Objective:To explore the efficacy of the Mirena intrauterine device(IUD)in the treatment of patients with adenomyosis.Methods:Forty patients with adenomyosis treated in our hospital from January 2021 to December 2024 ...Objective:To explore the efficacy of the Mirena intrauterine device(IUD)in the treatment of patients with adenomyosis.Methods:Forty patients with adenomyosis treated in our hospital from January 2021 to December 2024 were randomly divided into an observation group and a control group,with 20 cases in each group.The observation group received Mirena IUD treatment,while the control group received drug treatment.The treatment indicators were compared between the two groups.Results:The total effective rate in the observation group was higher than that in the control group(P<0.05).After treatment,the levels of sex hormone indicators in the observation group were better than those in the control group(P<0.05).Compared with the control group,the observation group had significant improvements in menstrual pain score,menstrual volume score,uterine volume,and endometrial thickness(P<0.05).The incidence of adverse reactions in the observation group was significantly lower than that in the control group(P<0.05).Conclusion:The treatment of adenomyosis patients with Mirena IUD is significantly effective,which can effectively improve menstrual volume and reduce the degree of menstrual pain.With fewer adverse reactions,the treatment is safer and feasible for promotion.展开更多
AIM： To review the safety （infection, perforation） and efficacy （expulsion, continuation rates, pregnancy） of intrauterine device （IUD） insertion in the postpartum period. METHODS： MEDLINE, PubMed and Google S...AIM： To review the safety （infection, perforation） and efficacy （expulsion, continuation rates, pregnancy） of intrauterine device （IUD） insertion in the postpartum period. METHODS： MEDLINE, PubMed and Google Scholar were searched for randomized controlled trials and prospective cohort studies of IUD insertions at different times during the postpartum period. Time of insertion during the postpartum period was documented speci-fically, immediate post placenta period （within 10 min）, early post placenta period （10 min to 72 h）, and de-layed/interval period （greater than 6 wk）. Other study variables included mode of delivery, vaginal vs cesarean, manual vs use of ring forceps to insert the IUD. RESULTS： IUD insertion in the immediate postpartum （within 10 min of placental delivery）, early postpartum （10 min up to 72 h） and Interval/Delayed （6 wk onward） were found to be safe and effcacious. Expulsion rates were found to be highest in the immediate postpartum groups ranging from 14% to 27%. Immediate post placental insertion found to have expulsion rates that ranged from 3.6% to 16.2%. Expulsion rate was significantly higher after insertion following vaginal vs cesarean delivery. The rates of infection, perforation and unplanned pregnancy following postpartum IUD insertion are low. Method of insertion such as with ring forceps, by hand, or another placement method unique to the type of IUD did not show any signifcant difference in expulsion rates. Uterine perforations are highest in the delayed/interval IUD insertion groups.Breastfeeding duration and infant development are not affected by delayed/interval insertion of the non-hormonal （copper） IUD or the Levonorgestrel IUD. Timing of the Levonorgestrel IUD insertion may affect breastfeeding. CONCLUSION： IUD insertion is safe and efficacious during the immediate postpartum, early postpartum and delayed postpartum periods. Expulsion rates are highest after vaginal delivery and when inserted during the immediate postpartum period. IUD associated infection rates were not increased by insertion during the postpartum period over interval insertion rates. There is no evidence that breastfeeding is negatively affected by postpartum insertion of copper or hormone-secreting IUD. Although perforation rates were higher when inserted after lactation was initiated. Randomized controlled trials are needed to further elucidate the consequence of lactation on postpartum insertion. Despite the concerns regarding expulsion, perforation and breastfeeding, current evidence indicates that a favorable risk beneft ratio in support of postpartum IUD insertion. This may be particularly relevant for women for whom barriers exist in achieving desired pregnancy spacing.展开更多
Objective:To summarize the perioperative nursing strategies of a patient undergoing laparoscopic retrieval and partial gastrectomy because of the gastric migration of an intrauterine device.Methods:The following indiv...Objective:To summarize the perioperative nursing strategies of a patient undergoing laparoscopic retrieval and partial gastrectomy because of the gastric migration of an intrauterine device.Methods:The following individualized care strategies were implemented:preoperative psychological optimization using cognitive-behavioral counseling,modified bowel preparation,accelerated postoperative recovery through early ambulation and stepwise nutritional advancement,strict condition monitoring of the patient,multimodal step analgesia,early tube removal,integration of medical and nursing checkups,and nursing measures using traditional Chinese medicine.Results:The patient was discharged from the hospital smoothly after 8 days.A follow-up visit was conducted one-week post-discharge,during which the patient’s general condition was assessed as good,and no complications were reported.Conclusion:The use of individualized nursing strategies has aided in the smooth postoperative recovery of patients with ectopic intrauterine devices while improving the quality and safety of nursing.展开更多
BACKGROUND A cystic lesion arising from the myometrium of the uterus, termed as cystic adenomyosis, has chocolate-like, thick viscous contents and contains various amounts of endometrial stroma below the glandular epi...BACKGROUND A cystic lesion arising from the myometrium of the uterus, termed as cystic adenomyosis, has chocolate-like, thick viscous contents and contains various amounts of endometrial stroma below the glandular epithelium. It is an extremely rare type of adenomyosis.CASE SUMMARY Herein, we report an unusual case of a giant cystic mass in the pelvic cavity after uterine myomectomy. The patient complained of abnormal uterine bleeding and severe dysmenorrhea. After a levonorgestrel-containing intrauterine device(LNG-IUD) was inserted, her symptoms were greatly alleviated. However, the LNG-IUD was detected in the cystic cavity during the follow-up. For fear of the intrauterine device migrating into and damaging the surrounding viscera,surgical treatment was proposed. Therefore, laparoscopic resection of the lesion and removal of the LNG-IUD were performed and cystic adenomyosis with an LNG-IUD out of the uterine cavity was diagnosed.CONCLUSION We believe that myomectomy breaking through the endometrial cavity may have been a predisposing factor for the development of cystic adenomyosis in this case.展开更多
