF/Ang-2 in bleeding group was significantly higher than that in nonbleeding group (P<0.05).The Ang-1 staining in glandular epithelium and stromal cells between two groups was not significant different (P>0.05).Divided the LNG-IUS group into the less than 1-year group,1-2 year group and more than 2-year group,we had found that the 1-2 year group and the more than 1-year group exhibited significantly lower immunoreactivity for VEGF and Ang-2 in both glandular epithelium and stromal cells (P<0.05),while there were no significant differences in immunoreactivity for the Ang-1 among different groups (P>0.05).Conclusion VEGF and Ang1,Ang-2 may play a role in provoking breakthrough bleeding in the use of LNG-IUS by influencing angiogenesis and vascular stability.%目的 研究子宫腺肌症患者放置左炔诺孕酮宫内缓释系统(LNG-IUS)后子宫内膜血管内皮生长因子(VEGF)、促血管生成素(Ang-1、Ang-2)表达的变化,从血管生成及血管稳定性方面探讨子宫腺肌症患者放置LNG-IUS后不规则出血的发生机制.方法 收集41例放置LNG-IUS腺肌症患者的子宫内膜,应用免疫组化染色(DAKO EnvisionTM System

  3. 某城镇妇女取环困难原因分析%Reason analysis on the difficulties of intrauterine device removal in a town

    Institute of Scientific and Technical Information of China (English)

    魏本翠; 刘贤云; 陶靖隆; 王俊虹; 关超玲

    2016-01-01

    [Objective]To explore the causes for the difficulties of intrauterine device removal in the Population and Family Planning Service Outlet of a town.[Methods] The clinical data of 1507 women undergoing intrauterine device removal were retrospectively analyzed from January 2014 to December 2014 in a town.Univariate and multivariate were used to analyze the causes for the difficulties of intrauterine device removal.[Results] The rate of difficult intrauterine device removal was 25.02% (95% CI 22.83%~27.20%).The results of univariate analysis indicated that there was significant difference in age,marriage period,duration of intrauterine device,times of labor and abortion between normal and difficult intrauterine device removal (P<0.05).The results of multivariate analysis showed that excepting the deflective factors,age (OR=4.86.95% CI 3.35~7.05),duration of intrauterine device (OR=1.60,95% CI 1.18~2.18) and caesarean-section history (OR=276.49,95% CI 19.48~3924.71) were the risk factors for the operation,while times of labor (OR=0.01,95% CI 0.00~0.10) and times of abortion (OR=0.01,95% CI 0.00~0.06) were the protective factors (P<0.05).[Conclusion] Multiple causes result in difficult intrauterine device removal.Age,duration of intrauterine device and caesarean-section history might be the risk factors,while the protective factors may include times of labor and abortion.However,particular reasons should be further explored.%[目的]探索某城镇计生服务中心妇女宫内节育器取出困难的原因.[方法]回顾性分析2014年1月至2014年12月共1507例城镇妇女取宫内节育器的临床资料,采用单因素和多因素分析取器困难的原因.[结果]妇女困难取环率为25.02%(95% CI22.83~27.20).单因素分析结果显示年龄、婚龄、环龄、产次、流产次数等指标在环困难妇女中显著均高于取环顺利妇女(P<0.05).多因素分析结果显示,去除判定存

  4. IUD (Intrauterine Device)

    Science.gov (United States)

    ... a woman is already pregnant or may be pregnant a woman has problems with her uterus, like a disease or malformation, or if she ... It? An IUD must be inserted into the uterus by a doctor or nurse ... as long as she is not pregnant. Copper IUDs need to be replaced every 10 ...

  5. [Expulsion proof intrauterine devices].

    Science.gov (United States)

    Kurpiel, M

    1997-09-01

    The author of this paper presents own new generation of IUDs, named "Antigrav", patented, and used for 14 years. Proper construction of these IUDs prevents expulsion by the uterus, and protects the uterus against injuries. This report comprise 7 year od study performed in two periods. Four size of the antigravs were used during the study. In the first period od study when applied only two sizes of antigravs-size 2, and 3 in parous women, very great different of Pearl index was obtained. In the case of the bigger size 3 of the antigravs-0.5, and for smaller size 2 of the antigravs-2.5. On the base of such differences results, the author of this paper came to the conclusion that efficacy of an IUD depend on paper selection od IUD to the dimension of the uterine cavity. For fulfill such condition the author performed measurements of the uteri cavities in vivo with a uterometer, and revealed great differences in their dimensions. Consequently the uteri were divided into four groups depending on inner length (depth), and four sizes of antigravs were used. Owing to such action in the second period of study was applied 4 size of antigravs selected to the dimension of the uterine cavity, what decreased Pearl index to 0.8. During 7 years of study none of the antigravs fell out of the uterus. Excluding pregnancies, 4 personal, and two clinical reasons requiring removal of antigravs, no others complications were record.

  6. IUD (Intrauterine Device)

    Science.gov (United States)

    ... she has an infection, it could lead to pelvic inflammatory disease (PID) . Abstinence (not having sex) is the only ... the uterus while it is being put in. Pelvic inflammatory disease (PID) . There's a very low risk of infection ...

  7. Intrauterine devices (IUD)

    Science.gov (United States)

    ... Jul;118(1):184-96. PMID: 21691183 www.ncbi.nlm.nih.gov/pubmed/21691183 . Association of Reproductive ... 62(RR-05):1-60. PMID: 23784109 www.ncbi.nlm.nih.gov/pubmed/23784109 . Cleland K, Raymond ...

  8. Effective inhibition of the early copper ion burst release with ultra-fine grained copper and single crystal copper for intrauterine device application.

    Science.gov (United States)

    Xu, X X; Nie, F L; Wang, Y B; Zhang, J X; Zheng, W; Li, L; Zheng, Y F

    2012-02-01

    To solve the main problems of existing coarse grained copper (CG Cu) intrauterine devices (IUD)-namely burst release and a low transfer efficiency of the cupric ions during usage-ultra-fine grained copper (UFG Cu) and single crystal copper (SC Cu) have been investigated as potential substitutes. Their corrosion properties with CG Cu as a control have been studied in simulated uterine fluid (SUF) under different conditions using electrochemical measurement methods. Long-term immersion of UFG Cu, SC Cu and CG Cu samples in SUF at 37 °C have been studied for 300 days. A lower copper ion burst release and a higher efficiency release of cupric ions were observed for UFG Cu and SC Cu compared with CG Cu in the first month of immersion and 2 months later. The respective corrosion mechanisms for UFG Cu, SC Cu and CG Cu in SUF are proposed. In vitro biocompatibility tests show a better cellular response to UFG Cu and SC Cu than CG Cu. In terms of instantaneous corrosion behavior, long-term corrosion performance and in vitro biocompatibility, the three pure copper materials follow the order: UFG Cu>SC Cu>CG Cu, which indicates that UFG Cu could be the most suitable candidate material for intrauterine devices.

  9. A systematic review of levonorgestrel-releasing intrauterine system in the treatment of primary endometriosis%左炔诺孕酮宫内缓释系统宫内节育器用于子宫内膜异位症治疗的meta分析

    Institute of Scientific and Technical Information of China (English)

    赵勤莉; 张文韬; 杨永秀

    2013-01-01

    目的 通过循证医学的方法评价左炔诺孕酮宫内缓释系统(曼月乐)治疗子宫内膜异位症的安全性及有效性.方法 计算机检索Medline、Embase、Cochrane Library、中国生物医学文献数据库、中国期刊全文数据库、中文科技期刊全文数据库,检索时间从各数据库建立至2012年4月;同时辅助其他检索方法,所检索文献由两名系统评价者独立评价纳入研究并提取资料,并用Revman 5.1软件进行统计学分析.结果 共纳入11项研究,meta分析结果显示,与促性腺激素释放激素类似物相比,曼月乐可以取得相当的缓解疼痛的效果.与子宫全切术相比,曼月乐可以明显缓解患者疼痛,且对其性生活质量影响较小.保守手术后使用曼月乐与期待疗法相比,可以缓解患者疼痛.结论 曼月乐可以有效缓解子宫内膜异位症患者的疼痛,不良反应发生率低,值得临床推广应用.%Objective To evaluate the efficacy and safety of the levonorgestrel-releasing intrauterine system (mirena) in the treatment of endometriosis.Methods Medline,Embase,The Chinese Biomedical Database (CJFD) and Chinese Science and Technology Journal Full-text Database (CSJD) from their establishment to April 2012 were employed in the study.All the studies included were evaluated by Cochrane Handbook,and homogenous studies were analyzed by Revman 5.1 software.Results Eleven studies were included.Compared with gonadotropin releasing hormone group,the mirena group had no statistical difference in visual analogue score; compared with hysterectomy group,the mirena group had statistical significance in pain relief rate; compared with expectant management group,the mirena group also had statistical significance in pain relief rate.The mirena group showed no statistical significance in adverse effect.Conclusion The mircna can significantly relieve the pain of the patients of cndometriosis,and it is worth generalization in clinical.But the related

  10. [Intrauterine insemination].

    Science.gov (United States)

    Merviel, Philippe; Cabry, Rosalie; Lourdel, Emmanuelle; Barbier, Frédéric; Scheffler, Florence; Mansouri, Naïma; Devaux, Aviva; Benkhalifa, Moncef; Copin, Henri

    2014-01-01

    The intrauterine insemination with husband's sperm is an assisted reproductive technologie, as proposed in the case of cervical infertility, moderate male infertility, dysovulation, mild or moderate endometriosis or unexplained infertility. In the last three indications the ovarian stimulation is necessary. The couple demographic criteria (age of both partners, lifestyle, duration of infertility) and the results of the infertility evaluation (ovarian reserve, uterus, spermogram-spermocytogram) increase the chances of pregnancy by intrauterine insemination with husband's sperm and reduce the risk of multiple pregnancies. Pregnancy rates observed ranged from 8 to 20% per cycle according to indications.

  11. Intrauterine insemination

    NARCIS (Netherlands)

    Aboulghar, M.; Baird, D. T.; Collins, J.; Evers, J. L. H.; Fauser, B. C. J. M.; Lambalk, C. B.; Somigliana, E.; Sunde, A.; Tarlatzis, B.; Crosignani, P. G.; Devroey, P.; Diczfalusy, E.; Diedrich, K.; Fraser, L.; Geraedts, J. P. M.; Gianaroli, L.; Glasier, A.; Van Steirteghem, A.

    2009-01-01

    Intrauterine insemination (IUI) with or without ovarian stimulation is a common treatment for infertility. Despite its popularity, the effectiveness of IUI treatment is not consistent, and the role of IUI and in vitro fertilization (IVF) treatment in practice protocols has not been clarified. Medlin

  12. Case Report-intrauterine Device Embedded in Placenta%病例报道-宫内节育器嵌入胎盘

    Institute of Scientific and Technical Information of China (English)

    侯瑞; 李颖; 赵静; 刘雨函

    2016-01-01

    宫内节育器(I U D)是安全、有效、经济、简便、可逆的避孕手段,自1965年起在全世界范围内推广应用。但是IUD置入后也会出现位置异常、避孕失败等情况。对IUD的随访观察以三维超声检查为首选。此次报道的这个病例在常规检查时发现节育器位置下移并发生宫内妊娠,在继续妊娠的过程中IUD逐渐嵌入至胎盘实质内。%The intrauterine devices (IUD) have been worldwide used as a safe, effective, economic, simple and reversible contraceptive method since 1965. Whereas IUD malposition and contraceptive failure may occur after IUD implantation. IUD fol ow-up prefer three-dimensional ultrasound examination. This case reported an intrauterine pregnancy occurred with malpositioned IUD, which gradual y embedded into placenta while pregnancy progressed.

  13. The Control Measure and Common Complications of Placing Intrauterine Device%放置宫内节育器的常见并发症及其防治措施

    Institute of Scientific and Technical Information of China (English)

    丁国文; 杜株梅

    2016-01-01

    Objective To explore common complications placed intrauterine device, and puts forward relevant countermeasures.Methods Selected 80 cases of women who were placed intrauterine device from December 2013 to December 2015 in our hospital clinical data of were retrospectively analyzed, analyzed the complications and prevention measures of women. ResultsAccording to the analysis of the results of the survey, the common complications of infection, IUD placed intrauterine device women incarcerated and ectopic, uterus perforation, bleeding, pain, etc. Conclusion Placed intrauterine device women should be checked to the hospital on a regular basis, radically reduce the incidence of complications.%目的:探析放置宫内节育器常见并发症,并提出相关防治对策。方法对2013年12月~2015年12月到我院放置宫内节育器的80例妇女的临床资料进行回顾性分析,分析妇女的并发症与防治措施。结果放置宫内节育器妇女常见并发症为感染、IUD嵌顿和异位、子宫穿孔、出血、疼痛等。结论放置宫内节育器妇女应该定期到医院检查,从根本上降低并发症发生率。

  14. [Can introduction of guidelines for use of an intrauterine device reduce changes in microbial flora of female genital system in IUD-users?].

    Science.gov (United States)

    Kaliterna, Vanja; Kucisec-Tepes, Nastja; Pejković, Lidija; Oresković, Slavko

    2010-01-01

    The intrauterine device (IUD), one of the most effective and most common methods of reversible contraception, is used by millions of women worldwide. Although various studies indicate the benefits of its use as a contraceptive method, the greatest concern regarding IUDs is the potential risk for infection. The presence of the IUD gives a solid surface for bacterial attachment and biofilm formation. Infections due to biofilm formation are chronic and difficult to resolve. However, women should be screened and treated for asymptomatic vaginal or cervical infections before IUD insertion. Based on the data in the literature and the data in study conducted in Croatia, it can be concluded that IUD users are at increased risk for development of infection. Treatment strategies in Croatia should take into consideration that Escherichia coli and Ureaplasma urealyticum are dominant causative agents. We conclude that guidelines for the use of IUD in Croatia are a necessity.

  15. [Study on the release of copper ion and corrosion for intrauterine contraceptive device with two kinds of Cu-containing stent].

    Science.gov (United States)

    Zou, Fengping; Huang, Shuze; Ji, Rong; Ding, Biao; Yao, Tianping

    2014-05-01

    Two kinds of Cu-containing intrauterine contraceptive device (Cu-IUD) has been evaluated through the study on the release of copper ion and corrosion of copper surface in artificially formulated fluid. The result showed that the copper ions were released profusely from the stainless steel stents Cu-IUD in the first week of soak (25-12 microg/d), and then it became slowly and steady. The release of the copper ions from the titanium nickel shape memory alloy stents Cu-IUD were always slowly and steady in two months (0.5-5 microg/d). It obviously shows that the corrosion on copper surface of stainless steel stents Cu-IUD were more serious than titanium nickel shape memory alloy stents Cu-IUD by using 200 times microscope testing before and after soaking in formulated fluid.

  16. The copper intrauterine device for emergency contraception: an opportunity to provide the optimal emergency contraception method and transition to highly effective contraception.

