Intrauterine Devices

宫内节育器
  • 文章类型: Journal Article
    背景:宫内节育器是有效的,安全,方便,经济,和可逆的避孕方法。虽然它的避孕效果是肯定的,一些女性患者可能会出现并发症,如驱逐,出血,在设备到位的情况下怀孕。直肠穿孔是一种罕见且严重的并发症,这可能导致并发症,如腹部感染和肠粘连,严重影响患者的生活质量。
    方法:一名34岁女性因明显的左下腹疼痛被送往消化内科。1年前,她出现了腹部不适和肛门里急后重。两个月前,她的腹痛逐渐加重,并被送往我们医院。
    方法:调查,包括结肠镜检查和计算机断层扫描,发现宫内节育器迁移并穿孔进入直肠。
    结果:患者在结肠镜下成功取出宫内节育器。治疗后她恢复得很好。
    结论:该病例证明内镜治疗可被认为是移除移位到消化道腔内的宫内节育器的首选方法。
    BACKGROUND: The intrauterine device is one of the effective, safe, convenient, economical, and reversible contraceptive methods. Although its contraceptive effect is definite, some female patients may experience complications such as expulsion, bleeding, and pregnancy with the device in place. Rectal perforation is one of the rare and serious complications, which can lead to complications such as abdominal infection and intestinal adhesions, severely affecting the quality of life of patients.
    METHODS: A 34-year-old female was sent to the Department of Gastroenterology with noticeable left lower quadrant abdominal pain. She had presented with abdominal discomfort and anal tenesmus 1 year earlier. Two months ago, her abdominal pain had gradually worsened and she was presented to our hospital.
    METHODS: Investigations, including colonoscopy and computed tomography scan, had revealed an intrauterine device migrated and perforated into the rectum.
    RESULTS: The patient underwent successful colonoscopic removal of the intrauterine device. She recovered well after the treatment.
    CONCLUSIONS: This case proves that endoscopic therapy can be considered the preferred method for removing intrauterine devices displaced into the digestive tract lumen.
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  • 文章类型: Case Reports
    背景:使用宫内节育器(IUD)进行避孕的个体的总体妊娠率<1%。如果在宫内节育器就位时怀孕,异位妊娠的风险更高。我们报告了一名怀孕7周并在1周后自然流产的IUD妇女的病例。
    方法:一位32岁的女性到我们的门诊部进行了几天的间歇性阴道染色。
    方法:她怀孕7周,放置宫内节育器超过4年。阴道检查显示没有阴道出血和血凝块;然而,观察到一个胎下子宫颈。IUD字符串不可见。经阴道超声检查显示子宫腔有一个孕囊,胎杆和冠状臀部长度为11.4毫米。胎儿心率为159次/分钟。宫内节育器位于胎盘后区域。双侧附件正常(右卵巢,2.9厘米;左卵巢,2.5厘米)。该患者被诊断为宫内妊娠,宫内节育器就位并有先兆流产。
    方法:移除宫内节育器的尝试由于其位置而被放弃,保守治疗开始于Utrogestan(100mg),每天3次,共1周.建议卧床休息。
    结果:不幸的是,一周后,她经历了一次完全流产。
    结论:本病例报告的新颖性在于罕见的宫内妊娠并长期放置宫内节育器,宫内节育器的具体位置带来的挑战,以及在这种情况下对先兆流产的复杂管理。我们的案例强调了宫内节育器到位的宫内妊娠的诊断管理方法。此外,探讨宫内节育器位置对妊娠预后的影响.
    BACKGROUND: The overall pregnancy rate in individuals with an intrauterine device (IUD) for contraception is <1%. If pregnancy occurs while an IUD is in place, there is a higher risk of an ectopic pregnancy. We report the case of a woman with an IUD who was 7 weeks pregnant and experienced a spontaneous abortion 1 week later.
    METHODS: A 32-year-old woman presented to our outpatient department with intermittent vaginal staining for several days.
    METHODS: She was 7 weeks pregnant and had an IUD in place for over 4 years. A vaginal examination revealed no vaginal bleeding and no blood clots; however, a parous cervix was observed. The IUD string was not visible. Transvaginal ultrasonography revealed a gestational sac in the uterine cavity, with a fetal pole and a crown-rump length of 11.4 mm. The fetal heart rate was 159 beats/min. The IUD was located in the retroplacental region. The bilateral adnexa appeared normal (right ovary, 2.9 cm; left ovary, 2.5 cm). The patient was diagnosed with an intrauterine pregnancy with an IUD in place and threatened abortion.
    METHODS: Attempts to remove the IUD were abandoned due to its location, and conservative treatment was initiated with Utrogestan (100 mg) administered 3 times a day for 1 week. Bed rest was advised.
    RESULTS: Unfortunately, she experienced a complete abortion 1 week later.
    CONCLUSIONS: The novelty of this case report lies in the rare occurrence of an intrauterine pregnancy with a long-term IUD in place, the challenges posed by the IUD\'s specific location, and the complex management of threatened abortion in this context. Our case highlights the diagnostic management approach for intrauterine pregnancy with an IUD in place. Furthermore, it explores the impact of IUD location on pregnancy prognosis.