BACKGROUND An intrauterine device(IUD)is a commonly used contraceptive among women in China.It is widely used because it is safe,effective,simple,economic,and reversible.Among the possible complications,an ectopic IUD...BACKGROUND An intrauterine device(IUD)is a commonly used contraceptive among women in China.It is widely used because it is safe,effective,simple,economic,and reversible.Among the possible complications,an ectopic IUD in the bladder is rare.It occurs insidiously,has a long course,is associated with a high risk for injury,and is difficult to treat.CASE SUMMARY A 44-year-old woman was admitted for repeated episodes of urinary frequency,urgency,and dysuria over three months.Laboratory tests revealed significantly elevated urine leukocytes and bacteria.Urine culture suggested colonization with Enterococcus faecalis.Abdominal computed tomography images suggested an abnormally positioned IUD that was protruding into the bladder.Cystoscopy revealed a metallic foreign body with multiple stones on its surface in the left posterior bladder wall.The foreign body measured approximately 1 cm.Hysteroscopy revealed the arm of a V-type metal IUD embedded in the middle and upper sections of the anterior wall of the cervical canal.The majority of the IUD was located in the uterine cavity.Cystoscopy was performed,and a holmium laser was utilized to break the stones attached to the portion of the IUD in the bladder.The IUD was then removed through hysteroscopy.CONCLUSION Ectopic IUDs in the bladder can be diagnosed with thorough imaging and safely removed through cystoscopy or hysteroscopy.展开更多
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 Cu 2+ releasing amounts of both IUDs in vitro w...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 Cu 2+ 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 PGI 2 was stronger than that on the TXA 2, the ratio of 6 keto PGF 1α /TXB 2 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.展开更多
BACKGROUND An intrauterine device(IUD)is a contraceptive device placed in the uterine cavity and is a common contraceptive method for Chinese women.However,an IUD may cause complications due to placement time,intraute...BACKGROUND An intrauterine device(IUD)is a contraceptive device placed in the uterine cavity and is a common contraceptive method for Chinese women.However,an IUD may cause complications due to placement time,intrauterine pressure and other factors.Ectopic IUDs are among the most serious complications.Ectopic IUDs are common in the myometrium and periuterine organs,and there are few reports of ectopic IUDs in the urinary bladder,especially in the anterior wall.CASE SUMMARY A 52-year-old woman was hospitalized due to a urinary bladder foreign body found via abdominal ultrasound and computed tomography(CT)examination.The patient had a 2-year history of recurrent abdominal distension and lower abdominal pain,accompanied by frequent urination,urgency,dysuria and other discomfort.Ultrasound examination revealed foreign bodies in the bladder cavity,with calculus on the surface of the foreign bodies.CT revealed a circular foreign body on the anterior wall of the urinary bladder,suggesting the possibility of an ectopic IUD.After laparoscopic exploration,an annular IUD was found in the anterior wall of urinary bladder,and an oval calculus with a diameter of approximately 2 cm was attached to the surface of the bladder cavity.The IUD and calculus were successfully and completely removed.The patient recovered well after surgery.CONCLUSION Abdominal ultrasound and CT are effective methods for detecting ectopic IUDs.The IUD is located in the urinary bladder and requires early surgical treatment.The choice of surgical method is determined by comprehensively considering the depth of the IUD in the bladder muscle layer,the situation of complicated calculus,the situation of intravesical inflammation and medical technology and equipment.展开更多
Objective To evaluate the cytotoxicity of six commonly used copper-bearing intrauterine devices （Cu-IUDs） on Chinese hamster ovary （CHO-K1） cells and to investigate the influence of frame, shape and copper surface...Objective To evaluate the cytotoxicity of six commonly used copper-bearing intrauterine devices （Cu-IUDs） on Chinese hamster ovary （CHO-K1） cells and to investigate the influence of frame, shape and copper surface area of Cu-IUDs on cell toxicity.Methods Cu-IUDs were incubated in 10% FBS-DMEM/F12 culture medium at 37 ℃ for 24 h. The extracts were analyzed by flame atomic absorption spectrometer and were then diluted into different concentrations with culture medium. Finally, cytotoxicity of these original and diluted extracts on CHO-K1 cells was detected by cell counting kit-8 （CCK-8） assay.Results The viabilities of cells treated with the original extracts of six Cu-IUDs （TCu220C bulb, TCu220C, GCu220, GCu300, Yuangong Cu270 and Yuangong Ⅱ- 300） were all below 10% and the cupric ion concentrations in these extracts were 28.22 mg/L, 31.80 mg/L, 92.80 mg/L, 99.74 mg/L, 114.90 mg/L and 119.20 mg/L, respectively. After these original extracts were diluted, significant differences in cytotoxicity were exhibited. IUDs with larger copper surface areas （GCu300 and Yuangong Ⅱ-300） showed more cytotoxicity than those with smaller areas （GCu220 and Yuangong Cu270） respectively; When different shapes of Cu-IUDs were compared, TCu220C bulb showed lower cytotoxicity than TCu220C, and GCu300 exhibited higher toxicity than Yuangong Ⅱ-300; TCu220C displayed significantly lower cytotoxicity than GCu220 due to their differences in frames.Conclusion We presented evidence on the cytotoxic effects of copper ions released from Cu-IUDs on CHO-K1 cells and found that shape, frame together with copper surface area of Cu-IUDs had obvious influence on the cytotoxicity.展开更多
Objective To determine the pattern of biosocial characteristics of the new IUD acceptors and describe their concerns. Methods This was a retrospective review of records of new IUD acceptors at the University Colleg...Objective To determine the pattern of biosocial characteristics of the new IUD acceptors and describe their concerns. Methods This was a retrospective review of records of new IUD acceptors at the University College Hospital, Ibadan, Nigeria from January to December 2007. Results The age range of subjects was 19 to 49 years with a mean of 33.5 ±% 2.4 years. The commonest source （46.0%） of clientele referral was through the health care providers -doctors and nurse/midwife. Other referral patterns were from friends/ relative （23.5%）, media -TV and radio （17.0%）, outreach programmes （7.3%）, self referral （5.2%） and others -the source was not indicated （1.2%）. Of the total participants, only 239 （56.1%） reported for follow-up visits. Majority had at least one visit; about a third had two, while others had three or four and above visits. About 43.2% of those at follow-up visits had complaints. The commonest （37.5%） complaint was menstrual irregularity. Other complaints were cramping abdominal pain （22.2%）, vaginal discharge （19.6%）, amenorrhoea （10.3%）, penile discomfort during sexual intercourse （4.3%）, expulsion of IUD （3.8%） and 2.2% of missing IUD. Conclusion This audit shows that new IUD acceptors are largely referred by health care providers and are mainly offered the TCu380A version. Community outreach programmes as alternative strategy is likely to boost the uptake of this particular method in Nigeria.展开更多