    Science.gov (United States)

    Dermish, Amna I; Turok, David K

    2013-07-01

    Worldwide, 40% of all pregnancies are unintended. Widespread, over-the-counter availability of oral emergency contraception (EC) has not reduced unintended pregnancy rates. The EC visit presents an opportunity to initiate a highly effective method of contraception in a population at high risk of unintended pregnancy who are actively seeking to avoid pregnancy. The copper intrauterine device (IUD), the most effective method of EC, continues to provide contraception as effective as sterilization for up to 12 years, and it should be offered as the first-line method of EC wherever possible. Increased demand for and supply of the copper IUD for EC may have an important role in reducing rates of unintended pregnancy. The EC visit should include access to the copper IUD as optimal care but should ideally include access to all highly effective methods of contraception.

  17. Geometric Foundations of Intrauterine Device Complications and Implications for IUD Users – Importance of the IUD Size to maximize Tolerability and Prevent Early Discontinuation

    Directory of Open Access Journals (Sweden)

    Goldstuck N

    2015-01-01

    Full Text Available Intrauterine devices (IUD are long-acting reversible contraceptive methods that are independent from daily attention. Unlike methods that need daily motivation, IUDs are “forgettable” methods that are also highly effective. They are, therefore, advocated by all major organizations to prevent unintended pregnancy. However, current IUD use often leads to early discontinuation, even within 3 or 6 months following insertion. It is known for many years that IUDs perform best, leading to high continuation of use, if attention is given to geometric factors such as size and shape of the host uterine cavity prior to inserting an IUD. Continuation of use, for the full claimed duration of action, will usually remain low if the relationship between IUD and uterine cavity is out of proportion.

  18. Uterine perforation in an adolescent using an intrauterine device with memory function: a case report and review of the published work.

    Science.gov (United States)

    Tong, Jin-Yi; Sun, Wen-Chao; Li, Juan; Jin, Mei; Shen, Xiu-Zhen; Zhang, Zhi-Fen

    2015-04-01

    Intrauterine devices (IUD) are the most common method of reversible birth control used worldwide. Adolescents infrequently have uterine perforation caused by IUD, hampering both the diagnosis and treatment. Herein, we report a case of uterine perforation in an 18-year-old primipara after insertion of an IUD that possessed memory function (AiMu MCu). The patient presented with vomiting and abdominal pain after insertion of an AiMu MCu IUD, was treated via laparoscopy and had a full recovery. The present case indicated that uterine perforation caused by an AiMu MCu IUD may occur as a rare complication and that uterine perforation can occur in an adolescent. Clinicians might consider a diagnosis of uterine perforation in an adolescent reporting vomiting and abdominal pain after IUD insertion. Laparoscopy could be a reasonable treatment option for such patients.

  19. 带器宫内外同时妊娠4例报道%The report of heterotopic pregnancy with intrauterine contraceptive device in 4 cases

    Institute of Scientific and Technical Information of China (English)

    施成翠; 李德琼

    2010-01-01

    @@ 近年来,随着计划生育工作的广泛开展,宫内节育器(intrauterine contraceptive device,IUD)的放置更为普遍.随着IUD的广泛应用,异位妊娠发生率增高.IUD本身并不增加异位妊娠的发生率,但若IUD避孕失败而受孕时,则发生异位妊娠的机会较大[1].现将笔者曾诊治的4例带器宫内宫外同时妊娠(heterotopicpregnancy,HP)的病例报道如下.

  20. 促性腺激素释放激素激动剂联合左炔诺孕酮宫内缓释系统治疗子宫腺肌病的疗效观察%Effect of GnRH-a combined with levonorgestrel-releasing intrauterine system on the treatment of large adenomyosis

    Institute of Scientific and Technical Information of China (English)

    刘芸; 段华

    2014-01-01

    目的:探讨促性腺激素释放激素激动剂(GnRH-a)联合左炔诺孕酮宫内缓释系统(LNG-IUS)治疗较大子宫腺肌病的效果。方法入选子宫腺肌病所致中、重度痛经合并月经量过多的患者54例,宫腔深度9~12 cm, GnRH-a治疗3个疗程后放置LNG-IUS,比较治疗前,放置后3个月、6个月、12个月患者的痛经缓解程度、子宫体积变化、血红蛋白及血清CA125水平。结果47例完成研究,患者痛经的VAS评分由治疗前的(75.9±10.3)下降为治疗后的(27.1±8.6),VRS评分由(2.2±0.4)分下降为(1.1±0.2)分,子宫体积由(268.2±12.0)cm3下降为(196.3±7.2)cm3,血清CA125水平由(68.2±22.2)U/ml下降为(43.4±22.1)U/ml,血红蛋白由(87.4±10.3)g/L上升为(123.9±23.1)g/L,差异均有统计学意义(P<0.01)。且上述指标在弥漫性和局限性子宫腺肌病均有明显改善。结论 GnRH-a联合LNG-IUS治疗宫腔深度在9~12 cm的子宫腺肌病,近期内能有效缓解痛经及月经量过多的临床症状,短期内避免手术治疗可能带来的相关风险,提高生活质量,值得临床应用。但对于局限性子宫腺肌病的患者使用前应与患者充分沟通,密切随访,观察疗效,适时修改治疗方案。%Objective To evaluate the effect of gonadotropin releasing hormone agonist (GnRH-a) combined with levonorgestrel-releasing intrauterine system (LNG-IUS) on the treatment of large adenomyosis. Methods Fifty-four women with moderate or severe dysmenorrhea associated with adenomyosis were recruited, whose depth of uterine cavity was from 9 to 12 cm. All women were inserted LNG-IUS following 3 courses of GnRH-a. Three, six and twelve months af-ter the placement of LNG-IUS, the uterine size, degree of dysmenorrhea, hemoglobin and CA 125 values were compared to those before therapy. Results Forty-seven women completed the study. There were significant differences between

  1. Clinical research of oral contraceptive and levonorgestrel-releasing intrauterine system after hysteroscopic endometrial polypectomy in preventing recurrence%口服避孕药与宫腔内放置左炔诺孕酮宫内缓释系统治疗子宫内膜息肉术后复发的临床研究

    Institute of Scientific and Technical Information of China (English)

    于慧; 周海慧

    2014-01-01

    Objective To explore the recurrence-prevention effect of oral contraceptive and levonorgestrel-releasing intrauterine system (Mirena) after hysteroscopic endometrial polypectomy.Methods One hundred and seventy-four patients who received hysteroscopic endometrial polypectomy were enrolled in this research.The patients were informed and divided into three groups according to their selection:51 cases were given oral contraceptive since one month until 12 months after the surgery (oral contraceptive group); 60 cases were received Mirena since one month after the surgery (Mirena group) ; and 64 cases were received no treatment after the surgery (control group).The groups were followed up at 3,6,12 months after the surgery and compared the recurrence rate,menstruation,level of hemoglobin and complication rate.Results The recurrence rate in oral contraceptive group,Mirena group and control group was 3.9%(2/51),3.3% (2/60) and 19.0% (12/63),respectively.The recurrence rate in control group was higher than that in oral contraceptive group and Mirena group,and there was significant difference (P < 0.05).The proportion of low menstruation volume in control group was lower than that in oral contraceptive group and Mirena group,and there was significant difference (P < 0.05).The level of hemoglobin in control group was lower than that in oral contraceptive group and Mirena group [(124.55 ±9.33) g/L vs.(133.71 ± 11.03),(135.89 ±6.88) g/L],and there was significant difference (P < 0.05).The incidence of complication in Mirena group [18.3% (11/60)] was less than that in oral contraceptive group[35.3%(18/51)],and there was significant difference (P < 0.05).Conclusions Oral contraceptive and Mirena after hysteroscopy for endometrial polys significantly decrease the recurrence rate.The complication rate of Mirena is lower and it is a safe and effective way to treat and prevent the endometrial polyp.%目的 探讨子宫内膜息肉行宫腔镜手术后口服避

  2. A comparison of the expected and actual pain experienced by women during insertion of an intrauterine contraceptive device

    Directory of Open Access Journals (Sweden)

    Brima N

    2015-02-01

    Full Text Available Nataliya Brima,1 Hannat Akintomide,2 Vivian Iguyovwe,3 Susan Mann4 1Medical Statistics, Centre for Sexual Health and HIV Research, Research Department of Infection and Population Health, University College London, London, UK; 2Sexual and Reproductive Health, CNWL Camden Provider Services, Margaret Pyke Centre, London, UK; 3Department of Sexual and Reproductive Health, Camberwell Sexual Health Centre, Denmark Hill, London, UK; 4Sexual and Reproductive Health, Kings College Hospital, London, UK Objective: To compare the expected and actual pain experienced with the insertion of intrauterine contraception in women, and to determine whether either of these are related to their personal circumstances, or affected their satisfaction with the procedure. Design: A convenience sample of 89 women aged 15–50 years attending a sexual health clinic for same day intrauterine contraception insertion were given a questionnaire that they completed following the procedure. The women were asked to rate their expectation of pain prior to insertion and to rate the actual pain they experienced immediately after insertion, on a scale of 1–10, with 10 being severe pain. Information on the women's circumstances and their level of satisfaction with the procedure was also obtained. Results: Overall, the median actual pain experienced by women during insertion (4 was significantly lower than the expected pain median (6 (P<0.001. For those women who had not had a previous vaginal delivery, actual pain was significantly higher compared with women who had had a previous vaginal delivery (median [interquartile range]: 6 [3.5–7.5] and 3 [1–5], P<0.001, respectively, but there was no significant difference between expected and actual pain experiences. In women who had a previous vaginal delivery, actual pain was much lower than expected (P<0.001. Neither actual nor expected pain experiences were linked to any other sociodemographic reproductive health or service use

  3. Knowledge and attitudes of Latin American obstetricians and gynecologists regarding intrauterine contraceptives

    Science.gov (United States)

    Bahamondes, Luis; Makuch, Maria Y; Monteiro, Ilza; Marin, Victor; Lynen, Richard

    2015-01-01

    Background Intrauterine contraceptives (IUCs), including the copper intrauterine device and the levonorgestrel-releasing intrauterine system (LNG-IUS), are among the reversible contraceptive methods with high effectiveness. However, use is low in many settings, including some Latin American countries, mainly due to the influences of myths, fears, and negative attitudes, not only of users and potential users, but also of different cadres of health care professionals. The purpose of this study was to assess the knowledge and attitudes of a group of Latin American obstetricians and gynecologists regarding IUCs. Methods A survey was conducted during a scientific meeting organized in Chile in 2014 to present and discuss updated information about contraception. Obstetricians and gynecologists from 12 Latin American countries, who reported that they provide daily contraception services in both the public and private sectors, participated in the meeting. Participants who agreed to take part in the survey responded to a multiple-choice questionnaire on issues regarding knowledge, use, and attitudes about IUCs. Results Of the 210 obstetricians and gynecologists participating in the meeting, the respondents to each question varied from 168 (80.0%) to 205 (97.6%). Almost 50% recognized that the failure rate of combined oral contraceptives, patches, and vaginal rings is 8%–10%. Furthermore, 10% of the participants did not recognize the high contraceptive effectiveness of long-acting reversible contraceptive methods. Additionally, almost 80% of the respondents answered that they did not offer IUCs to nulligravidas and almost 10% did not offer IUCs to adolescents, albeit almost 90% of the respondents reported that nulligravidas are candidates for an LNG-IUS. Conclusion Some deficiencies and contradictions in terms of knowledge and attitudes were identified from the answers of the Latin American obstetricians and gynecologists who participated in the survey. The knowledge and

  4. 复方短效口服避孕药、左炔诺孕酮宫内缓释系统和安全套在剖宫产瘢痕妊娠清宫术后的避孕效果比较%A comparative contraceptive effect among compound short-acting oral contraceptives,levonorgestrel releasing intrauterine system and condoms after cesarean scar pregnancy curettage

    Institute of Scientific and Technical Information of China (English)

    万金华; 朱艳琼

    2016-01-01

    Objective To explore the contraceptive efficacy and safety of compound short-acting oral contraceptives,levonorgestrel re-leasing intrauterine system and condoms after cesarean scar pregnancy curettage.Methods Totally 112 CSP patients,who were treated uterine artery embolization combined with curettage,were randomized into 3 groups.Patients (39 cases)in the contraceptive pill group were treated with compound short-acting contraceptives,patients (37 cases)in mirena group were placed Mirena (levonorgestrel-relea-sing intrauterine system)after curettage immediately,and patients (36 cases)in condom group were given condoms contraception. Three groups of patients were followed up to compare ultrasonic examination results,unexpected pregnancy and menstrual flow change. Results Patients were followed up for 1 year.The total effective rates of patients in contraceptive pill group,Mirena patient group and condoms contraception group were 94.88%,100.00% and 86.11%,respectively.There wasn’t significant difference in total contracep-tive effective rate among the three groups.There was 1 case of recurrent CSP in contraceptive pills group and condoms group respectively, but there was no recurrence in Mirena group.Ultrasonic examination showed there were noincision rupture or damage,no increase in the a-mount of menstruation in the 3 groups.With chi-square division method,the menstrual changes of the three groups were compared.The de-crease of menstruation in the patients of Mirena group was significantly higher than those of the condom group and the contraceptive pill group (P <0.017)at 3,6 and 12 months postoperatively.The menstrual blood loss decreased significantly in contraceptive pill group at 3 months after curettage compared with the other two groups (P <0.017).There were no serious adverse events and complaints about asexu-al life in the 3 groups.Conclusions After uterine artery embolization combined with uterine curettage CSP patients can take marvelon and Mirena

  5. 宫内节育器避孕效果分析及不良反应监测%Analysis of Contraceptive Effect and Adverse Reaction Monitoring of Intrauterine Device

    Institute of Scientific and Technical Information of China (English)

    张霞

    2016-01-01

    ObjectiveTo observe the effect and adverse reaction of intrauterine device.Methods Chose 205 women with intrauterine device,analyzed their contraceptive effect and adverse reaction. Results 205 cases of women,including 14 cases(6.83%)with the pregnancy,adverse reactions included infection,abnormal vaginal discharge,intrauterine device down and abnormal menstruation.Conclusion We should choose the appropriate contraceptive device according to the individual differences,and regularly monitor to improve the contraceptive effect and reduce adverse reaction rate.%目的:观察宫内节育器的避孕效果及不良反应。方法选择205例行宫内节育器妇女的临床资料,分析其避孕效果及不良反应。结果205例女性,其中14例(6.83%)带器妊娠;不良反应主要包括感染、白带异常、宫内节育器下移及月经异常等。结论应根据个体化差异选择合适的节育器,并定期监测以提高避孕效果,降低不良反应率。

  6. The Clinical Appearance of Pelvic Inflammatory Disease in Relation to Use of Intrauterine Device in Latvia : A Study with Special Emphasis on Factors Influencing the Clinical Course of PID in IUD Users

    OpenAIRE

    2006-01-01

    The objectives of this case-control study, investigating 51 in-patient women with acute pelvic inflammatory disease (PID) and 50 healthy women attending for routine gynecological check-up, were to investigate the background and reproductive history of women, who are considered at low risk of sexually transmitted infection presenting with PID, to examine whether intrauterine device (IUD) use per se and long use affects the microbiology and clinical course of the disease, to identify risk facto...