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  • 文章类型: Case Reports
    膀胱结石,虽然在健康的膀胱中很少见,可能由于各种因素而出现,包括尿流阻塞,反复感染,和异物。子宫内避孕装置(IUCD)以其从子宫腔迁移的潜力而闻名。导致膀胱结石等异常并发症。
    方法:一位52岁的女性,以前治疗过复杂的尿路感染,表现为间歇性下腹痛,排尿困难,还有血尿.她15年前有插入宫内节育器的历史,后来被记录为失踪。诊断成像显示膀胱大结石,封装先前插入的IUCD。进行了开放性膀胱切开取石术,在此期间,一块6×5厘米的石头被移除,揭示内的IUCD。在6个月的随访中,患者的康复无并发症,没有进一步的尿路感染。
    宫内节育器的迁移会导致各种并发症,取决于它的最终位置。在迁移的宫内节育器周围形成膀胱结石是一种罕见但显著的并发症,需要一个彻底的诊断方法。在这种情况下,X线摄影和超声检查足以诊断膀胱内迁移。
    结论:该病例强调了在表现为泌尿系症状的患者的鉴别诊断中考虑迁移IUCD的重要性。尤其是那些有IUCD缺失历史的人。及时的诊断和管理对于预防进一步的并发症至关重要。
    UNASSIGNED: Bladder stones, although rare in a healthy bladder, can emerge due to various factors, including obstructions in urinary flow, recurrent infections, and foreign bodies. Intrauterine contraceptive devices (IUCDs) are known for their potential to migrate from the uterine cavity, leading to unusual complications such as bladder stone formation.
    METHODS: A 52-year-old woman, previously treated for a complicated urinary tract infection, presented with intermittent lower abdominal pain, dysuria, and hematuria. She had a history of an IUCD insertion 15 years earlier, which was later documented as missing. Diagnostic imaging revealed a large bladder stone, encasing the previously inserted IUCD. An open vesicolithotomy was performed, during which a stone measuring 6 × 5 cm was removed, revealing the IUCD within. The patient had an uncomplicated recovery with no further urinary tract infections at a 6-month follow-up.
    UNASSIGNED: The migration of an IUCD can lead to various complications, depending on its final location. The formation of bladder stones around a migrated IUCD is a rare but significant complication, necessitating a thorough diagnostic approach. Radiography and ultrasonography proved sufficient for diagnosing the intravesical migration in this case.
    CONCLUSIONS: This case underscores the importance of considering a migrated IUCD in the differential diagnosis of patients presenting with urinary symptoms, especially those with a history of a missing IUCD. Timely diagnosis and management are crucial in preventing further complications.
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  • 文章类型: Case Reports
    据报道,每插入1000个宫内节育器,宫内节育器迁移和子宫穿孔的发生率为1.9-3.6。重要的是要注意,由错位的IUD引起的膀胱穿孔并不常见,并且被认为在插入期间最频繁发生。这里,我们描述了一名患者,他出现了与膀胱内宫内节育器错位有关的症状。可以得出结论,应将膀胱镜检查技术视为该器官中此类损伤的合适治疗选择。当仅通过膀胱镜检查无法有效治疗问题时,应该考虑剖腹手术.
    According to reports, there are 1.9-3.6 incidences of IUD migration and uterine perforation for every 1000 IUD insertions. It is important to note that bladder perforation caused by a misplaced IUD is uncommon and is thought to happen most frequently during insertion. Here, we describe a patient who presented with symptoms related to the malposition of IUD inside the bladder. It is feasible to draw the conclusion that the cystoscopy technique should be taken into consideration as a suitable therapy option for such injuries in this organ. When a problem cannot be effectively treated by cystoscopy alone, laparotomy should be considered.
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  • 文章类型: Case Reports
    背景:子宫穿孔是放置宫内节育器(IUD)的严重并发症。然而,因为完全子宫穿孔和宫外迁移可能仍然无症状,宫内节育器的彻底定位在重新插入之前很重要。
    方法:一名33岁患者,有4次宫内节育器插入,其中第一个宫内节育器(14年前插入)的位置在重新插入和替换随后的三个宫内节育器之前没有确定。她以6个月的腹痛病史就诊。盆腔超声检查(美国),射线照相术,宫腔镜和腹腔镜检查证实,保留的IUD在右阔韧带中迁移。
    方法:子宫穿孔,宫内节育器迁移到阔韧带。
    方法:患者接受了宫腔镜和腹腔镜检查。
    结果:两个宫内节育器均成功取出,无任何并发症。
    BACKGROUND: Uterine perforation is a serious complication of intrauterine contraceptive device (IUD) placement. However, as complete uterine perforation and extrauterine migration may remain asymptomatic, thorough localization of the IUD is important prior to reinsertion.
