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At least 145 records · Page 8Linked to original sources
PubMed2004

The reliability of the anchoring concept for suspension of bioactive substances in the human uterus evaluated by measuring the removal force: results after long-term use.

OBJECTIVE: The objective of the present study is to report on the force needed to remove the implanted GyneFix intrauterine contraceptive device (IUD) from the uterine cavity. This study is the first long-term study on the retrieval of the anchored IUD. STUDY DESIGN: A two-center, noncomparative study to measure the force needed to remove the IUD in 251 women. A dynamometer (Pesola, Switzerland) was used to measure the removal force in newtons. RESULTS: The results of this study show a mean removal force of 6.2 and 6.1 newtons, respectively (range, 0-10), in parous and nulligravid or nulliparous women (p = 0.62). There was no difference in removal force for those women with a duration of use either less than 60 months or longer than 60 months (median of 6 newtons in both groups; p = 0.22). CONCLUSIONS: The force needed to remove the GyneFix IUD suggests that the implantation technology used in the insertion of the device is reliable, provided the anchoring knot is properly inserted in the fundal myometrium. The results of this study indicate that early expulsion of the device could be explained by failure to implant the knot adequately (no implantation or partial implantation), which requires a degree of skill. The present study does not provide an explanation for the occurrence of late expulsion, although some speculations can be made.

Belgium↗
PubMed1986

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

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

Adult↗
PubMed1998

A 4-year pilot study on the efficacy and safety of Implanon, a single-rod hormonal contraceptive implant, in healthy women in Thailand.

OBJECTIVE: To investigate the contraceptive efficacy, safety and acceptability of a new single-rod, progestogen-only contraceptive implant (Implanon). METHODS: In an open, non-comparative pilot study, 100 healthy women received a contraceptive implant containing the progestogen etonogestrel (3-ketodesogestrel) for 2 years with an optional extension up to 4 years. RESULTS: Subjects were exposed to Implanon for 296.1 woman-years. There were no pregnancies during the study. Per 90-day reference period, the median number of bleeding-spotting days was 10 and the median number of bleeding-spotting episodes was 2. Amenorrhea occurred in 24-39% of subject during the first 2 years and in about 20% in those who continued in the 3rd and 4th years. The most common drug-related adverse event was headache (7%). A slight increase in body mass index was observed. Only a few subjects discontinued treatment early, due to bleeding irregularities (6%) or amenorrhea (1%). The cumulative discontinuation rates were 13.4% after 2 years, 25.3% after 3 years and 28.0% after 4 years of use. Within 3 months of implant removal, six normal pregnancies occurred, indicating a rapid return of fertility. The average time taken for insertion of the implant was 0.5 min, compared with 2.5 min for removal. CONCLUSIONS: Implanon demonstrated excellent contraceptive efficacy and was well tolerated during up to 4 years of use. The vaginal bleeding pattern was variable and was characterized by relatively few bleeding events, but proved acceptable to most subjects. Because of its single-rod design, Implanon was quickly inserted and removed without complications.

Adult↗
PubMed1985

Effects of sterilization on menstruation.

We surveyed 551 women more than a year after they or their husbands had had a sterilization operation. According to menstrual data from before and after the operation, a much greater proportion of women who had been sterilized had longer periods after the operation than before, but so did women whose husbands had had a vasectomy. Women who had taken an oral contraceptive before operation, had more days of bleeding and heavier bleeding than women who had been using other methods of contraception; those who had an intrauterine device removed had fewer days of bleeding after the sterilization operation. Discontinuing the previous contraception probably had a greater effect on menstruation than had the operation, for the effect was the same for those who had sterilization and the women whose husbands had an operation.

Contraception↗
PubMed2005

FemCap with removal strap: ease of removal, safety and acceptability.

OBJECTIVES: FemCap is a silicone-rubber barrier contraceptive approved for marketing in the United States. To address reported problems with removal and dislodgment, the device's developer added a strap to the device and increased the height of the brim. This trial assessed whether the new design reduced removal difficulties and had any effects on dislodgment, genital pain/discomfort, safety, and acceptability. METHODS: Women used the strapped device for 8 weeks with follow-up visits at 2 and 8 weeks. Outcome measures were obtained through diary cards, questionnaires, and naked eye examination. Data from these 120 women were compared with data from 419 women who used the unstrapped FemCap in a previous contraceptive effectiveness study. RESULTS: The strapped device was not significantly easier for users to remove than the unstrapped device. Similar odds of dislodgment and cervical/vaginal irritation were seen with the two devices. Both female and male participants were significantly more likely to report pain/discomfort with use of the strapped device. Female users of the strapped device were significantly more likely to say they disliked their device. In six weeks, two pregnancies were observed, but pregnancy was not an endpoint in the study and no conclusions should be drawn regarding pregnancy rates. CONCLUSIONS: The modifications to the FemCap did not significantly improve the ease of device removal and appears to have resulted in significantly more female and male partner pain/discomfort and decreased acceptability, compared with the unstrapped device.