  7. 9800例宫内节育器B超定位分析%Analysis of 9800 Cases on Type-B ultrasonic/ultrasound Positioning of Intrauterine Device (IUD)

    Institute of Scientific and Technical Information of China (English)

    梁妍

    2015-01-01

    目的:探讨宫内节育器的位置对避孕效果的影响。方法:对2008年7月至2009年5月来我站进行健康查体且采用宫内节育器避孕的9800例育龄妇女的避孕效果进行分析。结果:9800例采用宫内节育器避孕者节育器位置正常为9568例,占97.63%,其中带器妊娠2例,占0.02%。节育器下移142例,占1.45%,带器妊娠4例,占2.82%。90例宫腔内未见节育器强回声,脱落率占0.92%。结论:宫内节育器在宫腔中的位置与意外妊娠的发生关系密切。为减少意外妊娠的发生应定期B超检测宫内节育器的位置,尤其应在宫内节育器放置后第一、三、六个月按时做B超检查。%Objective:Investigate the effects of contraception caused by different Positions of the IUD.Methods: 9800 participants in the study were females of childbearing age who had been given the insertion operation of intrauterine device ﹙IUD﹚.They had a gynaecological examination in our service station during the period from July,2008 to May,2009.Then a data analysis was made on the evaluation of the effects of Intrauterine Device ﹙IUD﹚ on the contraception.Results:Among these 9800 participants,there were 9568 whose position of Intrauterine Device ﹙IUD﹚ was normal,accounting for 97.63%.Among these 9568 participants,2 of them were pregnant nevertheless,the percentage of pregnancy was 0.02%.There were 142 participants whose position of Intrauterine Device﹙IUD﹚ was ectopic﹙downward﹚,which occupied 1.45%.Of these 142 participants, 4 were pregnant, with a pregnant rate of 2.82%.90 participants had no dense echo of type-B ultrasonic in the ultrasound diagnosis,the figure of which showed that the rate of expulsion of Intrauterine Device ﹙IUD﹚ in this study was 0.92%.Conclusion: The statistics lead us to the conclusion that the position of the Intrauterine Device ﹙IUD﹚ in the uterine cavity has the significant effect on the rate of accidental pregnancy .In

  8. 医用几丁糖与宫内节育器预防宫腔粘连分离术后再粘连对比研究%Comparative study of chitosan and intrauterine contraceptive device of prevention of intrauterine adhesions

    Institute of Scientific and Technical Information of China (English)

    周婷; 邹放军

    2013-01-01

    目的:比较医用几丁糖与宫内节育器两种方法在宫腔镜下宫腔粘连分解术后预防再粘连的疗效。方法:对2011年1月至2012年6月宫腔粘连在我院行宫腔镜下宫腔分解术患者进行回顾性分析。术后宫腔内放置节育环( IUD)51例为IUD组,宫腔注入几丁糖52例为几丁糖组。结果:几丁糖组再粘连率7.7%,月经改善有效率94.2%,妊娠率68.5%;IUD组再粘连率21.6%,月经改善有效率78.4%,妊娠率41.6%,两组参数比较差异均具有统计学意义。结论:宫腔粘连分离术后使用医用几丁糖较宫内节育器更有效降低再粘连的发生,提高月经改善有效率及妊娠率,其作用优于安置宫内节育器。%Objective To explore the effect of Chitosan and intrauterine contraceptive device on the preven-tion of intrauterine adhesions after the intrauterine adhesions separation surgery with hysteroscopy. Methods Clinical data of 103 patients of Hysteroscopic adhesiolysis with hysteroscope in our hospital from January 2011 to June 2012, divided into the chitosan group and the IUD group according to the different methods of postoperative anti-adhesion. 52 patients were infused with Medical Chitosan in chitosan group; 51 patients who were placed with IUD postoperation were in the IUD group. Results In the chitosan group and the IUD group, the recurrence rate of adhesion was 7.7% vs. 21.6%, the menstrual improvement rate was 94.2% vs.78.4%, and the pregnancy rate was 68.5%vs. 41.6%(P<0.05). Conclusion The prevention effect of chitosan is better than intrauterine con-traceptive device on intrauterine adhesions after the intrauterine adhesions separation surgery with hysteroscopy.

  9. The Discussion about the Mobile Resisitance of Locating Block on the Inserter for Intrauterine Devices in the Standards of Intrauterine Devices%宫内节育器放置器定位块移动阻力在节育器系列标准中的要求探讨

    Institute of Scientific and Technical Information of China (English)

    李闻涛; 党琳琳; 邵文鹏; 王韵晴

    2015-01-01

    This artical compares the requirements of the mobile resisitance of locating block in the intrauterine devices and the inserter’s national standards with the requirements of the product registration standards. The writer points out the problums in those national standards and product registration standards and proposes the suggestions for improvement.%本文通过对现行宫内节育器及节育器放置器国行标及产品注册标准中对定位块移动阻力项规定的对比分析,提出了该类产品国行标及注册标准中存在的问题,并提出了改进的建议。

  10. Study on the acceptance, complications and continuation rate of post-partum family planning using the post placental intrauterine contraceptive device among women delivering at a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Rajya Lakshmi Bai Gujju

    2015-04-01

    Full Text Available Background: Post placental intrauterine contraceptive device use in India showed that most women were satisfied with their choice of immediate insertion of an IUCD and the rates of complications were relatively low. The large proportion of women accepting the method to limit future childbearing indicates the important place post placental IUCD hold. This study was done to evaluate the acceptance of intrauterine contraceptive device as an immediate family planning method following delivery. The complications associated with it were identified and continuation rates were assessed. Methods: Women admitted for delivery in a tertiary care hospital were included in the study. Only women who fulfilled the medical eligibility criteria were included in the study. Results: A total of 4209 women were counseled of which 780 (18.5% women accepted the method, 3429 declined. Out of the 780 cases, 764 came for follow up, and 16 were lost to follow up, spontaneous expulsion was seen in 2 (0.2% cases, removal was done on request in 1 case and continuation was seen in 761 (97.56% women. Conclusions: The Post placental intrauterine contraceptive device is safe to insert immediately after delivery. It has good acceptance with minimal expulsion and very high continuation rates. [Int J Reprod Contracept Obstet Gynecol 2015; 4(2.000: 388-391

  11. Clinical effect observation of different doses of estradiol valerate combined intrauterine device for the prevention of adhesion after the operation for intrauterine adhesion%宫腔粘连术后使用不同剂量戊酸雌二醇联合宫内节育器预防再粘连的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    吴岭; 崔超美

    2015-01-01

    Objective:To explore the clinical curative effect of different doses of estradiol valerate combined intrauterine device for the prevention of adhesion after the operation for intrauterine adhesion.Methods:150 cases of patients with intrauterine adhesion were treated with intrauterine device after the operation for intrauterine adhesion and were divided into 3 mg/d group,6 mg/d group and 9 mg/d group according to the given doses of estrogen,with 50 cases in each group.The postoperative menstrual recovery was follow-up visited,the adhesion was reviewed after treatment for 3 months.Results:The clinical curative effect of 3 mg/d group and 6 mg/d group,6 mg/d group and 9 mg/d group with severe intrauterine adhesion had statistically significant difference(P<0.05).Conclusion:Estradiol valerate 3 mg/d could improve the menstrual condition of patients with light,moderate intrauterine adhesion effectively and prevent the intrauterine adhesion,which also could avoid the unnecessary risk of drug adverse reactions.The postoperative estrogen dosage in the treatment of patients with severe intrauterine adhesion was increased in order to obtain ideal curative effect.%目的:探讨不同剂量戊酸雌二醇联合宫内节育器对宫腔粘连术后防止再粘连的临床疗效。方法:收治宫腔粘连患者150例予宫腔粘连分离术后上环,并根据给予雌激素剂量不同分为3 mg/d组,6 mg/d组,9 mg/d 组,每组50例。随访术后月经恢复情况,治疗3个月后复查粘连情况。结果:重度宫腔粘连3 mg/d组与6 mg/d组、6 mg/d组与9 mg/d组临床疗效差异均有统计学意义(P<0.05)。结论:戊酸雌二醇3 mg/d可有效改善轻、中度宫腔粘连患者月经情况,预防宫腔再粘连,又可规避不必要的药物不良反应风险。加大术后雌激素用药剂量治疗重度宫腔粘连患者可取得理想疗效。

  12. New developments in long-acting reversible contraception: the promise of intrauterine devices and implants to improve family planning services.

    Science.gov (United States)

    Turok, David K; Gawron, Lori M; Lawson, Samantha

    2016-11-01

    After decades of having the developed world's highest rates of unintended pregnancy, the United States finally shows signs of improvement. This progress is likely due in large part to increased use of highly effective long-acting reversible methods of contraception. These methods can be placed and do not require any maintenance to provide years of contraception as effective as sterilization. Upon removal, fertility returns to baseline rates. This article addresses advances in both software-improved use and elimination of barriers to provide these methods; and hardware-novel delivery systems and devices. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  13. Comparison of immunofluorescence and culture for the detection of Actinomyces israelii in wearers of intra-uterine contraceptive devices.

    Science.gov (United States)

    Leslie, D E; Garland, S M

    1991-10-01

    A direct immunofluorescence (IF) method was compared with traditional culture methods for the detection of Actinomyces israelii in endocervical and intra-uterine-device (IUD) smears from 124 IUD wearers. Of 11 specimens that gave positive results by IF, only one was positive by culture. Of the 10 patients with positive IF specimens, three (30%) had signs and symptoms suggestive of pelvic infection and no other pathogen was detected. Direct IF of cervical smears offers a simple, relatively cheap method to screen IUD wearers for A. israelii. Clinical management of such cases is discussed.

  14. 373例哺乳期放置TCu380A 1年临床效果观察%Observation on clinical effect of application of Tcu380A intrauterine device during lactation period for one year in 373 cases

    Institute of Scientific and Technical Information of China (English)

    刘宇; 刘玉花; 柴健; 张军喜; 马颖辉; 蒋丽芳

    2012-01-01

    目的:观察哺乳期放置TCu380A宫内节育器(IUD)的临床效果.方法:选择2006年6月2日~2007年6月3日期间到安阳市汤阴县宜沟镇计划生育服务站要求放置IUD观察对象373例.采用生存分析法,分析观察对象使用IUD的1年期带器妊娠率、脱落率、因症取出率等.结果:随访12个月末1例观察对象失访,无带器妊娠者,脱落相关终止率为0.27/每百妇女/年,因症取出率为1.07/每百妇女/年,与IUD使用相关终止率为1.34/每百妇女/年.结论:哺乳期放置Tcu380A宫内节育器安全、有效,优于其他放置时期.%Objective: To observe the clinical effect of application of Tcu38OA intrauterine device during lactation period. Methods: A total of 373 cases who applied intrauterine device in family - planning service outlet of Yigou Town from June 2nd in 2006 to June 3rd in 2007 were selected as observation objects; survival analysis method was used to analyze the pregnancy rate with intrauterine device in situ, the exfoliative rate of intrauterine device, and the medical removal rate of intrauterine device at one year. Results: One case was lost to follow up at one year after application of intrauterine device, no pregnancy with intrauterine device in situ occurred, the exfoliative rate of intrauterine device was 0. 27% per year, the medical removal rate of intrauterine device was 1. 07% per year. The cumulative events ratio due to IUD related reasons was 1. 34% per year. Conclusion; Applying Tcu380a intrauterine device during lactation period is safe and effective, which is superior to other periods.

  15. Temporal trends of copper-bearing intrauterine device discontinuation: a population-based birth-cohort study of contraceptive use among rural married women in China.

    Science.gov (United States)

    Zhou, Jie; Tan, Xiaodong; Song, Xiangjing; Zhang, Kaining; Fang, Jing; Peng, Lin; Qi, Wencai; Nie, Zonghui; Li, Ming; Deng, Rui; Yan, Chaofang

    2015-03-01

    Copper-bearing intrauterine device (IUD) insertion for long-term contraceptive use is high in China, but there has been evidence that first-year discontinuation rate of copper-bearing IUD has also increased rapidly in recent years especially among rural married women. To investigate long-term use of copper-bearing IUD, the authors examined the 7-year temporal trends of copper-bearing IUD discontinuation in a population-based birth-cohort study among 720 rural married women in China, from 2004 to 2012. Women requesting contraception were followed-up twice per year after the insertion of IUD. The gross cumulative life table discontinuation rates were calculated for each of the main reasons for discontinuation as well as for all reasons combined. By the end of 7 years, 384 discontinuations were observed. With a stepped-up trend, the gross cumulative life table rate for discontinuation increased from 10.06 (95% confidence interval = 7.86-12.27) per 100 women by the first year to 52.69 (95% confidence interval = 48.94-56.44) per 100 women by the end of 7 years, which increased rapidly in the first 2 years after copper-bearing IUD insertion, flattened out gradually in the following 2 years, then increased again in the last 3 years. Among reported method failure, expulsion and side effects were the main reasons for discontinuation of the copper-bearing IUD but not pregnancy. Personal reasons, such as renewal by personal will had influenced copper-bearing IUD use since the second year and should not be neglected. Based on this study, the temporal trends of copper-bearing IUD discontinuation was in a stepped-up trend in 7 years after insertion. Both reported method failure (expulsion and side effect) and personal reason had effect on the discontinuation of copper-bearing IUD, but pregnancy was no more the most important reason affecting the use of copper-bearing IUD.

  16. Effect of an atraumatic vulsellum versus a single-tooth tenaculum on pain perception during intrauterine device insertion: a randomized controlled trial.

    Science.gov (United States)

    Doty, Nora; MacIsaac, Laura

    2015-12-01

    Intrauterine devices (IUDs) are used by only 5.6% of contraceptive users in the United States. One barrier to IUD uptake is fear of pain during insertion, particularly among nulliparous women. Many interventions to reduce pain during IUD insertion have proven unsuccessful. Comparisons of different tenaculae have not been previously reported. This was a single-blinded, randomized control trial of 80 women randomized to the use of a vulsellum or a single-tooth tenaculum during IUD insertion. The primary outcome was reported pain on a 100-mm visual analog scale at the time of vulsellum placement. Secondary outcomes included pain at other intervals during IUD insertion and bleeding from the tenaculum site. Pain scores were analyzed with a Mann-Whitney test because they were not normally distributed. Pain scores at the time of single-tooth tenaculum (33.3 mm) and vulsellum (35.0 mm) placement were the same in both groups (p=0.58). It took longer to control bleeding in the single-tooth tenaculum versus the vulsellum group (1.1 vs. 0.4 min, p=0.001), although there was no statistically significant difference in the number of maneuvers required to control bleeding at the tenaculum site between the two groups. Preprocedure anxiety appeared to correlate with more pain during IUD insertion. This is the first randomized trial comparing tenaculae. There was no difference in reported pain, but the vulsellum may be associated with less bleeding than a single-tooth tenaculum. Women with higher preprocedure anxiety may experience more pain during IUD insertion. Future research could investigate an anxiolytic's effect on pain during IUD insertion. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. 流产后立即放置宫内节育器%Immediate Post-abortal Insertion of the Intrauterine Devices

    Institute of Scientific and Technical Information of China (English)

    王彩燕; 黄紫蓉

    2013-01-01

    Women generally have strong desire for contraception when they are suffering from artificial abortion. The immediate insertion of an intrauterine device (IUD) after an artificial abortion can induce higher rate of effective contraception and lower rate of repeated abortion,while the cost of public health was finally saved. The immediate insertion of IUD after an artificial abortion is safe and high-effective without increased risks of adverse outcomes,such as pain,bleeding,perforation and pelvic inflammatory disease (PID). Although the rate of IUD expulsion of the immediate post-abortal insertion is low,the follow-up examination is still very important. It's not clear whether the removal of IUD in those women after menopause is difficult. There are two types of IUD for the immediate post-abortal insertion,the copper IUD and the progesterone-releasing IUD.%  人工流产时女性对避孕的愿望最强烈,同时放置宫内节育器(IUD)能提高人工流产后有效避孕率,降低重复流产率,节约公共卫生开支。人工流产术后立即放置IUD安全有效,而且并不增加术后疼痛、阴道出血、穿孔和感染等不良反应的发生。人工流产术后立即放置IUD总体的脱落率是低的,放置后的随访非常重要。人工流产术后立即放置IUD是否增加绝经后取器困难尚无定论。放置的IUD主要为活性IUD,包括含铜IUD和含药IUD均可选择。

  18. Complete and partial uterine perforation and embedding following insertion of intrauterine devices. II. Diagnostic methods, prevention, and management.