    METHODS: A 33-year-old patient who has had 4 IUD insertions, wherein the location of the first IUD (inserted 14 years ago) was not identified prior to reinsertion and replacement of the subsequent three. She presented to hospital with a 6-month history of abdominal pain. Pelvic ultrasonography (US), radiography, hysteroscopy and laparoscopy examinations confirmed that a retained migrated IUD in the right broad ligament.
    METHODS: Uterine perforation, IUD migration to the broad ligament.
    METHODS: The patient underwent hysteroscopy and laparoscopy.
    RESULTS: Both IUDs were successfully removed without any complications.
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  • 文章类型: Case Reports
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  • 文章类型: Case Reports
    宫内节育器(IUD)是常用的,可由初级保健提供者插入的长效可移动避孕药的有效形式。特别是铜宫内节育器的不良结果已被广泛记录;然而,对于已经经历了与宫内节育器相关的不良结局的患者,是否提供宫内节育器的指导很少.在这个案例报告中,我们的病人经历了三种不同的铜宫内节育器的三种并发症,包括自发驱逐,一个支离破碎的设备,除了两次意外怀孕外,还有一个保留的装置。在我们看来,对于已经经历与宫内节育器相关的多种不良结局的患者,应提供不同形式的避孕.
    Intrauterine devices (IUDs) are commonly used, effective forms of long-acting removable contraceptives that may be inserted by primary care providers. Adverse outcomes with copper IUDs specifically have been extensively documented; however, there is little guidance on whether to offer an IUD to a patient who has already experienced adverse outcomes related to IUDs. In this case report, our patient experienced three complications with three different copper IUDs, including a spontaneous expulsion, a fragmented device, and a retained device in addition to two unintended pregnancies. In our view, a different form of contraception should be offered for a patient that has already experienced multiple adverse outcomes related to IUDs.
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  • 文章类型: Review
    背景:宫内节育器是世界范围内广泛使用的避孕方法。这些设备是可靠的,成本效益高,长效,和可逆的。它们在子宫中的放置通常是简单和安全的。被遗忘的宫内节育器会带来一些并发症,并可能对妇女的健康产生不利影响。因此,在插入和及时删除适当的咨询是至关重要的。我们介绍了来自埃塞俄比亚西部的75岁绝经后患者中保留Lippes环宫内节育器40年的情况。患者出现绝经后盆腔疼痛。用海绵状镊子除去环。患者通过镇痛和多西环素每天两次,连续3天出院。
    结论:不同的文献表明,保留Lippes环宫内节育器会带来一些并发症。我们的病例还出现了绝经后盆腔疼痛。因此,我们建议在宫内节育器的有效期或绝经期取出宫内节育器.
    BACKGROUND: Intrauterine devices are a widely used method of contraception worldwide. These devices are reliable, cost-effective, long-acting, and reversible. Their placement in the uterus is usually simple and safe. Forgotten IUDs carry some complications and can adversely affect the health of women. Therefore, appropriate counseling during insertion and timely removal are crucial. We present the case of retained Lippes loop IUD for 40 years in a 75-year-old postmenopausal patient from Western Ethiopia. The patient presented to the hospital with postmenopausal pelvic pain. The loop was removed with spongy forceps. The patient was discharged with analgesia and doxycycline twice a day for 3 days.
    CONCLUSIONS: Different works of the literature showed that retained Lippes loop IUD carries some complications. Our case was also presented with postmenopausal pelvic pain. Therefore, we recommend the removal of IUDs at their expiry date or menopause.
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  • 文章类型: Case Reports
    Intrauterine device(IUD)migrating to the bladder is rare,especially the migration far away from the uterus into the bladder wall.Due to no obvious clinical symptom in the early stage and being far away from the uterus,the IUD totally embedded in the bladder wall is prone to misdiagnosis and delay in treatment.We reported one case of such migration,aiming to improve the clinical management of the IUD totally embedded in the bladder wall.
    宫内节育器膀胱异位较为少见,尤其是远离子宫并完全膀胱壁内异位更为罕见。宫内节育器完全膀胱壁内异位早期无明显临床症状,且远离子宫,容易漏诊而延误治疗。本文报道1例宫内节育器完全膀胱壁内异位的诊疗过程,以提高该类疾病的诊疗认识。.
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  • 文章类型: Case Reports
    Intrauterine devices (IUDs) have become one of the most frequently used forms of long-acting reversible contraception (LARC) in women of childbearing age. While complications are generally considered to be minimal, they can occur during the insertion, during use, or upon removal. Uterine anomalies, such as a bicornuate uterus, can increase the risk of complications during all stages. Here, we describe a case of a patient with a bicornuate uterus who had a levonorgestrel IUD in place for five years before she experienced a dislodging of the IUD, fragmentation upon attempted removal, and ultimately required a hysteroscopy to remove an embedded fragment from the endocervical canal. Due to the limited reporting on fragmented IUDs, further studies will be required to assess the optimal management. While symptomatic patients should have the fragment removed, asymptomatic patients should have their individual history and desire for future pregnancy weighed against the risk and benefits of treatment.
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