Contraceptive Devices, Female↗
PubMed1986

How does the IUD influence subsequent fertility?

Analyzing the data of 649 women, 587 pregnancies and 502 deliveries after discontinuation of IUD use, the return of fertility was investigated in a retrospective study. The non-medicated, Szontágh-type device was removed for planned pregnancy in every case and after removal, the women did not use any kind of contraception until the first conception. Using the life table technique for calculation, the cumulative conception rate was 90.5 at the end of the first year after discontinuation of IUD use. The duration of IUD use did not influence the length of time that had elapsed until the first conception after removal, and the outcome of pregnancies was the same in the study and the local control group. The period of time between discontinuation and first conception did not influence the length of gestation and there were statistically no significant differences in the frequencies of abortion, immature or premature, and mature delivery among the pregnancies conceived in the first, second, third and fourth quarter of the year after removal. The frequency of malformations and the sex ratio of the newborns also were found to be the same in the study and the control group. The birthweight corresponded to that of the local standard values. It is stated that, as for the return of fertility, the Szontágh IUD fulfils the requirement established for all temporary contraceptive methods. After removing the device fertility was restored and no negative effects on conception, course and outcome of pregnancy were observed. In our opinion, the conclusions drawn from these results may apply to other inert IUDs, however, further investigation of the question with more cases and different types of IUD should be made.

Abortion, Spontaneous↗
PubMed1997

Factors predisposing to postoperative complications related to wisdom tooth surgery among university students.

In a retrospective study among 550 Helsinki University students 20 to 30 years old, factors predisposing to postoperative complications from removal of lower jaw wisdom teeth were evaluated. Patient records and panoramic tomograms covering the period from 1990 to 1993 were examined; 50 patients (9.1%) had postoperative complications after removal of a wisdom tooth. The most common complications were alveolar osteitis (2.9%), postoperative infection (2.6%), postoperative bleeding (1.5%), and dysesthesia of the lower lip or tongue (1.1%). Factors associated with increased postoperative complications were mesiohorizontal position of the tooth, deep impaction of the tooth, and use of oral contraceptives. Before patients undergo surgery for removal of wisdom teeth, those who use oral contraceptives or have difficult tooth impactions should be informed about the increased possibility of postoperative complications.

Adult↗
PubMed1999

Non-invasive reversal of intraluminal vas deferens polymer injection-induced azoospermia--technology.

AIM: The rationale and technique underlying a novel concept of non-invasive removal of an intravasal vas deferens polymeric contraceptive drug to reverse drug injection-induced azoospermia are explained. Thus the conventional methods of surgical exploration to remove vas deferens plugs and intravasal injection of solvents to flush out contraceptive drugs are to be replaced by steps which will be readily accepted by subjects. METHODS: The approach is based upon the non-invasive application of specific forces to various segments of the vas deferens so that non-sclerosing and non-tissue-adherent compounds, in particular styrene maleic anhydride (SMA) can be expelled. Forces are generated by palpation; percutaneous electrical stimulation; vibration application; and percussion. The forces help to propel the intravasal polymer towards the ejaculatory duct for expulsion during ejaculation. All aspects of the total technique are clinically acceptable, simple, atraumatic, unlikely to cause pain and discomfort even without tranquilizers, local or general anaesthetics. The procedure may be repeated several times in different sittings spaced apart by about one week to achieve adequate plug expulsion. RESULTS: Model experiments demonstrated the feasibility of the concept. The polymer was nonadherent and could be moved within the vas deferens by the application of specific forces. Sufficient removal was possible to enable spermatic fluid to be transported along a region previously occupied by the polymer. A corroborating subhuman primate study by an independent investigator has shown that the semen profile becomes normal following the reversal. CONCLUSION: Adoption of the new technique may provide a means of non surgical restoration of normal semen profile after a period of fertility control obtained by intravasal drug injection.

Animals↗
PubMed1992

Rates and outcomes of planned pregnancy after use of Norplant capsules, Norplant II rods, or levonorgestrel-releasing or copper TCu 380Ag intrauterine contraceptive devices.

OBJECTIVES: The objectives were to measure rates of planned pregnancy and factors affecting these rates after use of very-long-acting contraceptive methods (Norplant or Norplant II implants, a levonorgestrel-releasing intrauterine contraceptive device, or the copper T (model TCu 380Ag) intrauterine contraceptive device. STUDY DESIGN: The design was a concurrent, multicenter prospective study of 372 women who stopped contraception for planned pregnancy. Analysis was by life-table, log-rank, and standard chi 2 methods. RESULTS: Pregnancy rates 12 and 24 months after cessation of contraceptive use were 82 and 89 per 100, respectively. Age at removal and family planning intentions at initiation of contraception were both significantly correlated with pregnancy rates (p less than 0.05), but former contraceptive regimen and duration of contraceptive use were not. Pregnancy outcomes did not deviate from normal limits and did not differ by contraceptive formerly used. CONCLUSION: Contraceptive implants releasing 30 micrograms/day of levonorgestrel or intrauterine contraceptive devices releasing 20 micrograms/day of levonorgestrel or having copper surface areas of 380 mm2 are associated with normal fertility after use for women seeking pregnancy at termination. Durations of use do not affect pregnancy rates.