    Science.gov (United States)

    Zakin, D; Stern, W Z; Rosenblatt, R

    1981-08-01

    This paper discusses the various methods used to diagnose uterine perforation caused by an IUD. Radiography, or plain film, has a limited use in the diagnosis of uterine perforation since its usefulness depends on the radiopacity of the particular IUD; if the IUD appears on film, plain film does not allow one to conclude whether the device is in its proper position. Several modifications of plain film have been tried but all methods fall short of their goals. Hysterography permits the best diagnostic assessment since it allows the visualization of the entire uterine cavity so that the position of the IUD is immediately evident in cases of embedding and of perforation. Pelvic pneumography can differentiate between intraperitoneal or extraperitoneal locations of perforated IUDs; it can be enhanced by hysterosalpingography and can be done on an ambulatory basis. Ultrasonography simply determines the presence or absence of an IUD, but has the advantage of accurately demonstrating a concomitant pregnancy; the sonogram is not reliable if the IUD is surrounded by omentum or by loops of bowel; ultrasonography can be advantageously coupled with hysterography. Laparoscopy is still the method most used to diagnose uterine IUD perforation; when removal of the device is advisable laparotomy is usually carried out concomitantly; successful laparoscopy requires a skilled and experienced operator. Hysteroscopy is a new and extremely valuable technique which should not be chosen as a primary procedure because it carries a risk of complications. The best prevention of uterine perforation is a meticulous and well executed insertion technique, done only by an experienced operator and after a careful pelvic examination. Uterine size, consistency and position must be exactly known; IUD insertion is easier during or immediately after menstruation. Perforated IUDs should be removed even if considered innocuous, although this is a matter still debated by the specialists. Spontaneous IUD

  19. 固定式吉妮宫内节育器的临床效果分析%The clinical efficacy of GyneFix intrauterine contraceptive device

    Institute of Scientific and Technical Information of China (English)

    伍彩发

    2013-01-01

    Objective To explore the clinical efficacy of GyneFix intrauterine contraceptive device(IUD)in women of childbearing age.Methods 654 women received IUD in our Service Center from Apr.2006 to Mar.2012 were divided into two groups.The observation group(n =431)was placed GyneFix IUD,while the control group(n =213)was placed traditional IUD.6 and 12 months after treatment,pregnancy rate,expulsion rate,removal rate and the incidence of adverse reactions were observed and compared between the two groups.Results 6 and 12 months after treatment,pregnancy rate,expulsion rate and removal rate of the observation group were significantly lower than those of the control group,the differences were statistically significant(0% vs 1.41%,0.23% vs 2.35%,0.46% vs 4.23%;0.46% vs 2.81%,0.70% vs 5.16%,0.23% vs 6.10%,P<0.05).The incidences of adverse reactions such as irregular vaginal bleeding and abdominal pain of the observation group were significantly less than those of the control group(0.46% vs 8.45%,0% vs 2.35%;0.23% vs 7.98%,0% vs 1.88%,P<0.05).Conclusion GyneFix intrauterine contraceptive device is effective in clinical use with less adverse reactions,which is worthy of clinical application.%目的 探讨固定式吉妮宫内节育器(intrauterine device,IUD)在育龄妇女中使用的临床效果.方法 选择我中心2006年4月至2012年3月放置宫内节育器的妇女654例,分为观察组(n=431)与对照组(n=213),观察组放置吉妮宫内节育器,对照组放置传统宫内节育器,观察比较两组妇女放置6、12个月的带器妊娠率、脱落率、取出率及不良反应发生率.结果 观察组放置6、12个月的带器妊娠率、脱落率、取出率分别为0%,0.23%,0.46%和0.46%,0.70%,0.23%;对照组分别为1.41%,2.35%,4.23%和2.81%,5.16%,6.10%,两组差异有统计学意义(P<0.05).两组妇女放置后副反应以经量增多、经期延长为主,观察组放置6个月和1年

  20. Knowledge and attitudes of Latin American obstetricians and gynecologists regarding intrauterine contraceptives

    Directory of Open Access Journals (Sweden)

    Bahamondes L

    2015-07-01

    Full Text Available Luis Bahamondes,1 Maria Y Makuch,1 Ilza Monteiro,1 Victor Marin,2 Richard Lynen3 1Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, Brazil; 2Department of Obstetrics and Gynecology, Hospital Central, Petróleos Mexicanos, México City, Mexico; 3Bayer HealthCare, Newark, NJ, USA Background: Intrauterine contraceptives (IUCs, including the copper intrauterine device and the levonorgestrel-releasing intrauterine system (LNG-IUS, are among the reversible contraceptive methods with high effectiveness. However, use is low in many settings, including some Latin American countries, mainly due to the influences of myths, fears, and negative attitudes, not only of users and potential users, but also of different cadres of health care professionals. The purpose of this study was to assess the knowledge and attitudes of a group of Latin American obstetricians and gynecologists regarding IUCs.Methods: A survey was conducted during a scientific meeting organized in Chile in 2014 to present and discuss updated information about contraception. Obstetricians and gynecologists from 12 Latin American countries, who reported that they provide daily contraception services in both the public and private sectors, participated in the meeting. Participants who agreed to take part in the survey responded to a multiple-choice questionnaire on issues regarding knowledge, use, and attitudes about IUCs.Results: Of the 210 obstetricians and gynecologists participating in the meeting, the respondents to each question varied from 168 (80.0% to 205 (97.6%. Almost 50% recognized that the failure rate of combined oral contraceptives, patches, and vaginal rings is 8%–10%. Furthermore, 10% of the participants did not recognize the high contraceptive effectiveness of long-acting reversible contraceptive methods. Additionally, almost 80% of the respondents answered that they did not offer IUCs to nulligravidas and almost 10% did

  1. Clinical analysis of post-menopause difficulty taking out intrauterine device in 42 cases%绝经后宫内节育器取出困难42例临床分析

    Institute of Scientific and Technical Information of China (English)

    刘满平; 刘冬梅

    2015-01-01

    目的:对绝经后宫内节育器取出困难进行分析和探讨。方法:收治宫内节育器取出困难患者42例,对困难原因及具体处理方法进行分析。结果:在B型超声定位引导下,23例用环钩,19例因IUD断裂、尾丝缺失等用取环钳,成功率100%。取出金属单环21例,T型环10例,IUD断裂残留11例。手术过程顺利,手术时间10~30 min,术中出血量少,除轻微腹痛外,患者无其他不适。结论:在绝经后 IUD 取出困难手术中,采用术前用药软化扩张宫颈,术中B型超声引导,根据具体情况选用取环钩或取环钳取出宫内节育器,缩短了手术时间,减轻了患者痛苦,提高了取器的安全性。%Objective:To analyze and explore the post-menopause difficulty taking out intrauterine device.Methods:42 patients with difficulty taking out intrauterine device were selected.The difficult causes and specific treatment methods were analyzed. Results:Under the guidance of B ultrasound positioning,23 cases were used ring hook,19 cases were used taking ring clamp because of IUD rupture,tail wire loss.The success rate was 100%.21 cases were taken out single steel intrauterine device,10 cases were T type ring,11 cases were IUD rupture fracture.The operation was successful,the operation time was 10 to 30 minutes,the intraoperatve blood soss was small.Except for slight abdominal pain,the patients had no other discomfort.Conclusion:In post-menopause difficulty taking out IUD operation,using premedicate softened and expanded cervix uteri,under the guidance of B ultrasound,choosing taking ring hook or taking ring clamp taken out intrauterine device according to the specific circumstances. It shortens the operation time,reduces the pain of patients,improves the safe of device.

  2. Levonorgestrel

    Science.gov (United States)

    ... It works by preventing the release of an egg from the ovary or preventing fertilization of the egg by sperm (male reproductive cells). It also may ... as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant ...

  3. 人工流产术后即时放置吉尼致美宫内节育器的临床观察%Clinical observation of placing immediately Gini Zhimei intrauterine device after artificial abortion

    Institute of Scientific and Technical Information of China (English)

    周金凤

    2014-01-01

    目的:探究人工流产术后即时放置吉尼致美宫内节育器的避孕效果和不良反应。方法:收治人流手术后放置吉尼致美宫内节育器妇女240名,作为研究对象,将其随机均分为观察组和对照组。其中观察组为人流手术后即时放置吉尼致美宫内节育器的妇女,对照组为同期经期间放置吉尼致美宫内节育器的妇女,分析两组妇女在放置后的不良反应与避孕效果。结果:人流手术后放置吉尼致美宫内节育器1个月,观察组和对照组的不良反应比较差异有统计意义,术后3个月和6个月的不良反应比较差异无统计意义,放置1年内避孕效果和节育器脱落两组比较比较差异无统计意义。结论:吉尼致美宫内节育器在人流手术后即时放置和经期间放置的避孕效果一样,放置3个月后没有不良反应出现,因此应在人流手术后即时放置。%Objective:To explore the contraceptive effect and adverse reactions of placing immediately Gini Zhimei intrauterine device after artificial abortion.Methods:240 woman with placing immediately Gini Zhimei intrauterine device after artificial abortion were selected.They were as the research object and randomly divided into the observation group and the control group. The observation group was woman with placing immediately Gini Zhimei intrauterine device after artificial abortion.The control group was woman with placing Gini Zhimei intrauterine device during the menstruation.The adverse reactions and contraceptive effects of women in the two groups after placing were analyzed.Results:In 1 month of placing Gini Zhimei intrauterine device after artificial abortion,the adverse reactions of the observation group and the control group had significant differences.The adverse reactions had no significant in 3 months and 6 months after operation.The contraceptive effects and IUD expulsion rates of the two groups had no significant difference

  4. 宫内节育器应用失败和出血的临床体会%Clinical Experience of Failure and Bleeding in the Application of Intrauterine Device

    Institute of Scientific and Technical Information of China (English)

    喻莉

    2016-01-01

    Among the various contraceptive measures adopted by women of childbearing age in our country, the placement of IUD accounted for 39.1%. Inert IUD pregnancy rate and loss rate is very high, has gradually been replaced by the new IUD; in 1970s began to develop copper containing IUD, it has anti fertility effect, acceptable strong advantages, is currently the intrauterine device widely used in China. But there are still some side effects, such as natural shedding, pregnancy and bleeding. In this paper, the application failure of intrauterine device and bleeding are analyzed, in order to improve the clinical application effect of intrauterine device.%在我国育龄妇女所采用的各种避孕措施中,放置IUD的占39.1%。惰性IUD带器妊娠率和脱落率均比较高,已经逐渐被新型IUD所取代;到20世纪70年代开始研制出含铜的IUD,它具有抗生育效果高、可接受性强的优点,目前是我国应用最多的宫内节育器。但仍然不可避免地存在一些自然脱落、带器妊娠和出血现象等副反应。本文将对宫内节育器应用失败和出血的相关情况进行分析,以期能提高宫内节育器的临床应用效果。

  5. 放置宫内节育器妇女B超检查结果分析及临床评价%Analysis and Clinical Evaluation of the Results of Ultrasound Examination for the Women With Intrauterine Device

    Institute of Scientific and Technical Information of China (English)

    孙道龙

    2016-01-01

    目的:探究B超在放置宫内节育器妇女检查中的应用价值。方法回顾性分析2015年2月~2016年2月我站计划生育门诊500例放置宫内节育器妇女的临床资料,并用B超跟踪随访。结果本组500例放置宫内节育器妇女,B超检查结果显示宫内节育器位置基本正常,其中异常状态多见下移、带器妊娠和嵌顿,诊断符合率为98.2%,并发症以合并附件包块居多。结论 B超对宫内节育器进行检查,具有安全、准确等优点,是对放置宫内节育器妇女进行跟踪随访的一种理想手段。%Objective To explore the application value of B ultrasound examination of intrauterine device.Methods To analyze 500 clinical patients data of intrauterine device from February 2015 to February 2016, and were followed up by B ultrasound.Results For 500 patients, B ultrasonic examination results showed the position of IUD basic normal, which abnormal state mainly include position download, pregnancy and incarcerated, diagnosis coincidence rate was 98.2%, complications with adnexal were majority.Conclusion B ultrasound is an ideal means for the follow-up of the intrauterine device, which has the advantages of safety, accuracy and so on.

  6. Clinical value of ultrasonic diagnosis in the intrauterine device with the second and third pregnancy%超声诊断宫内节育器合并中、晚期妊娠的临床价值

    Institute of Scientific and Technical Information of China (English)

    蔡金萍; 吴菲

    2011-01-01

    目的:探讨应用超声诊断宫内节育器(IUD)合并妊娠的准确性及临床应用价值.方法:对16例带节育器合并妊娠的中、晚期妊娠患者行超声检查,直观地显示节育器在宫腔内的位置及类型.结果:本组带节育器妊娠均在妊娠中、晚期发现,多见于带节育器5年内.IUD下移是导致妊娠的最主要原因.结论:放置IUD后应用超声监护宫内节育器的位置是一种较为理想的监测手段,特别是放置IUD 5年内要加强随访,以便发现IUD下移,预防意外妊娠.%Objective: To evaluate the clinical application value and the veracity of ultrasonic diagnosis in the intrauterine device (IUD) with pregnancy. Methods: An ultrasonography was done for 16 patients during the second and third pregnancy with intrauterine device to directly show the type and location of the intrauterine device. Results: The ILJD of the 16 patients were all discovered during the second and third pregnancy, most of the patients applied the ILJD within 5 years. The moving down of the ILJD was the main reason of pregnancy. Conclusion: The ultrasound technique is suitable for women to monitor the position of ILJD, especially for those who has been with ILJD for less than 5 years. They should be strengthened follow-up in order to discover the moving down of the ILJD earlier and prevent unplanned pregnancy.