Objective To explore and investigate a new treatment of releasing the risks and pain in removing intrauterine devices （IUD） from postmenopausal women. Methods Totally 240 postmenopausal women who needed to remove IU...Objective To explore and investigate a new treatment of releasing the risks and pain in removing intrauterine devices （IUD） from postmenopausal women. Methods Totally 240 postmenopausal women who needed to remove IUD were randomly divided into 3 groups. Group A （n =80） were preoperatively treated with 20 g/L vaginal testosterone propionate cod liver oil ointment （1 g/d） over a 2-week span of period, and vaginal misoprostol （200 μg） was one-time used at 2-3 h before operation. Group B （n =80） were treated with oral estradiol valerate （3 mg/d） from 7 d before operation. Other 80 women （group C） were treated with vaginal cod liver oil ointment （1 g/d） over a 2-week span of period before the operation day. The degree of cervical relaxation, operational difficulty, blood loss volume, the length of operation time and visual analogue scales （VAS） were evaluated, also the serum estradiol, testosterone and endometrial thickness were measured before and after medication. Results The degree of cervical relaxation, operational difficulty, blood loss, the length of operation time and VAS in group A were significantly better than those group C （P〈0.01）, whiles its blood loss volume was less than group B （P〈0.05） and there were no significant differences in serum estradiol, testosterone and endometrial thickness before and after medication. Conclusion Preoperative vaginal testosterone propionate combined with misoprostol would reduce the operational difficulties/risks and release the suffering of patients. The study may represent a safe and effective alternative to remove IUD in postmeno- pausal women.展开更多
Objective To analyze the possible cause leading to death during the procecture oy IUD removal under hysteroscopy and how it could be prevented. Methods All （11 110） cases of IUD removal under hysteroscopy performed ...Objective To analyze the possible cause leading to death during the procecture oy IUD removal under hysteroscopy and how it could be prevented. Methods All （11 110） cases of IUD removal under hysteroscopy performed at 87 hospitals in Shanghai from 2001 to 2007 were reviewed. Four dead cases were reported. Results Air embolism was suspected as the cause of death. Associated risk factors included insufficient preoperative preparation, short duration between surgeries, non-standard procedure, careless observation and untimely resuscitation. Conclusion This emphasizes the necessity of early interventions taken such as prevention, early detection and management of the fatal complications.展开更多
Three hundred and eighty four women in Shanghai who delivered vaginally and chose IUD for contraception received the copper T 380A IUD inserted vaginally within 10 min after delivery of the placenta(i.e.,immediate pos...Three hundred and eighty four women in Shanghai who delivered vaginally and chose IUD for contraception received the copper T 380A IUD inserted vaginally within 10 min after delivery of the placenta(i.e.,immediate postplacental insertion, IPPI). Among them, 98.70% were primipara. The women were randomly divided into two groups: IUD inserted by hand and IUD insreted by ring forceps. Using Life Table Method and χ 2 test, expulsion and other discontinuation rates were compared at 6, 12, 24, and 36 months post insertion between these two different groups. No uterine perforation, infection or prolonged period of lochia occurred in the 384 cases. Expulsions were the main reason for discontinuation. From 6 months to 36 months, the gross cumulative rates of all discontinuation events (expulsion, pregnancy, removal for bleeding/pain, etc.) were not statistically significantly different (P>0.05). The results suggest that these two different insertion techniques do not significantly affect discontinuation rate in vaginal IPPI using the TCu 380 A, which appears to be suitable for postpartum insertion in Chinese women. Other relevant issues, such as breast feeding and IUD position in uterine cavity, are also analyzed and discussed in this paper.展开更多
Effect of domestically-made levonorgestrel-releasing intrauterine device (LNG, release rate: 6 μg/day) on the endocrine system and menstruation in mondeys was investigated. The results showed that the Estradiol (E2) ...Effect of domestically-made levonorgestrel-releasing intrauterine device (LNG, release rate: 6 μg/day) on the endocrine system and menstruation in mondeys was investigated. The results showed that the Estradiol (E2) and progesterone (P) levels were significantly decreased 2 ovulatory cycles after iusertion of the devices as compared with those before insertion in 3 monkeys (P>0. 001) ,suggesting an evident ovulation-suppressing effect. In 1 monkey, the E2 and P levels were the same before and after insertion,and expulsion of device was found in the monkey later. The plasma LNG concentration in 3 animals was 493. 69-454. 60 pg/ml and plasma LNG was not detected in 1 monkey. The hormone level returned to normal level after removal of the devices.展开更多