Adult↗
PubMed1977

[The problem of the lost intrauterine contraceptive device (author's transl)].

Report on 18 patients who were treated in hospital during the last 4 years because of a lost intrauterine contraceptive device. Carbon dioxide hysteroscopy was found to be a more advantageous diagnostic procedure in the search than radiography. In 14 cases, the intrauterine contraceptive device was grasped and removed under hysteroscopic control. In 4 cases the uterine cavity was empty on hysteroscopy. The device had perforated into the uterine muscle or into the peritoneal cavity. These 4 cases are reported in detail.

Abdomen↗
PubMed2000

Clinical profile of Implanon: a single-rod etonogestrel contraceptive implant.

This 3-year study investigating the contraceptive efficacy and tolerability of Implanon in 635 volunteers demonstrates that it was well tolerated and had excellent, reversible, contraceptive efficacy. No pregnancies (Pearl index, 0; 95% CI 0.0-0.2) occurred during 1,200 woman-years of exposure. Irregular bleeding, mainly frequent and prolonged, was the primary reason for discontinuation (19.0%). Infrequent bleeding (29-51%) was the most common bleeding disturbance. Adverse events, other than bleeding irregularities, were generally mild to moderate in intensity and resulted in 9.3% of discontinuations. Over 85% of women with dysmenorrhea at baseline noted an improvement at the end of treatment, while 4% reported new or worsened symptoms. The most commonly reported non-bleeding adverse events were breast pain (16%), acne (12.6%), vaginitis (12%) and pharyngitis (10.5%). However, acne present at enrolment improved or disappeared during treatment in 59% of women. Less than 5% of women experienced implant site symptoms after insertion or removal, mainly mild pain of short duration. Average insertion and removal times were 2.2 and 5.4 min, respectively. In most women, menses returned to normal within 3 months of implant removal. Of those using no contraceptive method, 13.8% became pregnant within 90 days. Implanon represents a highly effective contraceptive option for women.

Adolescent↗
PubMed1981

A fifteen year experience with ectopic pregnancy.

The increasing importance of an ectopic pregnancy as a cause of maternal death presents a challenge that will be met when primary care physicians combine a high index of suspicion with the ability to recognize the patient most at risk. The major symptoms, abdominal pain, secondary amenorrhea and abnormal vaginal bleeding are well known, as are the major signs, abdominal tenderness, adnexal mass and tenderness on motion of the cervix. Less well known are factors in the clinical history which indicate the patient to be at high risk. These include primary or secondary infertility, previous abortion or ectopic pregnancy and previous tubal operation, either reconstructive or sterilizing. In addition, the use of an intrauterine contraceptive device or its recent removal because of abdominal pain or bleeding, or both, is highly significant. Of major importance is a history of recent uterine evacuation. Should the diagnosis of ectopic pregnancy be under consideration, procrastination by observation is no longer acceptable. An active effort must be made to confirm or deny the diagnosis, Culdocentesis should be performed in the emergency department or clinic. If positive, prompt laparotomy is indicated. Should the result of culdocentesis be unsatisfactory or negative, laparotomy should be undertaken with further delay.

Adult↗
PubMedDate not supplied

Removal of completely perforating IUDs by explorative laparotomy.

Nine patients with completely perforating intrauterine contraceptive devices are presented. In all cases, the device was removed by explorative laparotomy. In eight out of the nine women, the device was found to be embedded in the omentum or vesical peritoneal plica. The advantages of explorative laparotomy over laparoscopy or colpotomy are emphasized.

Adult↗
PubMed1987

Antigenic and cytochemical characterization of cells adhering to intrauterine contraceptive devices.

Eighteen copper intrauterine devices (IUDs), removed after 25 months of use, were examined to evaluate cells adhering to them (IAC). By means of monoclonal antibodies, the antigenic phenotype of IAC was studied, along with some IAC cytochemical properties. Sixty percent of IAC were identified as granulocytes based on morphological, cytochemical, and antigenic characteristics. A small proportion of IAC were shaped like large foreign-body macrophages, with multiple picnotic nuclei, and diffused alpha naphthyl acetate esterase (ANAE) activity. Some IAC identified as macrophages from a morphological view point also showed dipeptidyl-diaminopeptidase IV (DAPIV) reactivity, previously described only in T-helper lymphocytes. Most IAC identified as macrophages reacted with the monoclonal antibodies OKM1 and HLA-DR, and showed ANAE activity in the form of small multiple granules. The hypothesis that IUD-adhering macrophages with an ANAE+, DAPIV+, OKM1+, and HLA-DR+ phenotype could play a role in the inactivation of spermatozoa can be proposed.

Antibodies, Monoclonal↗