  7. Clinical observation of Mirena intrauterine device in the treatment of adenomyosis%曼月乐宫内节育器治疗子宫腺肌病的疗效观察

    Institute of Scientific and Technical Information of China (English)

    邓淑珍

    2014-01-01

    目的:探讨曼月乐宫内节育器( intrauterine device, IUD)治疗子宫腺肌病的临床疗效。方法选取郴州市第一人民医院中心医院2012年4月至2013年4月期间收治的子宫腺肌病患者共80例,随机分为观察组和对照组各40例。对照组给予药物治疗,观察组给予曼月乐IUD治疗,通过比较两组患者治疗前后的痛经情况、月经状况、子宫体积进行效果评价。结果治疗后两组患者临床症状均得到明显改善(P<0.05);观察组痛经程度,月经状况、子宫体积缩小程度,均明显优于对照组,差异有统计学意义(P<0.05)。结论曼月乐IUD对于治疗子宫腺肌病有一定的临床价值。%Objective To explore the clinical effect of Mirena intrauterine device on adenomyosis. Methods 80 patients with adenomyosis from April 2012 to April 2013 in The Central Hospital of Chenzhou No. 1 People 's Hospital were chosen. All cases were randomized into observation group and control group with 40 cases in each group. Patients in control group were treated with medicine while patients in observation group were treated with Mirena intrauterine device. Dysmenorrhea, menses situation, uterine volume were compared between two groups to evaluate the effect. Results Clinical symptoms of patients in both groups were improved after treatment(P<0. 05). Improvement of dysmenorrhea, menses situation and uterine volume of patients in observation group were superior to that in control group(P<0. 05). Conclusion Mirena intrauterine device is effective in treatment of adenomyosis.

  8. The influence of intrauterine contraception on the prevalence and severity of dysmenorrhea: a longitudinal population study.

    Science.gov (United States)

    Lindh, Ingela; Milsom, Ian

    2013-07-01

    Does intrauterine contraception influence the prevalence and severity of dysmenorrhea? In this longitudinal study, a copper intrauterine device (Cu-IUD) did not influence the severity of dysmenorrhea, whereas the levonorgestrel-releasing intrauterine system (LNG-IUS) reduced dysmenorrhea severity. Dysmenorrhea is a common problem among young women. The LNG-IUS has been reported to be associated with less painful menstruation, although more long-term studies are necessary. In contrast Cu-IUDs have been reported to exacerbate dysmenorrhea. A longitudinal population study. The prevalence and severity of dysmenorrhea was compared in a longitudinal analysis of variance performed in the same women when using either intrauterine contraception (Cu-IUD or LNG-IUS) or combined oral contraceptives (COCs) with other methods of contraception or no contraception. Random samples of 19-year-old women born in 1962 (n = 656), 1972 (n = 780) and 1982 (n = 666) assessed at 5-year intervals between 1981 and 2001. Current severity of dysmenorrhea was assessed on each occasion by a verbal multidimensional scoring system (VMS) and by a visual analog scale (VAS). Dysmenorrhea severity was unchanged in the same woman when using a Cu-IUD compared with using other methods (= condom use, barrier methods, natural family planning, coitus interruptus and sterilization)/no method of contraception in the longitudinal analysis of factors influencing dysmenorrhea severity (VMS score: +0.05 units/VAS: -0.3 mm, both NS). LNG-IUS and COC use were associated with reduced dysmenorrhea severity compared with other methods/no method (LNG-IUS use, VMS score: -0.4 units/VAS: -13 mm, both P VMS score: -0.4 units/VAS: -11 mm, both P VMS score: -0.3 units, P < 0.05/VAS: -16 mm, P < 0.001). Dysmenorrhea severity decreased between the ages of 19 and 44 years. There was a decline in the response rate over time during the 20 years of this longitudinal study which may be due to the fact that the distribution of

  9. Clinical research of the novel medical device for removal of retained intrauterine contraceptive devices under direct vision%"光学直视手术系统"取出宫内节育器临床试验研究

    Institute of Scientific and Technical Information of China (English)

    董白桦; 苏士利

    2013-01-01

    目的 探讨"光学直视手术系统"在宫内节育器(intrauterine contraceptive device,IUD)取出过程中的临床应用价值.方法 分析311例应用"传统手术方式"取出IUD妇女(对照组)和247例应用"光学直视手术系统"取出IUD妇女(观察组)的临床资料.结果 两组在扩张子宫颈、手术时间、出血量、疼痛程度等方面比较差异无统计学意义(P>0.05),观察组手术过程中可清晰显示IUD位置,变盲视下取出IUD为直视下取出,手术全程清晰可见.结论 应用"光学直视手术系统"能够在直视、无膨宫的情况下取出IUD.

  10. Effect of cervical lidocaine-prilocaine cream on pain perception during copper T380A intrauterine device insertion among parous women: A randomized double-blind controlled trial.

    Science.gov (United States)

    Abbas, Ahmed M; Abdellah, Mohamed S; Khalaf, Mohamed; Bahloul, Mustafa; Abdellah, Noura H; Ali, Mohamed K; Abdelmagied, Ahmed M

    2017-03-01

    The objective was to investigate the analgesic effect of cervical lidocaine-prilocaine (LP) cream in alleviating pain during copper T380A intrauterine device (IUD) insertion among parous women. We conducted a randomized, double-blind, placebo-controlled trial at Assiut Women's Health Hospital, Egypt, from October 2015 to April 2016 of parous women desiring copper IUD insertion. We randomized the subjects in a 1:1 ratio to LP cream or placebo. Seven minutes prior to IUD insertion, women received 2 ml of LP cream or placebo to the anterior cervical lip, followed by 2 ml placed in the cervical canal using a Q-tip applicator. The study end point was the subjects' self-reported pain using a 10-cm visual analog scale (VAS) during cervical tenaculum placement, sound insertion, IUD insertion and 5 min postprocedure. We considered a 2-cm difference in VAS scores between study groups as clinically significant. Also, the difference in the ease of insertion score using a 10-cm VAS with 0=very easy insertion and 10=terribly difficult insertion was assessed. The study included 120 women (n=60 in each group). LP cream reduces the median VAS pain scores during tenaculum placement (2 vs. 4), sound insertion (3 vs. 6) and IUD insertion (3 vs. 6.5) with p=.0001 at all steps. A lower ease of insertion score was also determined among LP women (2.5±0.98 vs. 4.5±2.7, p=.001). Participants reported no side effects. Use of cervical LP cream prior to copper T380A IUD insertion may alleviate the IUD insertion pain among parous women. Cervical LP cream could be effective as an analgesic prior to copper T380A IUD insertion with no side effects. Further studies are needed to assess the women's satisfaction from lying with a speculum in place for 7 min while waiting for the cream to be effective. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Analysis of intrauterine device and treatment on infection after abortion%放取宫内节育器与人流术后感染治疗分析

    Institute of Scientific and Technical Information of China (English)

    赵奕奕

    2016-01-01

    In order to discuss intrauterine device (IUD) and treatment on infection after abortion, 130 patients who underwent abortive surgery from 2008 to 2013 were analyzed. By correct diagnosis and examination, infected patients were taken timely accurate treatment. Abortion patients infected with accurate and scientific treatment will return to normal in the short term. It is an effective way to carry out the family planning, and it is a timely and effective remedy for the patients infected after abortion. Many scholars believe that the low pregnancy rate pelvic inflammatory and other diseases are caused by infection after abortion.%以探讨放取宫内节育器与人流术后感染患者的治疗分析为目的,截取本院2008———2013年130位接受人流手术的患者,通过对其正确的诊断与检查,对人流手术后感染的患者采取及时准确的治疗方法。对放取宫内节育器与人流术后感染患者采取及时准确、科学的治疗方法,患者及时康复,即使有少数感染患者也会在短期内恢复正常。说明放取宫内节育器是实行计划生育的一个有效途径,对于实行计划生育人流手术后感染患者来说,采取有效的治疗方式是一种及时有效补救的治疗方法。很多学者认为,很多患者在放取宫内节育器之后,或是在经过人流手术后妊娠率很低的原因就是因为术后感染造成了盆腔炎等疾病的发生。

  12. Avaliação do desempenho de novilhas nelore implantadas com dispositivo intra-uterino (DIU recebendo ou não mistura mineral Evaluation of Nelore heifers performance with intrauterine devices with or without mineral mixture

    Directory of Open Access Journals (Sweden)

    Lúcia Maria Zeoula

    1999-11-01

    Full Text Available Trinta e duas novilhas nelore (208,3kg foram distribuídas em 16 baias (duas/baia, em um delineamento experimental inteiramente casualizado, sendo analisado em parcela sub-subdividida. Os tratamentos com sal comum ou mistura mineral constituíram as parcelas, o implante ou não do DIU as subparcelas e os períodos as sub-subparcelas. A ração concentrada participou em média 40% do total da matéria seca fornecida. Os tratamentos estudados não afetaram (P > 0,05 o ganho de peso e o rendimento de carcaça. Independentemente de tratamento, houve um ganho compensatório (P 0,05 comparado ao dos animais sem DIU.Thirty-two Nelore heifers (208.3kg were allocated into 16 pens (two/pen in randomized design, analyzed as split-splitplot. The treatments with salt or mineral mixture were considered plot, with or without intrauterine devices as split plots and periods as split-split plots. The concentrated ration participated with 40% of the total dry matter offered. There was no effect of the treatments (P > 0.05 on live weight gain or carcass yield. Apart from treatments, a compensatory growth (P 0.05 between animals using intrauterine devices and control groups.

  13. 影响育龄妇女放置宫内节育器的顾虑与依从性%Misgivings and Compliance Influencing Intrauterine Device Placement of Women with Reproductive Age

    Institute of Scientific and Technical Information of China (English)

    廖洪; 陈国荣; 王明真; 王萍; 饶双华; 李春龙; 方珍琼; 崔雅苓; 李彩军; 袁淑华; 陈晖; 张东方; 李贤芬

    2012-01-01

    [目的]探讨育龄妇女放置宫内节育器(IUD)的顾虑及其影响因素.[方法]采用问卷调查方法调查准备放置IUD的育龄妇女492例,分析其顾虑及影响因素.[结果]放置IUD的育龄妇女主要顾虑是害怕疼痛(39.8%)、害怕炎症(23.8 %)、出血多(31.5 %)、腰痛(28.9%);其次是怕不安全(11.4 %)、怕影响生育(0.4%);不同文化程度之间对放置IUD顾虑有显著差异,文化程度越高顾虑越多(χ2=33.098,P0. 05). [Conclusion] According to the characteristics of misgivings of difference people to intrauterine device placement, the propaganda of the knowledge about contraception and birth control should be carried out actively, and the misgivings of women with reproductive age should be eliminated, and good services should be done to improve the satisfactory and compliance, and the married women with reproductive age should be guided to consciously receive the long acting contraception measurement of intrauterine device.

  14. Treatment based on syndrome differentiation of irregular menstruation after intrauterine device insertion%放置宫内节育器后月经不调辨证论治

    Institute of Scientific and Technical Information of China (English)

    吕应慧

    2014-01-01

    Intrauterine device (IUD) is the most convenient, safety, long lasting and economic method of contraception for women at childbearing age[1]. Abnormal menstruation is the main adverse reaction after intrauterine device (IUD) insertion, also the main reason of the discontinuation of IUD, mainly for menorrhagia, namely menstruation too much and prolonged menstruation, drip or irregular. This article only states cases given treatment based on syndrome differentiation of Traditional Chinese Medicine in recent years which has reached great curative effects.%宫内节育器是目前育龄妇女最方便、安全、长效且经济的避孕方法[1]。月经异常是宫内节育器的主要不良反应,也是宫内节育器停用的主要原因,主要表现为月经过多,即月经量增多或流血时间和经期延长、点滴或不规则。本文仅对近几年在临床中遇到的病例运用中医中药进行分型辨证论治取得了较好疗效。

  15. [In vitro biofilm formation and relationship with antifungal resistance of Candida spp. isolated from vaginal and intrauterine device string samples of women with vaginal complaints].

    Science.gov (United States)

    Calışkan, Seyda; Keçeli Özcan, Sema; Cınar, Selvi; Corakçı, Aydın; Calışkan, Eray

    2011-10-01

    Intrauterin device (IUD) application is a widely used effective, safe and economic method for family planning. However IUD use may cause certain changes in vaginal ecosystem and may disturb microflora leading to increased colonization of various opportunistic pathogen microorganisms. The aims of this study were (i) to detect the biofilm production characteristics of Candida spp. isolated from vaginal and IUD string samples of women with IUDs, and (ii) to investigate the relationship between biofilm production and antifungal resistance. A total of 250 women (mean age: 34.4 ± 7.6 years) admitted to gynecology outpatient clinics with vaginal symptoms (discharge and itching) were included in the study. The patients have been implanted CuT380a type IUDs for a mean duration of 59.8 ± 42.4 months. Without removing IUD, string samples were obtained by cutting and simultaneous vaginal swab samples were also collected. Isolated Candida spp. were identified by conventional methods and API 20C AUX (BioMerieux, Fransa) system. Minimal inhibitory concentrations (MIC) of fluconazole, itraconazole and amphotericin B were determined by broth microdilution method according to the CLSI guidelines. Biofilm formation was evaluated by crystal violet staining and XTT-reduction assays, and the isolates which yielded positive results in both of the methods were accepted as biofilm-producers. In the study, Candida spp. were isolated from 33.2% (83/250) of the vaginal and 34% (85/250) of the IUD string samples, C.albicans being the most frequently detected species (54 and 66 strains for the samples, respectively). The total in vitro biofilm formation rate was 25% (21/83) for vaginal isolates and 44.7% (38/85) for IUD string isolates. Biofilm formation rate of vaginal C.albicans isolates was significantly lower than vaginal non-albicans Candida spp. (14.8% and 44.8%, respectively; p= 0.003). Biofilm formation rate of C.albicans strains isolated from vaginal and IUD string samples were found

  16. 宫内节育器与子宫异常出血的关系分析%Analysis of the relationship between intrauterine devices and uterine bleeding

    Institute of Scientific and Technical Information of China (English)

    闫丽华; 孙涛; 宋永昌; 段微

    2011-01-01

    目的 了解与放置宫内节育器有关的子宫异常出血的相关因素.方法 采用病例对照研究方法,比较放置宫内节育器后子宫异常出血的132例患者(研究组)与放置宫内节育器后无异常子宫出血的132例妇女(对照组)的放置时机、类型和子宫内膜炎等情况.结果 研究组中金属宫内节育器比例最高(48.48%),对照组则以活性带铜宫内节育器最多(37.88%),两组使用节育器类型比较有显著性差异(χ2=6.01,P<0.05).研究组中人工流产后立即放置宫内节育器的比例高于对照组,经比较有显著性差异(χ2=12.97,P<0.05).研究组有59.09%患有子宫内膜炎,其中宫内节育器异位合并子宫内膜炎者占53.85%,明显高于宫内节育器异位无子宫内膜炎者的20.37%,经比较有显著性差异(χ2=14.88,P<0.05).结论 宫内节育器类型、放置时机、子宫内膜炎和节育器异位与子宫异常出血有关.%To investigate the relationship between intrauterine device ( IUD ) and abnormal uterine bleeding. Methods Casecontrol study was carried out to compare IUD type, inserting time and endometritis between 132 women with abnormal uterine bleeding after inserting IUD ( study- group ) and 132 cases without abnormal uterine bleeding after inserting IUD ( control group ). Results The proportion of metal IUD in study group was highest ( 48.48% ), while in control group the proportion of copper IUD was highest ( 37.88% ). The IUD types in two groups were significantly different ( X2 = 6.01, P < 0.05 ). The cases who were inserted with IUD immediately after induced abortion were more in study group than those in control group, and the difference was significant (X2= 12.97, P < 0.05 ). In study group 59.09% of cases developed endometritis, and of them 53.85% complicated with dystopia. The rate was higher than that of IUD dystopia without endometritis ( 20.37% ) (X2= 14.88,P < 0.05 ). Conclusion IUD types, insertion time