<strong>Objective: </strong><span><span><span style="font-family:""><span style="font-family:Verdana;">The purpose of this study was to analyze the opinions...<strong>Objective: </strong><span><span><span style="font-family:""><span style="font-family:Verdana;">The purpose of this study was to analyze the opinions of gynecologists, midwives, and interns/Specialist students practicing in Senegal about the use of IUD, and to assess factors that stand as obstacles to IUD prescribing. </span><b><span style="font-family:Verdana;">Patients and methods: </span></b><span style="font-family:Verdana;">An online questionnaire was developed to assess providers’ IUD practices and attitudes. The questionnaire was based on the one used in a Swiss study on the same topic. The platform used was Google forms. The questionnaire was shared in associative platforms involving gynecologists, midwives and interns/Specialist students. </span><b><span style="font-family:Verdana;">Results and comments: </span></b><span style="font-family:Verdana;">We received 292 feedbacks. Gynecologists represented 13.7% of the sample, interns and specialist students 11.3% and midwives 76%. Parity is a determining factor in IUD selection. The care-providers were concerned about the followings, which might have prevented the use of IUD, even </span><span style="font-family:Verdana;">though it </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">was</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> indicated: infections (75.7%), pelvic pain (61.3%), expulsion (48.3%), increased risk of perforation (46.9%), women’s appreciation </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">(45.2%), ectopic pregnancy (33.9%) and sexual behavior (28.4%). </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">Our study reveals that providers’ apprehensions and concerns severely limit the availability of IUDs. These concerns are often unfounded, based on personal experiences and not on official recommendations. Parity is a major obstacle.</span></span></span></span>展开更多
Objective: The aim of this study was to describe the use of the postpartum intrauterine device in the maternity ward of the Ratoma communal medical center in Conakry. Methods: This was a descriptive cross-sectional st...Objective: The aim of this study was to describe the use of the postpartum intrauterine device in the maternity ward of the Ratoma communal medical center in Conakry. Methods: This was a descriptive cross-sectional study carried out between July 1<sup>st</sup> 2015 and June 30 2016, i.e. a duration of one year. Results: A total of 551 patients received advice on various contraceptive methods. Most of this advice was given in the post-partum period (40.2%) and during antenatal care (39.1%). Of the patients advised, 87 (15.8%) used the intrauterine device. The majority of users (93%) were married and uneducated (63.2%), and 39.1% were poor. The majority (56.3%) of intra-uterine devices were inserted in the immediate post-partum period. The majority of women had no adverse events either during the first six weeks (n = 57;65.5%) or at 3<sup>rd</sup> months (n = 75;86.2%) or 6<sup>th</sup> months (n = 76;87.4%) after IUD insertion. Most users remained complication-free throughout the follow-up period (n = 76;87.4% at 6<sup>th</sup> weeks and 3<sup>rd</sup> months, and n = 77;88.5% at 6<sup>th</sup> months). The continuation rate was 89.7% at 6 weeks and 3<sup>rd</sup> months, and 87.4% at 6<sup>th</sup> months after insertion. The majority of users (87.0%) were satisfied with the care they received. Conclusion: This study showed very few complications among intrauterine device users, and high continuation and satisfaction rates. The intrauterine device is a long-acting, effective, reversible and safe contraceptive that can be used by most women for birth spacing in Guinea, where women do not regularly visit health facilities.展开更多
Objective: to study and analyze the clinical treatment and effect of uterine perforation caused by intrauterine device. Methods: the data of 30 patients with intrauterine device admitted in our hospital from January 2...Objective: to study and analyze the clinical treatment and effect of uterine perforation caused by intrauterine device. Methods: the data of 30 patients with intrauterine device admitted in our hospital from January 2017 to February 2022 were retrospectively analyzed. All of the patients were followed up for 6 months after treatment, and the treatment effect, coagulation function and quality of life were evaluated and analyzed. Results: after treatment of 93.33%, 30 patients with intrauterine perforation active thrombin time, thrombin time, prothrombin time, fibrinogen and fibrinogen, after treatment of 30 patients with intrauterine perforation SF-36 scale evaluation dimension score increased, compared with before treatment (P < 0.05). Conclusion: in the treatment of intrauterine device-induced uterine perforation, it is necessary to formulate the treatment plan to ensure the treatment effect. Active and effective treatment can promote the improvement of the coagulation function and the quality of life of the patients.展开更多
Pyometra is an intrauterine abscess formation.It is a potentially lethal disease.In the postmenopausal patients,forgotten intrauterine device(IUD)gives rise to pyometra.Sonography and computed tomography(CT)are requir...Pyometra is an intrauterine abscess formation.It is a potentially lethal disease.In the postmenopausal patients,forgotten intrauterine device(IUD)gives rise to pyometra.Sonography and computed tomography(CT)are required for the diagnosis.Drainage and uterine curettage after dilatation are essential procedures.Antibiotics that are effective against both aerobic and anaerobic bacteria should be given patients.展开更多
An intrauterine device （IUD） is a safe, effective, simple, and reversible method tbr birth control, but some women with IUD may still become pregnant. Induced abortion is the main method for termination of pregnancy...An intrauterine device （IUD） is a safe, effective, simple, and reversible method tbr birth control, but some women with IUD may still become pregnant. Induced abortion is the main method for termination of pregnancy. If induced abortion is not well-managed in these patients, it may result in serious vaginal bleeding and uterine rupture. We report a case of uterine artery rupture after induced abortion combined with extraction of an IUD. This case highlights the necessity of a standard operation for complicated induced abortion, and the value of interventional therapy, such as uterine artery embolization （UAE）, for controlling serious vaginal bleedit3g.展开更多
Objective To investigate IUD-related vaginitis in IUD users at the University College Hospital Ibadan, South-western Nigeria.Methods A prospective cohort study in IUD users present with abnormal vaginal discharge at t...Objective To investigate IUD-related vaginitis in IUD users at the University College Hospital Ibadan, South-western Nigeria.Methods A prospective cohort study in IUD users present with abnormal vaginal discharge at the family planning clinic of the University College Hospital, Ibadan was conducted between lOth of October, 2008 and 31st of May 2009. High Vaginal Swabs were taken from the clients for microbiology, culture and drug sensitivity test. Diagnosis of bacterial vaginosis was made based on gram stained vaginal smear using the standard Nugents criteria. Other aetiological agents were identified either on wet preparation or culture using standard techniques. Treatment given was by the family planning nurse, as was the protocol at the family planning clinic.Results Twenty-four IUD users present at the Jamtty ptannmg ctmtc with vaginal discharge were studied. Their ages ranged 28-51 years（38.14 ± 5.9 years）, Mean parity was 4.4 ± 1.4, All the women were married and all used CuT 380A. The mean duration of lUCD use was 2.5 years only. Majority （46%） had used it for more than 3 years and most （75%） of the visits were unscheduled. All the clients complained of abnormal vaginal discharge which was copious, watery and foul smelling, or clumpy. Nine users （37.5%） complained of pruritus vulvae, 3 users （12.5%） lower abdominal pain, 1 user （4,2%） dyspareunia and vaginosis was made in 16 （66. 