Intrauterine devices and severe pelvic inflammatory disease require
V. Kova, V. Vlaisavljevic, M. Reljic, M. Rebolj Stare
Department of Gynaecology and Perinatology, Teaching Hospital Maribor,
Introduction: The intrauterine device (IUD) is a highly effective
method of contraception but the concern about the connection with the risk of
upper genital tract infection often limits the use of the IUD. Lately many
studies have suggested that the risk of pelvic inflammatory disease (PID) and
infertility associated with IUD use is slightly increased only in the first days
following IUD insertion, that the PID risk does not increase with long-term use
of IUD and even that the risk of PID in women with symptomless sexually
transmitted diseases (STD) having an IUD inserted, is similar to the risk not
having an IUD inserted.
Aim and methods: Twenty five IUD users were hospitalized in 2001 and
twenty four in 2002 because of severe PID. The aim of our study was to analyse
some clinical characteristics of IUD users with severe PID. The different value
of variables were compared using t-test.
Results: In 2001 the mean age of patients was 41,9+6,37 (29–51)
years, mean time of using IUD was 12,65+7,32 (2–25) years, 40% of
patients were older than forty five, 44% of patients were using IUD more than
ten years. In 2002 the mean age of patients was 42,20+6,68 (21–53)
years, mean time of using IUD was 11,5+7,78 (1–22) years, 37,5 % of
patients were older than forty five years, 37,5% were using IUD more than 10
years. In 2001 36 % and in 2002 20,8 % of patients were treated with surgery.
There were no statistical significant differences in mean age and in mean number
of years using IUD between patients treated with surgery and without surgery.
There were no severe PID appearing in the first days after insertion of IUD.
Conclusion: According to our analysis the prolonged use of IUD is an
important risk factor for PID. The high percent of patients older than forty
five shows that perimenopausal state with hormonal changes could be also
important in etiopathogenesis of PID. We cannot confirm that age and time of
using IUD influence the degree of clinical picture.