  17. The Effect of Levonorgestrel on Fibrinolytic Factors in Human Endometrial Endothelial Cells.

    Science.gov (United States)

    Pakrashi, Tarita; Taylor, Joelle E; Nelson, Ashley; Archer, David F; Jacot, Terry

    2016-11-01

    The levonorgestrel-releasing intrauterine system is considered a highly effective treatment of heavy menstrual bleeding (HMB). While LNG has established effects on the stromal and glandular compartments of the endometrial tissue, its effect on the endometrial endothelial cells has not been investigated. We examined whether LNG regulates fibrinolytic factors, tissue plasminogen activator (tPA), and urokinase plasminogen activator (uPA) secreted by human endometrial endothelial cells (HEECs) and determined the steroid receptor through which LNG exerts its effect on the endothelium. The HEECs were treated with LNG or progesterone and levels of tPA and plasminogen activator inhibitor 1 (PAI-1) measured. The HEECs were specifically examined for the presence of androgen receptors through Western blot. Levonorgestrel ± flutamide were added to HEECs and the levels of tPA and uPA were examined. An enzyme-linked immunosorbent assay performed on culture media confirmed a statistically significant decrease in tPA levels in cells treated with LNG (77.80% ± 8.0% of control; n = 5, P < .05 vs control) but not progesterone. The androgen receptor (110 kDa) was detected in HEEC lysates. The decrease in tPA was blocked by the addition of flutamide (101.3% ± 16% of control), a classic nonsteroidal androgen receptor blocker. There was no change in uPA or PAI-1 levels in cells treated with LNG. Levonorgestrel decreases tPA levels through the androgen receptor in HEECs. Thus, LNG inhibits tPA secretion by the endometrial endothelial cell. This response suggests reduction in HMB with LNG-IUS could reflect an LNG-mediated promotion of hemostasis. © The Author(s) 2016.

  18. Ectopic pregnancy following levonorgestrel emergency contraception: a case report

    Science.gov (United States)

    Kaymak, Oktay; Şimşek, Yavuz; Doğanay, Melike; Yıldız, Yasemin; Mollamahmutoğlu, Leyla

    2010-01-01

    Hormonal contraceptive pills containing 750 microgram levonorgestrel are the most commonly used postcoital contraceptive method because of their high efficacy and fewer side effects. Emergency contraceptive pills containing levonorgestrel present their effects by several mechanisms, including delayed tubal transport of the ovum. A delay of tubal transportation of an ovum is also one of the possible etiologic factors of tubal ectopic pregnancies. There are limited data on the risk of ectopic pregnancy following levonorgestrel treatment as an emergency contraception. Here, a case of tubal pregnancy associated with the use of levonorgestrel containing emergency contraceptive pills has been presented along with discussion of the relevant literature. PMID:24591928

  19. Diagnosis and treatment of abdominal ectopic intrauterine device%腹腔内异位宫内避孕器诊治分析

    Institute of Scientific and Technical Information of China (English)

    孙阳; 王元佩

    2005-01-01

    宫内避孕器(intrauterine device,IUD)是一种常用的比较安全的避孕工具,但因其放置是一种相对盲目性的操作,如对子宫位置扪诊不清、操作不当或患者处于哺乳期等原因可造成IuD异位。现将本院1995-2003年8例腹腔内IUD异位病例回顾分析如下,探讨其原因和诊治。

  20. Clinical effect analysis of ultrasound guiding treatment in 3 8 cases of intrauterine device incarceration%超声引导下治疗宫内节育器嵌顿38例临床疗效分析

    Institute of Scientific and Technical Information of China (English)

    邵芳英

    2014-01-01

    Objective:To investigate the clinical effect of ultrasound guiding treatment in cases of intrauterine device incarceration.Methods:76 cases of intrauterine device incarceration in our hospital patients were admitted,the cases were randomly divided into observation group and control group,38 cases in each group,cases in observation group were treated by ultrasound guiding,cases in control group were treated routinely,compared the clinical effect of cases in two groups.Result:The treatment time and amount of bleeding of cases in observation group were significantly less than that in control group,the treatment success rate was 97.4%,significantly higher than that in control group (81.6%),the differences between two groups were al has statistical y significant (P<0.05).Conclusion:Using ultrasound guiding treatment of intrauterine device incarceration is an ideal way,worthy of further clinical application.%目的:探讨超声引导下治疗宫内节育器嵌顿的疗效.方法:选取我院近期收治的76例宫内节育器嵌顿患者,随机将患者分为观察组和对照组,每组各38例,观察组患者在超声引导下取出,对照组患者常规取出,比较两组患者的临床疗效.结果:观察组患者的治疗时间及出血量均少于对照组患者,治疗成功率为97.4%,显著高于对照组患者的81.6%,组间差异均有统计学意义(P<0.05).结论:超声引导下治疗宫内节育器嵌顿是一种理想的方式,值得临床进一步推广使用.

  1. Predictors of non-use of intrauterine contraception among women aged 18–49 years in a general practice setting in the UK

    Directory of Open Access Journals (Sweden)

    Walker SH

    2016-10-01

    Full Text Available Susan H Walker,1 Victoria L Newton,2 Lesley Hoggart,3 Mike J Parker4 1Faculty of Health, Social Care & Education, Anglia Ruskin University, Chelmsford, 2Faculty of Health & Social Care, The Open University, Milton Keynes, 3School of Health, Wellbeing and Social Care, The Open University, Milton Keynes, 4Postgraduate Medical Institute, Anglia Ruskin University, Chelmsford, UK Objectives: Our research examined the barriers to the uptake of intrauterine contraception (IUC by women in a general practice (GP setting in the UK. This study reports predictors of non-use of IUC in this context.Design: We used a mixed method Qual/Quant approach in which the initial qualitative research provides a framework for subsequent larger quantitative surveys. Utilizing findings derived from 30 qualitative interviews, a quantitative survey was developed and distributed to a pragmatic sample of 1,195 women, aged 18–49 years, who were recruited through 32 participating GP practices in an area of England, UK. Outcome measures were percentage of attributes or responses in the sample and use or non-use of IUC. Results were analyzed using descriptive statistical analysis and binary logistic regression, using use/non-use as a binary response variable.Results: Attitudinal variables, which were the strongest predictors of non-use of IUC, were an adverse opinion on long-acting aspect of IUC (odds ratio [OR]=8.34, disliking the thought of IUC inside the body (OR=3.138, concerns about IUC causing difficulties becoming pregnant in the future (OR=2.587, concerns about womb damage (OR=2.224, having heard adverse opinions about levonorgestrel-releasing intrauterine system (Mirena® (OR=2.551, having an adverse opinion of having light, irregular periods (OR=2.382 and, having an adverse opinion of having no periods (OR=2.018.Conclusion: Concerns about the long-acting nature of IUC and persisting concerns about the safety of IUC may act as barriers to its use. Information for

  2. Effect of a hormone-releasing intrauterine system (Mirena® on aromatase and Cox-2 expression in patients with adenomyosis submitted or not, to endometrial resection

    Directory of Open Access Journals (Sweden)

    Maia R

    2012-04-01

    Full Text Available Hugo Maia Jr1,2, Clarice Haddad1, Julio Casoy1, Rebeca Maia1, Nathanael Pinheiro3, Elsimar M Coutinho11Centro de Pesquisa e Assistência em Reprodução Humana (CEPARH, 2Itaigara Memorial Day Hospital, 3IMAGEPAT, Salvador, Bahia, BrazilObjective: To investigate the effect of a levonorgestrel-releasing intrauterine system (Mirena® on aromatase and cyclooxygenase-2 (Cox-2 expression in the endometrium of patients with adenomyosis who were submitted to endometrial resection at the time of insertion, compared to a group not submitted to endometrial resection and a group of controls with adenomyosis not submitted to any previous hormonal treatment.Patients and methods: Patients with adenomyosis (n = 89 were included in this study. Twenty-two patients had been using Mirena® for 5 years but had not been submitted to endometrial resection prior to insertion of the device. Twenty-four patients were submitted to endometrial resection at the time of Mirena® insertion. The remaining 43 patients with adenomyosis had undergone no previous hormonal treatment and served as a control group. Cox-2 and aromatase expression were determined in the endometrium by immunohistochemistry.Results: Use of Mirena® for 5 years reduced aromatase expression in the endometrium; however, this reduction was significantly greater in the uteri previously submitted to endometrial resection. The reduction in Cox-2 expression was significant only in the uteri submitted to endometrial resection followed by the insertion of Mirena®.Conclusion: Endometrial resection followed by the insertion of Mirena® was associated with greater rates of amenorrhea in patients with adenomyosis, which in turn were associated with a more effective inhibition of aromatase and Cox-2 expression in the endometrium.Keywords: aromatase, Mirena®, adenomyosis, Cox-2, endometrium, levonorgestrel

  3. Intrauterin graviditet efter Cavatermbehandling

    DEFF Research Database (Denmark)

    Shokouh-Amiri, Ali; Kjaergaard, Niels

    2009-01-01

    A case of intrauterine pregnancy occurring after successful balloon thermal endometrial ablation is described. Although rare, pregnancy after endometrial ablation is possible, and use of a supplemental contraceptive method should be planned. In case of pregnancy after endometrial ablation...

  4. Clinical observation on 126 patients used Gynefix intrauterine uterine device%固定式吉妮宫内节育器与Tcu200节育器的临床应用观察

    Institute of Scientific and Technical Information of China (English)

    陈京川

    2012-01-01

    Objective To investigate clinical efficiency of Gynefix intrauterine uterine device. Methods 126 peoples used Gynefix intrauterine uterine device were selected in the hospital from December 2008 to November 2011 as the observation group. 125 peoples used TCu200 intrauterine uterine device were randomly selected in the hospital as the control group. All of IUD users were followed up for 1 years. The contraceptive efficacy and adverse reaction were compared between two groups. Results The effective contraception rate (95.2%) in the observation group was significantly higher than that in the control group (72.8%). The contraceptive failure rate (1.6%) and for some reason extraction rate (3.2% ) in the observation group was significantly lower than contraceptive failure rate(8.8% ) and for some reason extraction rate (18.4%) in the control group. The rate of adverse reactions (10.3%) in the observation group was significantly lower than that in the control group (22.4%). The differences were statistically significant (P<0.05). Conclusion The use of Gynefix intrauterine uterine device has good clinical effect. The effective contraception rate is high while adverse reactions are low. That is a safe and effective method of contraception. That is worthy of clinical use.%目的 探讨固定式吉妮宫内节育器的临床疗效.方法 选取本院2008年12月至2010年11月固定式吉妮宫内节育器使用者126例作为观察组,随机选取在我院使用Tcu200节育器避孕者125例作为对照组,并对所有节育器使用者进行1年随访,比较两组人员的避孕效果和不良反应情况.结果 观察组有效避孕率(95.2%)明显高于对照组(72.8%),观察组避孕失败率(1.6%)和因故取出率(3.2%)明显低于对照组(8.8%、18.4%),观察组不良反应率(10.3%)明显低于对照组(22.4%),差异均有统计学意义(P<0.05).结论 应用固定式吉妮宫内节育器的临床效果显著,有效避孕率高且不良反应低,

  5. Clinical observation of intrauterine contraceptive device removed in 74 postmenopausal women%绝经后宫内节育器取出74例临床观察

    Institute of Scientific and Technical Information of China (English)

    吴淑梅

    2012-01-01

    目的 探讨绝经后妇女宫内节育器(intrauterine contraceptive device,IUD)取出困难的原因及应对措施.方法 回顾分析荥阳市人民医院74例绝经后妇女行IUD取器术情况.结果 28例顺利取出,45例取器困难,1例金属环残端严重嵌入宫颈壁.结论 绝经后妇女IUD的取出首选常规取器术.对患者术前进行综合评价及宫颈软化处理是成功施术的关键.

  6. The Exploration on the Safety of Intrauterine Device Retention During Perimenopausal Period%围绝经期宫内节育器滞留的安全性探讨

    Institute of Scientific and Technical Information of China (English)

    李桂玲

    2013-01-01

    Objective To research the safety of intrauterine device retention during perimenopausal period. Methods The form of questionnaire was used to investigate women in perimenopausal period in this district. We selected 300 women using intrauterine device as observing group and 300 using other contraceptive methods. Not using intrauterine device ) as control group. The enrolled subjects were given consultation and health examination and the menstruation state waist and abdomen's pain and the occurrence of gynecological inflammation were compared between two groups. Results There was no statistically significant difference in the menstrual blood volume of women in perimenopausal period between two groups (P>0.05).There was statistically significant difference in the incidence of pain in waist or abdomen in women in perimenopausal period between two groups (P<0.05). The incidence of gynecological inflammation in women in perimenopausal period was 63.33%and 59.67%in the observing group and control group respectively and there was no statistically significant difference between two groups. Conclusion Intrauterine device retention during perimenopausal period has no impact on women' menstruation state and gynecological inflammation,but is relevant with waist and abdomen's pain.%目的探讨女性围绝经期宫内节育器滞留的的安全性问题.方法采用调查问卷形式在本区对围绝经期女性进行调查,抽取300例使用宫内节育器的女性作为观察组,300例使用其他避孕方式(即未使用宫内节育器)的女性作为对照组,并对其进行咨询和健康检查,比较两组女性的月经情况、围绝经期腰腹部疼痛情况及妇科炎症的发生情况.结果观察组围绝经期女性月经量少、中、多的发生率和对照组比较,差异无统计学意义(P>0.05);观察组围绝经期腰腹部疼痛无症状、轻症、中症、重症的发生率和对照组比较,差异有统计学意义(P<0

  7. 宫腔镜在宫内节育器常规取出失败后的应用%The hysteroscopy application in the failed-to-removal of intrauterine contraceptive device by the routine method

    Institute of Scientific and Technical Information of China (English)

    沈山; 高李英

    2010-01-01

    目的 探讨宫腔镜在用常规方法取出宫内节育器(intrauterine contraceptive device,IUD)失败后的临床应用价值.方法回顾性分析117例用常规方法取出IUD失败后的病例,应用宫腔镜处理的结果.结果 应用宫腔镜取出断裂、残留、嵌顿等IUD 116例,成功率为99.1%(116/117).117例中,无子宫穿孔、水中毒等并发症发生.结论宫腔镜用于常规方法取出IUD失败的病例,是安全有效的,可作为该类病例的首选诊治方法.