7%） and 1 （4.2%） dysuria. The diagnosis of bacterial vaginal candidiasis in 8 （33.3%）. Age less than 40 years, Christianity and IUD use more than 3 years were associated with a higher risk of bacterial vaginosis （OR=1.29, 1.67 and 6.6, respectively）, while women above 40 years, Muslims and women with lower educational status had a higher risk of candida-related vaginitis （OR=1.67 and 4.2, respectively）. Eight clients （33.3%） were treated for candidiasis with antifungals （3 empirically, and 5 after obtaining results of vaginal swab）, 9 （37.5%） were given oral metronidazole, 3 patients were referred to the gynaecological emergency unit on account of abdominal pain and 4 did not return for follow up.Conclusion IUD associated vaginitis is a disturbing condition causing unscheduled visits among IUD users. Bacterial vaginosis and Candidia albicans are major aetiologies in south western Nigeria Ibadan. Persistent discharge is a documented reason for discontinuation of lUD use. Periodic empirical treatment for candidiasis and bacterial vaginosis with antifungals and oral metronidazole is advocated. This may reduce the discomfort caused by IUD-related vaginitis, the risk of PID and other risks exposed to the IUD users and ensure continued use of the IUD.展开更多
文摘Objective:To explore the efficacy of the Mirena intrauterine device(IUD)in the treatment of patients with adenomyosis.Methods:Forty patients with adenomyosis treated in our hospital from January 2021 to December 2024 were randomly divided into an observation group and a control group,with 20 cases in each group.The observation group received Mirena IUD treatment,while the control group received drug treatment.The treatment indicators were compared between the two groups.Results:The total effective rate in the observation group was higher than that in the control group(P<0.05).After treatment,the levels of sex hormone indicators in the observation group were better than those in the control group(P<0.05).Compared with the control group,the observation group had significant improvements in menstrual pain score,menstrual volume score,uterine volume,and endometrial thickness(P<0.05).The incidence of adverse reactions in the observation group was significantly lower than that in the control group(P<0.05).Conclusion:The treatment of adenomyosis patients with Mirena IUD is significantly effective,which can effectively improve menstrual volume and reduce the degree of menstrual pain.With fewer adverse reactions,the treatment is safer and feasible for promotion.
文摘AIM： To review the safety （infection, perforation） and efficacy （expulsion, continuation rates, pregnancy） of intrauterine device （IUD） insertion in the postpartum period. METHODS： MEDLINE, PubMed and Google Scholar were searched for randomized controlled trials and prospective cohort studies of IUD insertions at different times during the postpartum period. Time of insertion during the postpartum period was documented speci-fically, immediate post placenta period （within 10 min）, early post placenta period （10 min to 72 h）, and de-layed/interval period （greater than 6 wk）. Other study variables included mode of delivery, vaginal vs cesarean, manual vs use of ring forceps to insert the IUD. RESULTS： IUD insertion in the immediate postpartum （within 10 min of placental delivery）, early postpartum （10 min up to 72 h） and Interval/Delayed （6 wk onward） were found to be safe and effcacious. Expulsion rates were found to be highest in the immediate postpartum groups ranging from 14% to 27%. Immediate post placental insertion found to have expulsion rates that ranged from 3.6% to 16.2%. Expulsion rate was significantly higher after insertion following vaginal vs cesarean delivery. The rates of infection, perforation and unplanned pregnancy following postpartum IUD insertion are low. Method of insertion such as with ring forceps, by hand, or another placement method unique to the type of IUD did not show any signifcant difference in expulsion rates. Uterine perforations are highest in the delayed/interval IUD insertion groups.Breastfeeding duration and infant development are not affected by delayed/interval insertion of the non-hormonal （copper） IUD or the Levonorgestrel IUD. Timing of the Levonorgestrel IUD insertion may affect breastfeeding. CONCLUSION： IUD insertion is safe and efficacious during the immediate postpartum, early postpartum and delayed postpartum periods. Expulsion rates are highest after vaginal delivery and when inserted during the immediate postpartum period. IUD associated infection rates were not increased by insertion during the postpartum period over interval insertion rates. There is no evidence that breastfeeding is negatively affected by postpartum insertion of copper or hormone-secreting IUD. Although perforation rates were higher when inserted after lactation was initiated. Randomized controlled trials are needed to further elucidate the consequence of lactation on postpartum insertion. Despite the concerns regarding expulsion, perforation and breastfeeding, current evidence indicates that a favorable risk beneft ratio in support of postpartum IUD insertion. This may be particularly relevant for women for whom barriers exist in achieving desired pregnancy spacing.
文摘Objective:To summarize the perioperative nursing strategies of a patient undergoing laparoscopic retrieval and partial gastrectomy because of the gastric migration of an intrauterine device.Methods:The following individualized care strategies were implemented:preoperative psychological optimization using cognitive-behavioral counseling,modified bowel preparation,accelerated postoperative recovery through early ambulation and stepwise nutritional advancement,strict condition monitoring of the patient,multimodal step analgesia,early tube removal,integration of medical and nursing checkups,and nursing measures using traditional Chinese medicine.Results:The patient was discharged from the hospital smoothly after 8 days.A follow-up visit was conducted one-week post-discharge,during which the patient’s general condition was assessed as good,and no complications were reported.Conclusion:The use of individualized nursing strategies has aided in the smooth postoperative recovery of patients with ectopic intrauterine devices while improving the quality and safety of nursing.
