Tuboovarian abscess associated with an intrauterine device: report on
A. Pretnar-Darovec, B. Pinter
Gynaecological Clinic, Ljubljana, Slovenia
Objective: As a CCR WHO we have conducted many multicentre studies. In
most IUD studies we have find this contraceptive favourable for multiparas .
However. We claim IUD so harmful, that the opinion was established on
its longevity. We left Cupper IUD in place for yearsby menopause. Perhaps this
policy should be changed, as at our clinic we have been admitting long term IUD
users with severe pelvic inflammatory disease (often ending in hysterectomy) for
years, approximately one case per month.
Design: We present three – in our opinion – typical cases which
were admitted to the Hospital in the same month. Similarities between them was
in the length of IUD usage, their age and severity of infection. As conservative
treatment was ineffective the women had to undergo hysterectomy,.
Results: All three women showed the same information as we found in
other similar cases: they were in late 40th years of age, and had IUD in place
for more than 5 years. We can not prove changing of partners or STD, not even so
often reported actynomyces infection.
Conclusions: We still find IUD very suitable contraception for many
women. However, we should bear in mind that every IUD has a lifespan, and should
be removed according to the manufacterer’s recommendations for each type
separately. In literature numerous cases have been reported on with a history,
similar to that found in our reported cases: pelvic abscesses at aged women with
long IUD use. What is the thruth reason for such serious complication we can
only speculate. Is this STD or impairment of immunity or IUD as reservoir for
bacteria? But nevertheless: for older women we had to find better solution for
contraceptive method, which will not put them in such hazard.