  8. 宫腔镜下困难取环108例临床分析%Clinical Analysis of 108 Cases of Performing Difficult Removal of Intrauterine Device under Hysteroscopy

    Institute of Scientific and Technical Information of China (English)

    王光花; 吴逸; 钱春妹; 黄蕴思

    2005-01-01

    宫内节育器(intrauterine device,IUD)是一种安全、有效、简便、经济的避孕工具.绝经后、带器妊娠、活性环到期及各种指征要求取环时易发生宫内节育器常规取出困难.我院自1999年1月至2004年8月诊治的宫内节育器常规取出困难108例,采用官腔镜定位、诊断、处理,结果令人满意,现在分析如下.

  9. The research progress on the intrauterine contraceptive device and the reproductive tract infection%宫内节育器与生殖道感染研究进展

    Institute of Scientific and Technical Information of China (English)

    熊英; 徐克惠

    2009-01-01

    使用宫内节育器(intrauterine contraceptive device, IUD)是我国妇女主要避孕措施之一,具有长效、简便、可逆、经济的优点.IUD是否增加女性生殖道的感染,国内外报道不一致.本文对IUD与生殖道感染关系的文献进行综述和分析,有助于医务工作者在临床中尽量减少和避免生殖道感染的发生,提高IUD使用率及续用率.

  10. Situation on the Removal of Intrauterine Device in Shanghai%上海市宫内节育器取出术现状的调查分析

    Institute of Scientific and Technical Information of China (English)

    康建中; 肖志琴; 黄咏梅; 刘晓瑷

    2011-01-01

    Objective: To explore the possible causes of complications that happened at removal of intrauterine devices (IUD) as well as to find measures to improve the safety of the surgery based on analysis of the current situation and methods of IUD removal in Shanghai. Methods: A retrospective survey was conducted on all IUD removal cases at 87 hospitals in Shanghai from January 2001 to December 2007, including the method and place of IUD removal and with or without intravenous anaesthesia. Further investigations were performed on cases with severe complications. Results: The amount of regular IUD removal was increased from 2001 to 2007 ranging from 60000 to 100000 per year. Among which, 37. 61% were carried in the secondary general hospitals, 16. 41% were in the tertiary general hospitals, and 45. 98% were in maternal and child hospital (MCH), respectively. Compared with that in 2001, the number of hospitalized hysteroscopic removal of IUD was increased 158.47% in 2007, and the number of hysteroscopic removal of an IUD with intravenous anaesthesia was increased 124. 47%. The incidence of severe complications of regular removal of IUD was 2.99/100000, while that of hysteroscopic removal was 36. 00/100000. The severe complications of regular removal of IUD included viscus injury (14 cases) and infection-induced laparotomy (3 cases). The severe complications of hysteroscopic removal of IUD were death (4 cases). Conclusions: The number of IUD removal is increasing in recent years. The use of hysteroscope is proved helpful in difficult situations. It is right time to formulate a guideline for the hysteroscopic removal of IUD, which includes the first-aid supplies and the evaluation of the qualification of the operators.%目的:调查上海市宫内节育器(IUD)取出的现状和方法,探讨手术并发症的因为及安全取出IUD的措施.方法:对上海市87所医院2001~2007年期间所有IUD取出术病例进行回顾性调查,内容包括手术方式、

  11. 宫型节育器对中重度宫腔粘连患者子宫内膜CTGF、PDGF的影响%Influnce of Intrauterine Device on Endometrium CTGF and PDGF of Patients with Moderate and Severe Intrauterine Adhesion

    Institute of Scientific and Technical Information of China (English)

    陈滢; 王晶; 黄惠娟; 童明

    2015-01-01

    目的 观察放置宫型节育器(intrauterine device,IUD)预防宫腔镜宫腔粘连分离术后再次宫腔粘连(intrauterine adhesion,IUA)临床疗效,比较结缔组织生长因子(connective tissue growth factor,CTGF)、血小板源性生长因子(platelet-derived growth factors,PDGF)在治疗前后宫内膜的表达变化,探讨其与IUA的关系,进一步阐明宫型节育器防治IUA的作用机理.方法 将40例中重度IUA患者随机分为节育器组、空白组,每组20例,采用逆转录聚合酶链式反应(reverse transcription polymerase chain reaction,RT-PCR)方法,观察治疗前后CTGF、PDGF的表达情况.结果 治疗前2组CTGF、PDGF的表达水平比较差别无统计学意义(P>0.05),治疗后节育器组宫内膜CTGF、PDGF表达水平低于空白组(P<0.05).结论 CTGF、PDGF的异常表达导致子宫纤维增殖活跃,可能参与宫腔粘连的发生发展,术后放置宫型节育器可降低CTGF、PDGF表达,减少粘连形成,有效预防术后再次粘连,提高子宫内膜容受性.

  12. 一体化持续护理模式在放置宫内节育器妇女中的应用%Application of the integration of continuing nursing mode in women with intrauterine device

    Institute of Scientific and Technical Information of China (English)

    邢伟娜

    2015-01-01

    目的:探讨一体化持续护理模式对宫内节育器放置妇女健康知识知晓率及并发症的影响。方法:2012年1月-2014年1月收治行宫内节育器育龄妇女160例,根据随机数字表分为观察组及对照组各80例,对照组放置后实施常规性健康教育,观察组在对照组基础上实施一体化持续护理模式,干预前后应用自行设计的《宫内节育器健康知识调查问卷》对两组患者节育器健康知识知晓情况进行调查,并观察两组患者放置节育器后不良反应发生情况。结果:观察组干预后对节育器放置时间、宫内节育器放置禁忌证、节育器避孕的原理、放置节育器不良率、节育器放置年限、节育器取出情况、节育器放置后注意事项等方面的知晓率高于对照组,差异有统计学意义(P<0.05)。观察组下腹不适、不规则出血、白带过多、IUD下移等不良反应率显著低于对照组,差异有统计学意义(P<0.05)。结论:一体化持续护理模式可提高宫内节育器放置患者相关健康知识,降低患者并发症发生率,提高患者生存质量。%Objective:To explore the influence of the integration of continuing nursing mode in women with intrauterine device for health knowledge awareness rate and complications.Methods:160 cases of women of childbearing age with intrauterine device were selected from January 2012 to January 2014.According to the random number table,they were divided into the observation group and the control group with 80 cases in each group.The control group were given routine sex health education after placing intrauterine device.The observation group were given the integration of continuing nursing mode on the basis of the control group. Before and after the intervention,we investigated the health knowledge for IUD using the self-designed "IUD health knowledge questionnaire",and observed the adverse reactions of the two groups.Results:In the

  13. 左炔诺孕酮宫内节育器治疗围绝经期功能性子宫出血50例临床分析%Levonorgestrel IUD treatment of dysfunctional uterine bleeding of perimenopausal period in 50 cases

    Institute of Scientific and Technical Information of China (English)

    徐艳; 李淑清; 周巧梅

    2009-01-01

    Objective To explore the role of levonorgestrel intrauterine device in the treatment of peri-menopausal dysfunctional uterine bleeding, to find theoretical basis for effective and rational treatment of peri-menopausal dysfunctional uterine bleeding and reduce the rate of hysterectomy. Methods Fifty patients received levonorgestrel intrauterine device (treatment group) and another 50 cases were given oral Fukang tablets (control group). The rate of hysterectomy, assessment of menstrual volume and endometrial thickness were observed between the two groups. Results In treatment group, 1 (2%) patient was performed hysterectomy, 2 (4%) had the assessment of menstrual volume score greater than 100, while in control group, 8 (16%) were performed operations, and 12 (24%) had the assessment of menstrual volume score greater than 100. The assessment of menstrual volume scores were 131.0±51.2, 53.0±21.9, 36.7±19.7, 17.9±6.8, respectively, and endometrialt thickness reduced from (13.2±4.3) mm to (8.5±1.9)mm, (7.2±1.5)mm,(6.2±1.1)ram before or 3, 6 and 12 months after the use of the device. Conclusion The use of levonorgestrel intrauterine device can reduce the volume of menstruation and the hysterectomy rate caused by dysfunctional uterine bleeding.%目的:探讨左炔诺孕酮宫内节育器治疗围绝经期功能性子宫出血的疗效,为寻找有效、合理治疗围绝经期功能性子宫出血提供理论依据并减少子宫切除率.方法:治疗组50例患者放置左炔诺孕酮宫内节育器,对照组为口服妇康片(炔诺酮)50例患者,观察2组子宫切除率、月经量评分、子宫内膜厚度.结果:治疗组50例中1例手术(2%)、月经量评分>100分2例(4%);对照组50例中8例手术(16%)、月经量评分>100分12例(24%).治疗组子宫切除率和出血量均低于对照组;放置左炔诺孕酮宫内节育器前及放置后3,6,12个月月经量评分分别为131.0±51.2,53.0±21.9,36.7±19.7,17.9±6.8;子宫内膜由(13.2±4.3)mm

  14. Assessment of a high-fidelity mobile simulator for intrauterine contraception training in ambulatory reproductive health centres

    Directory of Open Access Journals (Sweden)

    Laura E. Dodge

    2016-02-01

    Full Text Available Objectives. Little is known about the utility of simulation-based training in office gynaecology. The objective of this cross-sectional study was to evaluate the self-reported effectiveness and acceptability of the PelvicSim™ (VirtaMed, a high-fidelity mobile simulator, to train clinicians in intrauterine device (IUD insertion. Methods. Clinicians at ambulatory healthcare centres participated in a PelvicSim IUD training programme and completed a self-administered survey. The survey assessed prior experience with IUD insertion, pre- and post-training competency and comfort and opinions regarding the acceptability of the PelvicSim. Results. The 237 participants were primarily female (97.5% nurse practitioners (71.3%. Most had experience inserting the levonorgestrel LNG20 IUD and the copper T380A device, but only 4.1% had ever inserted the LNG14 IUD. For all three devices, participants felt more competent following training, with the most striking change reported for insertion of the LNG14 IUD. The majority of participants reported increased comfort with uterine sounding (57.7%, IUD insertion on a live patient (69.8%, and minimizing patient pain (72.8% following training. Of the respondents, 89.6% reported the PelvicSim IUD insertion activities as “valuable” or “very valuable.” All participants would recommend the PelvicSim for IUD training, and nearly all (97.2% reported that the PelvicSim was a better method to teach IUD insertion than the simple plastic models supplied by IUD manufacturers. Conclusions. These findings support the use of the PelvicSim for IUD training, though whether it is superior to traditional methods and improves patient outcomes requires evaluation.

  15. Clinical research progress on Intrauterine device for contraception%宫内节育器的临床研究进展

    Institute of Scientific and Technical Information of China (English)

    韩咏梅; 王翠梅; 王风华; 管蓬香

    2008-01-01

    宫内节育器(Intrauterine device,IUD)最早于1909年用于避孕。但广泛研制始于20世纪60年代。是一种避孕效果良好、安全、使用简便、经济、作用可逆的长效避孕方法。2002年世界卫生组织统计数字显示全世界已有1.56亿妇女使用IUD,其中亚洲国家使用者占多数。中国使用者几乎占全世界的2/3。从第一代惰性IUD到第二代释放活性物质(铜或药物)的IUD,又到第三代无支架型IUD,宫内节育器经历了不断的改进。其作用也从单纯地用于避孕.发展到现在尝试用于治疗多种妇科疾病。如子宫内膜异位症和痛经、月经过多等。

  16. Dislodgment of intrauterine contraceptive device under combined hysteroscope: 56 cases report%宫腔镜下取出宫内节育器56例

    Institute of Scientific and Technical Information of China (English)

    申玉红

    2005-01-01

    1临床资料2002-01/2004-01我院接诊取出宫内节育器(intrauterine device,IUD)失败56例,育龄期5例,年龄20-40岁,上环时间1~7a;绝经前期10例,年龄43~54岁,上环年限6~24a;绝经期1~2a者18例,年龄45—56岁,上环年限10~26a;绝经2a以上者23例,年龄52—75岁,上环16-42a.所有病例均有1~5次取环失败,均无取环禁忌.设备运用日本Olympus公司生产的宫腔镜,要求取器者术前先行宫腔镜联合B超检查.对宫颈黏连者,宫腔镜下分离;

  17. Comparison of Mirena intrauterine device with copper - bearing intrauterine devices with different surface areas of copper: A systematic review%曼月乐与不同铜表面积宫内节育器比较的系统评估

    Institute of Scientific and Technical Information of China (English)

    张磊; 张妍; 车焱; 周维谨

    2011-01-01

    目的:评价曼月乐宫内节育器(IUD)的有效性、副反应和续用情况.方法:通过电子检索查阅1999年1月~2010年12月国内外发表的相关文献,并依照循证医学的方法对纳入评估的文献进行筛选、评价和分析.结果:共获得合格文献9篇,均为临床对照试验且正式发表.评估结果显示,置器后12个月和24个月,曼月乐与同属高铜表面积(≥300mm2)的GyneFix330、MLCu375和TCu380A IUD及低铜表面积(<300mm2)的TCu220C和MCu110 IUD的带器妊娠率和脱落率类似.与高铜表面积IUD相比,放置曼月乐妇女的月经量增多、不规则出血和腰、腹痛等副反应发生率略低,而闭经发生率略高.置器后12个月,曼月乐的因症取出率低于TCu220C IUD,续用率高于TCu220C IUD.而与其他IUD相比无统计学意义.结论:曼月乐临床综合效果略优于TCu220C IUD,而与高铜表面积及MCu110 IUD相比,则互有优劣,尚无法得出明确结论.%Objective: To explore the effectiveness, side effects, and acceptability of Mirena intrauterine device (IUD). Methods; Electronic searches were used to identify relevant literatures published between January 1999 and December 2010. Papers were included and evaluated according to established criteria of evidence - based medicine. Results: Nine papers were included and all of them were controlled clinical trials. Within 12/24 months of follow - up after IUD insertion, the pregnancy rate with IUD in situ and the expulsion rate of Mirena were similar to those of GyneFix330, MLCu375, TCu380A, TCu220C and MCu110 IUDs. Compared with women using IUDs with high surface area of copper ( ≥300mm2) , those using Mirena had slightly lower rates of heavy menstrual bleeding, irregular vaginal bleeding and low back - abdominal pain, but slightly higher rate of amenorrhea. Within 12 months of follow - up after IUD insertion, the removal rate due to medical reasons was significantly lower, but the continuation rate was

  18. Levonorgestrel, not etonogestrel, provides contraception in free-ranging koalas.

    Science.gov (United States)

    Hynes, E F; Handasyde, K A; Shaw, Geoff; Renfree, Marilyn B

    2010-01-01

    Management of high-density koala (Phascolarctos cinereus) populations is essential because of the browsing damage they inflict on their habitat. We have tested two types of gestagen implant, namely levonorgestrel and etonogestrel, as contraceptives for koalas. Free-ranging female koalas were given either a control, levonorgestrel (70 mg) or etonogestrel (34 or 68 mg) implant before the breeding season. Koalas were monitored every 4-12 weeks for births. Plasma progesterone was measured and a cytological smear of the urogenital sinus was taken. Fertility was high in the control group and the two etonogestrel-treated groups, with approximately 90% of females giving birth. In contrast, no levonorgestrel-treated female produced young during the study. Removal of levonorgestrel implants from six females reversed the contraceptive effect in the next breeding season, whereas the eight females in which the levonorgestrel implants were left in remained infertile for six breeding seasons. Vaginal cytology showed evidence of oestrous cycles during the breeding season in all females from all groups and there was no difference seen in the prevalence of cornified epithelial cells in the oestrous smears. This indirectly suggests that levonorgestrel does not prevent follicular development and oestrous cycling. Plasma progesterone in levonorgestrel-treated females remained low all year, but rose in controls concurrent with the onset of the breeding season. This suggests that levonorgestrel prevents pregnancy by blocking ovulation. Etonogestrel had absolutely no contraceptive effect at the two doses delivered and so is not suitable for controlling koala populations. In contrast, levonorgestrel was effective as a long-term, reversible contraceptive in wild koalas.