文摘BACKGROUND A cystic lesion arising from the myometrium of the uterus, termed as cystic adenomyosis, has chocolate-like, thick viscous contents and contains various amounts of endometrial stroma below the glandular epithelium. It is an extremely rare type of adenomyosis.CASE SUMMARY Herein, we report an unusual case of a giant cystic mass in the pelvic cavity after uterine myomectomy. The patient complained of abnormal uterine bleeding and severe dysmenorrhea. After a levonorgestrel-containing intrauterine device(LNG-IUD) was inserted, her symptoms were greatly alleviated. However, the LNG-IUD was detected in the cystic cavity during the follow-up. For fear of the intrauterine device migrating into and damaging the surrounding viscera,surgical treatment was proposed. Therefore, laparoscopic resection of the lesion and removal of the LNG-IUD were performed and cystic adenomyosis with an LNG-IUD out of the uterine cavity was diagnosed.CONCLUSION We believe that myomectomy breaking through the endometrial cavity may have been a predisposing factor for the development of cystic adenomyosis in this case.
文摘BACKGROUND An intrauterine device(IUD)is a commonly used contraceptive among women in China.It is widely used because it is safe,effective,simple,economic,and reversible.Among the possible complications,an ectopic IUD in the bladder is rare.It occurs insidiously,has a long course,is associated with a high risk for injury,and is difficult to treat.CASE SUMMARY A 44-year-old woman was admitted for repeated episodes of urinary frequency,urgency,and dysuria over three months.Laboratory tests revealed significantly elevated urine leukocytes and bacteria.Urine culture suggested colonization with Enterococcus faecalis.Abdominal computed tomography images suggested an abnormally positioned IUD that was protruding into the bladder.Cystoscopy revealed a metallic foreign body with multiple stones on its surface in the left posterior bladder wall.The foreign body measured approximately 1 cm.Hysteroscopy revealed the arm of a V-type metal IUD embedded in the middle and upper sections of the anterior wall of the cervical canal.The majority of the IUD was located in the uterine cavity.Cystoscopy was performed,and a holmium laser was utilized to break the stones attached to the portion of the IUD in the bladder.The IUD was then removed through hysteroscopy.CONCLUSION Ectopic IUDs in the bladder can be diagnosed with thorough imaging and safely removed through cystoscopy or hysteroscopy.
基金This project was supported by a grant from Hubei Science and Technology Com mittee(No.96 1P190 1)
文摘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 Cu 2+ 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 PGI 2 was stronger than that on the TXA 2, the ratio of 6 keto PGF 1α /TXB 2 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.
文摘BACKGROUND An intrauterine device(IUD)is a contraceptive device placed in the uterine cavity and is a common contraceptive method for Chinese women.However,an IUD may cause complications due to placement time,intrauterine pressure and other factors.Ectopic IUDs are among the most serious complications.Ectopic IUDs are common in the myometrium and periuterine organs,and there are few reports of ectopic IUDs in the urinary bladder,especially in the anterior wall.CASE SUMMARY A 52-year-old woman was hospitalized due to a urinary bladder foreign body found via abdominal ultrasound and computed tomography(CT)examination.The patient had a 2-year history of recurrent abdominal distension and lower abdominal pain,accompanied by frequent urination,urgency,dysuria and other discomfort.Ultrasound examination revealed foreign bodies in the bladder cavity,with calculus on the surface of the foreign bodies.CT revealed a circular foreign body on the anterior wall of the urinary bladder,suggesting the possibility of an ectopic IUD.After laparoscopic exploration,an annular IUD was found in the anterior wall of urinary bladder,and an oval calculus with a diameter of approximately 2 cm was attached to the surface of the bladder cavity.The IUD and calculus were successfully and completely removed.The patient recovered well after surgery.CONCLUSION Abdominal ultrasound and CT are effective methods for detecting ectopic IUDs.The IUD is located in the urinary bladder and requires early surgical treatment.The choice of surgical method is determined by comprehensively considering the depth of the IUD in the bladder muscle layer,the situation of complicated calculus,the situation of intravesical inflammation and medical technology and equipment.
基金supported by Public Service Platform of Science and Technology Projects in Data mining of contraceptives monitoring and research of risk assessment model(BM2012062)the Priority Academic Program Development of Jiangsu Higher Education Institutions
文摘Objective To evaluate the cytotoxicity of six commonly used copper-bearing intrauterine devices （Cu-IUDs） on Chinese hamster ovary （CHO-K1） cells and to investigate the influence of frame, shape and copper surface area of Cu-IUDs on cell toxicity.Methods Cu-IUDs were incubated in 10% FBS-DMEM/F12 culture medium at 37 ℃ for 24 h. The extracts were analyzed by flame atomic absorption spectrometer and were then diluted into different concentrations with culture medium. Finally, cytotoxicity of these original and diluted extracts on CHO-K1 cells was detected by cell counting kit-8 （CCK-8） assay.Results The viabilities of cells treated with the original extracts of six Cu-IUDs （TCu220C bulb, TCu220C, GCu220, GCu300, Yuangong Cu270 and Yuangong Ⅱ- 300） were all below 10% and the cupric ion concentrations in these extracts were 28.22 mg/L, 31.80 mg/L, 92.80 mg/L, 99.74 mg/L, 114.90 mg/L and 119.20 mg/L, respectively. After these original extracts were diluted, significant differences in cytotoxicity were exhibited. IUDs with larger copper surface areas （GCu300 and Yuangong Ⅱ-300） showed more cytotoxicity than those with smaller areas （GCu220 and Yuangong Cu270） respectively; When different shapes of Cu-IUDs were compared, TCu220C bulb showed lower cytotoxicity than TCu220C, and GCu300 exhibited higher toxicity than Yuangong Ⅱ-300; TCu220C displayed significantly lower cytotoxicity than GCu220 due to their differences in frames.Conclusion We presented evidence on the cytotoxic effects of copper ions released from Cu-IUDs on CHO-K1 cells and found that shape, frame together with copper surface area of Cu-IUDs had obvious influence on the cytotoxicity.
文摘Objective To determine the pattern of biosocial characteristics of the new IUD acceptors and describe their concerns. Methods This was a retrospective review of records of new IUD acceptors at the University College Hospital, Ibadan, Nigeria from January to December 2007. Results The age range of subjects was 19 to 49 years with a mean of 33.5 ±% 2.4 years. The commonest source （46.0%） of clientele referral was through the health care providers -doctors and nurse/midwife. Other referral patterns were from friends/ relative （23.5%）, media -TV and radio （17.0%）, outreach programmes （7.3%）, self referral （5.2%） and others -the source was not indicated （1.2%）. Of the total participants, only 239 （56.1%） reported for follow-up visits. Majority had at least one visit; about a third had two, while others had three or four and above visits. About 43.2% of those at follow-up visits had complaints. The commonest （37.5%） complaint was menstrual irregularity. Other complaints were cramping abdominal pain （22.2%）, vaginal discharge （19.6%）, amenorrhoea （10.3%）, penile discomfort during sexual intercourse （4.3%）, expulsion of IUD （3.8%） and 2.2% of missing IUD. Conclusion This audit shows that new IUD acceptors are largely referred by health care providers and are mainly offered the TCu380A version. Community outreach programmes as alternative strategy is likely to boost the uptake of this particular method in Nigeria.
文摘Objective To explore and investigate a new treatment of releasing the risks and pain in removing intrauterine devices （IUD） from postmenopausal women. Methods Totally 240 postmenopausal women who needed to remove IUD were randomly divided into 3 groups. Group A （n =80） were preoperatively treated with 20 g/L vaginal testosterone propionate cod liver oil ointment （1 g/d） over a 2-week span of period, and vaginal misoprostol （200 μg） was one-time used at 2-3 h before operation. Group B （n =80） were treated with oral estradiol valerate （3 mg/d） from 7 d before operation. Other 80 women （group C） were treated with vaginal cod liver oil ointment （1 g/d） over a 2-week span of period before the operation day. The degree of cervical relaxation, operational difficulty, blood loss volume, the length of operation time and visual analogue scales （VAS） were evaluated, also the serum estradiol, testosterone and endometrial thickness were measured before and after medication. Results The degree of cervical relaxation, operational difficulty, blood loss, the length of operation time and VAS in group A were significantly better than those group C （P〈0.01）, whiles its blood loss volume was less than group B （P〈0.05） and there were no significant differences in serum estradiol, testosterone and endometrial thickness before and after medication. Conclusion Preoperative vaginal testosterone propionate combined with misoprostol would reduce the operational difficulties/risks and release the suffering of patients. The study may represent a safe and effective alternative to remove IUD in postmeno- pausal women.
文摘Objective To analyze the possible cause leading to death during the procecture oy IUD removal under hysteroscopy and how it could be prevented. Methods All （11 110） cases of IUD removal under hysteroscopy performed at 87 hospitals in Shanghai from 2001 to 2007 were reviewed. Four dead cases were reported. Results Air embolism was suspected as the cause of death. Associated risk factors included insufficient preoperative preparation, short duration between surgeries, non-standard procedure, careless observation and untimely resuscitation. Conclusion This emphasizes the necessity of early interventions taken such as prevention, early detection and management of the fatal complications.
文摘Three hundred and eighty four women in Shanghai who delivered vaginally and chose IUD for contraception received the copper T 380A IUD inserted vaginally within 10 min after delivery of the placenta(i.e.,immediate postplacental insertion, IPPI). Among them, 98.70% were primipara. The women were randomly divided into two groups: IUD inserted by hand and IUD insreted by ring forceps. Using Life Table Method and χ 2 test, expulsion and other discontinuation rates were compared at 6, 12, 24, and 36 months post insertion between these two different groups. No uterine perforation, infection or prolonged period of lochia occurred in the 384 cases. Expulsions were the main reason for discontinuation. From 6 months to 36 months, the gross cumulative rates of all discontinuation events (expulsion, pregnancy, removal for bleeding/pain, etc.) were not statistically significantly different (P>0.05). The results suggest that these two different insertion techniques do not significantly affect discontinuation rate in vaginal IPPI using the TCu 380 A, which appears to be suitable for postpartum insertion in Chinese women. Other relevant issues, such as breast feeding and IUD position in uterine cavity, are also analyzed and discussed in this paper.
文摘Effect of domestically-made levonorgestrel-releasing intrauterine device (LNG, release rate: 6 μg/day) on the endocrine system and menstruation in mondeys was investigated. The results showed that the Estradiol (E2) and progesterone (P) levels were significantly decreased 2 ovulatory cycles after iusertion of the devices as compared with those before insertion in 3 monkeys (P>0. 001) ,suggesting an evident ovulation-suppressing effect. In 1 monkey, the E2 and P levels were the same before and after insertion,and expulsion of device was found in the monkey later. The plasma LNG concentration in 3 animals was 493. 69-454. 60 pg/ml and plasma LNG was not detected in 1 monkey. The hormone level returned to normal level after removal of the devices.