  19. Analysis of psychological status of women before intrauterine device insertion%放置宫内节育器育龄妇女的心理状态分析

    Institute of Scientific and Technical Information of China (English)

    陈粮; 袁荣亲; 郭练; 林佩萱; 杨烨; 张淑婷; 袁玉枝; 刁伟坚

    2011-01-01

    Objective: To explore the psychological and mental health status of women at reproductive age before intrauterine device (IUD) insertion, in order to provide a theoretical and practice basis for better family planning and contraceptive quality service. Methods: Women underwent psychological evaluation with symptom checklist 90 (SCL -90) , selfrating anxiety scale (SAS) and selfrating depression scale (SDS) before intrauterine device insertion. Results; There was no significant difference between the score of SCL - 90 of these women and that of the national norm in somatization and psychosis (P > 0.05 ) , while scores of other factors were even lower than those of the national norm ( P < 0. 05 ). The score of SDS was lower than that of -the national norm ( P < 0.05 ). And the score of SAS was higher than that of the national norm ( P < 0.05 ). Conclusion: IUD insertion was a safe, simple, effective, reversible and acceptable contraceptive measure. While it could induce symptoms of mild anxiety because of the operation may act as a stress source.%目的:了解放置宫内节育器(IUD)育龄妇女的精神症状及心理卫生状况,为更好地开展避孕节育优质服务提供理论和实践依据.方法:对2008年3月~2009年12月在广州市人口和计划生育科学研究所放置IUD的妇女行症状自评量表(SCL-90)、焦虑自评量表(SAS)和抑郁自评量表(SDS)心理测评.结果:SCL-90与全国常模相比,除躯体化、精神病性因子无明显差异外,其余各因子评分均低于全国常模(P<0.05);SDS分值亦低于全国常模(P<0.05);SAS分值则高于全国常模(P<0.05).结论:放置IUD是一个安全、简单、有效、可逆的避孕措施,但作为一项手术,可能成为一个应激源,引发置器妇女的轻度焦虑症状.

  20. The Investigation of Methods of IUD (Intrauterine Device) from Postmenopausal Women Summary%绝经后妇女宫内节育器取出方法探讨

    Institute of Scientific and Technical Information of China (English)

    侯小君; 辜钦娅

    2012-01-01

    Objective:Investigating effective methods of IUD (Intrauterine device) from postmenopausal women one hundred postmenopausal women whose IUD (Intrauterine device) would be taken out were divided into two groups.Methods:Group A women were applied OU Wei Ting ointment 0.5g (containing estriol0.5mg) to their vaginal nightly one week before surgery, and were applied Misoprostol 400ug to their vaginal posterior fornix two hours before surgery. During surgery they inhaled nitrous oxide. Group B women were applied Misoprostol 400ug to their vaginal posterior fornix two hours before surgery.Results:The comparison of cervical softening, operation time and bleeding between group A and group B is statistically significant (P<0.05).Conclusion:Using OU Wei Ting ointment 0.5g (containing estriol 0.5mg) one week before surgery and inhaling nitrous oxide during surgery can improve the success rate of surgery and reduce pain by the surgeon%目的:探讨绝经后妇女取器的有效方法.方法:将收集绝经后妇女取器100例相关资料分为2组,A组手术前1周每晚阴道给欧维婷软膏0.5g(含雌三醇0.5mg),术前2小时阴道后穹窿置米索前列醇400ug,术中吸入氧化亚氮;B组于术前2小时阴道后穹窿置米索前列醇400ug.结果:A组宫颈软化程度、手术时间及出血与B组比较均有统计学意义(P<0.05).结论:术前应用欧维婷、米索前醇、术中吸入氧化亚氮,可以提高手术成功率,减轻受术者痛苦.

  1. Clinical analysis of reproductive tract infections among women with intrauterine devices%使用宫内节育器女性生殖道感染临床特征及相关因素分析

    Institute of Scientific and Technical Information of China (English)

    徐美清

    2012-01-01

    目的 对使用宫内节育器的女性发生生殖道感染的相关因素进行分析,以降低生殖道感染率.方法 对255例使用宫内节育器妇女的临床资料进行回顾性分析,主要包括患者的年龄、孕次、官腔深度、宫内节育器的使用时间、是否发生异常子宫出血、节育器有无尾丝和节育环种类.结果 生殖道感染的发生与孕次、官内节育器的使用时间、是否发生异常子宫出血、节育器有无尾丝和节育环种类相关;感染率为40.4%;阴道炎、宫颈炎、盆腔炎患者感染分别占39.8%、42.7%、17.5%.结论 尽量减少孕次、注意异常子宫出血、避免节育器携带尾丝和使用含铜节育器可有效减少宫内节育器使用者发生生殖道感染.%OBJECTIVE To analyze the related factors for reproductive tract infections among women with intrauterine devices (IUD) so as to reduce the incidence of reproductive tract infections. METHODS Totally 255 patients with intrauterine devices were chosen and studied to analyze the risk factors which might cause the reproductive tract infections. The main factors included the age, gravidity, the uterine cavity depth, the using time of IUD, abnormal uterine bleeding, the tailed IUD , and type of IUD. RESULTS The incidence of the reproductive tract infections was closely related to the gravidity, the using time of IUD, abnormal uterine bleeding, the tailed IUD, and IUD types. The infection rate was 40.4%. Of all the patients with infections, the patients with vaginitis accounted for 39. 8%, the patients with cervicitis 42. 7%, and the patients with pelvic inflammatory 17. 5%. CONCLUSION It is an effective way to reduce the incidence of reproductive tract infections in the women with IUD by reducing the pregnancies, avoiding using the tailed IUD, noting the abnormal uterine bleeding ,and using the IUD containing copper.

  2. Intrauterine contraception: the pendulum swings back.

    Science.gov (United States)

    MacIsaac, Laura; Espey, Eve

    2007-03-01

    Intrauterine contraception is the most widely used method of reversible fertility regulation in the world. Finally, IUC is undergoing a renaissance in the US and it's role will expand as new devices and systems are developed and as old biases among clinicians and women are erased. Successful fertility regulation is a defining factor of the overall health of a population; the expanded use of IUC can help achieve that public health success.

  3. Intrauterine infection and prematurity.

    Science.gov (United States)

    Gonçalves, Luís F; Chaiworapongsa, Tinnakorn; Romero, Roberto

    2002-01-01

    Intrauterine infection is a major cause of premature labor with and without intact membranes. Intrauterine infection is present in approximately 25% of all preterm births and the earlier the gestational age at delivery, the higher the frequency of intra-amniotic infection. Microorganisms may also gain access to the fetus before delivery. A fetal inflammatory response syndrome elicited in response to microbial products is associated with the impending onset of preterm labor and also with multi-systemic organ involvement in the human fetus and a higher rate of perinatal morbidity. The most common microorganisms involved in intrauterine infections are Ureaplasma urealyticum, Fusobacterium species and Mycoplasma hominis. The role of Chlamydia trachomatis and viruses in preterm labor remain to be determined. Use of molecular microbiology techniques to diagnose intrauterine infection may uncover the role of fastidious microorganisms that have not yet been discovered. Antibiotic administration to patients with asymptomatic bacteriuria is associated with a significant reduction in the rate of preterm birth. However, such benefit has not been demonstrated for patients with bacterial vaginosis, or women who carry Streptococcus agalactia, Ureaplasma urealyticum or Trichomonas vaginalis. Antibiotic administration to patients with preterm premature rupture of membranes is associated with prolongation of pregnancy and a reduction in the rate of clinical chorioamnionitis and neonatal sepsis. The benefit has not been demonstrated in patients with preterm labor and intact membranes. Major efforts are required to determine why some women develop an ascending intrauterine infection and others do not and also what interventions may reduce the deleterious effect of systemic fetal inflammation. Copyright 2002 Wiley-Liss, Inc.

  4. Contracepción de emergencia con Levonorgestrel Emergency contraception with levonorgestrel

    Directory of Open Access Journals (Sweden)

    Fernando D. Saraví

    2007-10-01

    Full Text Available La contracepción de emergencia puede evitar el embarazo luego de un coito sin medidas contraceptivas o cuando éstas fallan. Se recomienda el levonorgestrel, un gestágeno sintético, en dosis única de 1.5 mg (alternativamente en dos dosis de 0.75 mg espaciadas 12 h. Su eficacia es moderada, pues impide aproximadamente 80% de los embarazos. La eficacia es mayor cuanto más precozmente se administre, pero puede darse hasta 5 días post-coito. La tolerancia es similar o superior a la de otros preparados empleados con igual propósito. Los efectos adversos comprenden náuseas, vómitos, cefalea, tensión mamaria y alteraciones transitorias en la siguiente menstruación. Se desconoce si el levonorgestrel aumenta la probabilidad de embarazo ectópico cuando el tratamiento fracasa. No se recomienda su empleo como contraceptivo habitual. Cuando se administra antes del pico preovulatorio de LH, el levonorgestrel generalmente bloquea o retrasa la ovulación. Puede asimismo afectar la migración de los espermatozoides en el tracto genital femenino e, indirectamente, la fertilización. Pese a haberse postulado reiteradamente, no existe evidencia de un efecto antiimplantatorio. El conocimiento del método es muy variable en diferentes sociedades, pero aun donde es bien conocido permanece subutilizado. Se ha propuesto proveer levonorgestrel por adelantado para promover su uso. En ensayos clínicos, tal provisión no afectó adversamente el comportamiento sexual ni el empleo de otros contraceptivos, pero tampoco redujo el número de embarazos o abortos. En consecuencia, el empleo de levonorgestrel debe considerarse un método de respaldo que no reemplaza el uso de contraceptivos más eficaces.Emergency contraception may avoid pregnancy after unprotected intercourse or when regular contraceptive measures fail. Levonorgestrel, a synthetic gestagen, is recommended for emergency contraception as a single 1.5-mg dose or, alternatively, two 0.75-mg doses taken 12

  5. GyneFix330和TCu220C、TCu380A宫内节育器比较的系统评估%Comparison of GyneFix330 intrauterine device with TCu220C and TCu380A intrauterine devices: A systematic review

    Institute of Scientific and Technical Information of China (English)

    张磊; 张妍; 李敏; 毛燕燕; 车焱; 周维谨

    2011-01-01

    Objective: To explore the effectiveness, side effects, and the continuation rates of GyneFix330 and TCu220C and TCu380A intrauterine devices (IUDs). Methods: Electronic and hand searches were used to identify relevant literature published in Chinese and English between January 1990 and November 2009. Relevant papers were evaluated and selected according to the criteria of evidence-based medicine. Results: A total of twenty-six randomized controlled clinical trials (RCTs) were included in this review. Compared with TCu220C IUD, GyneFix330 IUD had lower expulsion and pregnancy rates with IUD in situ at 12 months and 24 months of use; while it was less likely to introduce prolonged menstrual bleeding, heavy menstrual bleeding, irregular vaginal bleeding and low back -abdominal pain during 6, 12 and 24 months of the observation, and lower rate of discontinuation due to medical reasons and higher continuation rate at 12 months of use. The one -year, two -year, three -year and nine -year pregnancy rates with IUD in situ of both GyneFix330 and TCu380A IUDs were lower than 2.50 per hundred women. The likelihood of increasing duration of menstrual bleeding, heavy menstrual bleeding and irregular vaginal bleeding was similar between GyneFix330 and TCu380A IUDs. The removal rate due to medical reasons of GyneFix330 IUD was similar to that of TCu380A IUD. However, the continuation rate of GyneFix330 IUD was slightly higher than its counterpart. Conclusion: The effectiveness, side effects and continuation rate of GyneFix330 IUD were similar to those of TCu380A IUD. These measurements were demonstrated to be better for Gynefix330 IUD than for TCu220C IUD. However, more large-scale RCTs with high quality of research need to be done to confirm this conclusion.%目的:评价GyneFix330与TCu220C、TCu380A宫内节育器(IUD)的有效性、副反应和续用情况.方法:电子和手工检索1990年1月~2009年11月中英文发表的相关文献,按循证医学方法对

  6. Levonorgestrel decreases cilia beat frequency of human fallopian tubes and rat oviducts without changing morphological structure.

    Science.gov (United States)

    Zhao, Weihong; Zhu, Qian; Yan, Mingxing; Li, Cheng; Yuan, Jiangjing; Qin, Guojuan; Zhang, Jian

    2015-02-01

    Levonorgestrel, a derivative of progesterone, effectively protects women against unwanted pregnancy as an emergency contraceptive. Previous studies have not been successful in determining the mechanism by which levonorgestrel acts. In the present study we analysed cilia beat action and cilia morphology following levonorgestrel exposure in vitro and in vivo using both light and electron microscopy. There was a significant decrease in the ciliary beat frequency (CBF) of human fallopian tubes between mucosal explants bathed in 5 μmol/L levonorgestrel and those bathed in medium alone (P levonorgestrel produced a similar reduction in CBF (~ 10%) compared with the saline control group (P levonorgestrel treatment in either system. Thus, levonorgestrel reduces CBF without damaging cilia morphology. Decreases in CBF may indicate a pathological role for levonorgestrel in the transportation of the ovum and zygote in the fallopian tube.

  7. Ectopic pregnancy after levonorgestrel emergency contraception

    Directory of Open Access Journals (Sweden)

    Ahmet Karatas

    2013-08-01

    Full Text Available Levonorgestrel Emergency Contraception (LNG-EC is the safest and the most commonly used oral regimen that can be used after an unprotected intercourse. Although it is highly effective, failures can occur especially if it is used in the peri /or postovulatory period. It can not inhibit ovulation if used in these periods and the altered tubal motility together with the ciliary dysfunction can prevent the transfer of the fertilized ovum from the fallopian tube to the endometrial cavity, causing an ectopic pregnancy, which is one of the important concerns after failed LNG-EC. This risk was reported not to be higher than the risk of ectopic pregnancy observed in the general population, but the users of this medication should still warned about this risk. Here we report a case of ectopic pregnancy from Turkey after midcyclic use and failure of LNG-EC. [Int J Reprod Contracept Obstet Gynecol 2013; 2(4.000: 749-750

  8. Modern Intrauterine Contraception: a Better Option

    Institute of Scientific and Technical Information of China (Engl