文摘<strong>Objective: </strong><span><span><span style="font-family:""><span style="font-family:Verdana;">The purpose of this study was to analyze the opinions of gynecologists, midwives, and interns/Specialist students practicing in Senegal about the use of IUD, and to assess factors that stand as obstacles to IUD prescribing. </span><b><span style="font-family:Verdana;">Patients and methods: </span></b><span style="font-family:Verdana;">An online questionnaire was developed to assess providers’ IUD practices and attitudes. The questionnaire was based on the one used in a Swiss study on the same topic. The platform used was Google forms. The questionnaire was shared in associative platforms involving gynecologists, midwives and interns/Specialist students. </span><b><span style="font-family:Verdana;">Results and comments: </span></b><span style="font-family:Verdana;">We received 292 feedbacks. Gynecologists represented 13.7% of the sample, interns and specialist students 11.3% and midwives 76%. Parity is a determining factor in IUD selection. The care-providers were concerned about the followings, which might have prevented the use of IUD, even </span><span style="font-family:Verdana;">though it </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">was</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> indicated: infections (75.7%), pelvic pain (61.3%), expulsion (48.3%), increased risk of perforation (46.9%), women’s appreciation </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">(45.2%), ectopic pregnancy (33.9%) and sexual behavior (28.4%). </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">Our study reveals that providers’ apprehensions and concerns severely limit the availability of IUDs. These concerns are often unfounded, based on personal experiences and not on official recommendations. Parity is a major obstacle.</span></span></span></span>
文摘Objective: The aim of this study was to describe the use of the postpartum intrauterine device in the maternity ward of the Ratoma communal medical center in Conakry. Methods: This was a descriptive cross-sectional study carried out between July 1<sup>st</sup> 2015 and June 30 2016, i.e. a duration of one year. Results: A total of 551 patients received advice on various contraceptive methods. Most of this advice was given in the post-partum period (40.2%) and during antenatal care (39.1%). Of the patients advised, 87 (15.8%) used the intrauterine device. The majority of users (93%) were married and uneducated (63.2%), and 39.1% were poor. The majority (56.3%) of intra-uterine devices were inserted in the immediate post-partum period. The majority of women had no adverse events either during the first six weeks (n = 57;65.5%) or at 3<sup>rd</sup> months (n = 75;86.2%) or 6<sup>th</sup> months (n = 76;87.4%) after IUD insertion. Most users remained complication-free throughout the follow-up period (n = 76;87.4% at 6<sup>th</sup> weeks and 3<sup>rd</sup> months, and n = 77;88.5% at 6<sup>th</sup> months). The continuation rate was 89.7% at 6 weeks and 3<sup>rd</sup> months, and 87.4% at 6<sup>th</sup> months after insertion. The majority of users (87.0%) were satisfied with the care they received. Conclusion: This study showed very few complications among intrauterine device users, and high continuation and satisfaction rates. The intrauterine device is a long-acting, effective, reversible and safe contraceptive that can be used by most women for birth spacing in Guinea, where women do not regularly visit health facilities.
文摘Objective: to study and analyze the clinical treatment and effect of uterine perforation caused by intrauterine device. Methods: the data of 30 patients with intrauterine device admitted in our hospital from January 2017 to February 2022 were retrospectively analyzed. All of the patients were followed up for 6 months after treatment, and the treatment effect, coagulation function and quality of life were evaluated and analyzed. Results: after treatment of 93.33%, 30 patients with intrauterine perforation active thrombin time, thrombin time, prothrombin time, fibrinogen and fibrinogen, after treatment of 30 patients with intrauterine perforation SF-36 scale evaluation dimension score increased, compared with before treatment (P < 0.05). Conclusion: in the treatment of intrauterine device-induced uterine perforation, it is necessary to formulate the treatment plan to ensure the treatment effect. Active and effective treatment can promote the improvement of the coagulation function and the quality of life of the patients.
文摘Pyometra is an intrauterine abscess formation.It is a potentially lethal disease.In the postmenopausal patients,forgotten intrauterine device(IUD)gives rise to pyometra.Sonography and computed tomography(CT)are required for the diagnosis.Drainage and uterine curettage after dilatation are essential procedures.Antibiotics that are effective against both aerobic and anaerobic bacteria should be given patients.
文摘An intrauterine device （IUD） is a safe, effective, simple, and reversible method tbr birth control, but some women with IUD may still become pregnant. Induced abortion is the main method for termination of pregnancy. If induced abortion is not well-managed in these patients, it may result in serious vaginal bleeding and uterine rupture. We report a case of uterine artery rupture after induced abortion combined with extraction of an IUD. This case highlights the necessity of a standard operation for complicated induced abortion, and the value of interventional therapy, such as uterine artery embolization （UAE）, for controlling serious vaginal bleedit3g.
文摘Objective To investigate IUD-related vaginitis in IUD users at the University College Hospital Ibadan, South-western Nigeria.Methods A prospective cohort study in IUD users present with abnormal vaginal discharge at the family planning clinic of the University College Hospital, Ibadan was conducted between lOth of October, 2008 and 31st of May 2009. High Vaginal Swabs were taken from the clients for microbiology, culture and drug sensitivity test. Diagnosis of bacterial vaginosis was made based on gram stained vaginal smear using the standard Nugents criteria. Other aetiological agents were identified either on wet preparation or culture using standard techniques. Treatment given was by the family planning nurse, as was the protocol at the family planning clinic.Results Twenty-four IUD users present at the Jamtty ptannmg ctmtc with vaginal discharge were studied. Their ages ranged 28-51 years（38.14 ± 5.9 years）, Mean parity was 4.4 ± 1.4, All the women were married and all used CuT 380A. The mean duration of lUCD use was 2.5 years only. Majority （46%） had used it for more than 3 years and most （75%） of the visits were unscheduled. All the clients complained of abnormal vaginal discharge which was copious, watery and foul smelling, or clumpy. Nine users （37.5%） complained of pruritus vulvae, 3 users （12.5%） lower abdominal pain, 1 user （4,2%） dyspareunia and vaginosis was made in 16 （66. 7%） and 1 （4.2%） dysuria. The diagnosis of bacterial vaginal candidiasis in 8 （33.3%）. Age less than 40 years, Christianity and IUD use more than 3 years were associated with a higher risk of bacterial vaginosis （OR=1.29, 1.67 and 6.6, respectively）, while women above 40 years, Muslims and women with lower educational status had a higher risk of candida-related vaginitis （OR=1.67 and 4.2, respectively）. Eight clients （33.3%） were treated for candidiasis with antifungals （3 empirically, and 5 after obtaining results of vaginal swab）, 9 （37.5%） were given oral metronidazole, 3 patients were referred to the gynaecological emergency unit on account of abdominal pain and 4 did not return for follow up.Conclusion IUD associated vaginitis is a disturbing condition causing unscheduled visits among IUD users. Bacterial vaginosis and Candidia albicans are major aetiologies in south western Nigeria Ibadan. Persistent discharge is a documented reason for discontinuation of lUD use. Periodic empirical treatment for candidiasis and bacterial vaginosis with antifungals and oral metronidazole is advocated. This may reduce the discomfort caused by IUD-related vaginitis, the risk of PID and other risks exposed to the IUD users and ensure continued use of the IUD.
