Intrauterine Foreign Body Research Articles

Thorn in my Side - A Case of Entrapped, Intra-uterine Foreign Body and Delayed, Atypical Pelvic Inflammatory Disease

Uterine foreign bodies are a rare, but important cause of infertility and pelvic pain. Due to their relative scarcity, the diagnosis may be either missed or simply not considered as contributory to aetiology when patients present with symptoms. We report the case of a 42-year-old woman diagnosed with Atypical Pelvic Inflammatory Disease (APID). She presented with lower abdominal pain, vaginal discharge and inflammatory markers consistent with acute infection. Paradoxically, diagnostic imaging revealed an unsuspected intrauterine foreign body. The significance of this to the presenting complaint was initially uncertain however conservative management with antibiotics alone was sufficient to allow complete recovery. Later, the patient consented to operative hysteroscopy which identified and removed the object which was shown by histology to be a residual bone fragment derived most probably, from retained products of conception. The patient was noted to have had a surgical termination of pregnancy 5 years prior.

Implementation of Office Hysteroscopy for the Evaluation and Treatment of Intrauterine Pathology.

Hysteroscopy provides a minimally invasive strategy to evaluate intrauterine pathology and manage conditions such as abnormal uterine bleeding, infertility, intrauterine adhesions, müllerian anomalies, and intrauterine foreign bodies. Increasing access to hysteroscopy procedures in the office has the potential to improve patient care by minimizing financial and logistical barriers, aiding in streamlined diagnosis and treatment planning, and potentially averting unnecessary operative procedures and anesthesia. Office hysteroscopy refers to procedures performed in outpatient settings where pain management involves no medications, oral nonsedating medications, local anesthetic agents, or oral or inhaled conscious sedation. We present best practices for the implementation of hysteroscopy in an office setting. These include appropriate patient selection, optimal procedural timing, cervical preparation for patients at highest risk of cervical stenosis or pain with dilation, individualized pain-management strategies, use of distension media, and video monitoring to engage patients in the procedure. We describe miniaturized equipment for use in the office setting and "no-touch" vaginoscopic approaches to limit patient discomfort. With appropriate training and experience, office hysteroscopy presents a simple and cost-effective modality for optimizing gynecologic care for our patients.

Effect of intrauterine balloon placement combined with ultrasonic removal of intrauterine foreign body in patients with scar pregnancy

Objective To explore the effect of intrauterine balloon placement combined with ultrasonic removal of intrauterine foreign body in patients with cesarean scar pregnancy (CSP). Methods Totally 80 CSP patients were selected and divided into experimental group (n=42) and control group (n=38) according to therapeutic plan. The control group was treated with ultrasonic removal of intrauterine foreign body by hysteroscopy, and the experimental group was treated with intrauterine balloon placement on the basis of the control group. Vaginal bleeding, curative effect and complications were compared between the two groups. Results The amount of intraoperative blood loss and the bleeding within 24 hours after operation in the experimental group were significantly less than those in the control group (P 0.05). The incidence of complications in the experimental group was significantly lower than that in the control group (P Conclusion Intrauterine balloon placement combined with ultrasonic removal of intrauterine foreign body is effective and safe in the treatment of patients with CSP.

Incidence, indication and prognosis of ovariohysterectomy in dogs in Abeokuta, Nigeria

Case records of dogs that underwent ovariohysterectomy at the Veterinary Teaching Hospital, Federal University of Agriculture, Abeokuta (FUNAAB) between January, 2010 and December, 2016 were reviewed to determine the prevalence, indication and prognosis of this surgical condition. Data recorded include breed and age of the dogs at presentation and reason for ovariohysterectomy. Information on type of anaesthetic techniques, outcome of the surgery and occurrence and severity of complications were also noted. Ovariohysterectomy was performed in nine out of two thousand, two hundred and eighty five dogs that were presented during this period. The nine dogs included seven breed types which were Rottweiler (2), Samoyed (2), Alsatian (1), Doberman (1), Boerboel (1), Lhasa apso (1) and Pug (1). Mean age of the dogs presented for ovariohysterectomy was 5.7 ± 2.9 years with the age ranging between 18 months and 10 years. Indications for ovariohysterectomy in the dogs were pyometra (4), ovarian adenocarcinoma (2), transmissible venereal tumour (1), intra-uterine foreign body (1) and elective request (1). Surgical outcome was good in seven of the dogs, while one dog died secondary to hypovolemia after surgery and another dog was euthanized a week after surgery due to poor renal function. Five of the dogs had moderate obesity about six months after surgery, while a dog had mammary adenocarcinoma two years after ovariohysterectomy. It was therefore concluded that elective ovariohysterectomy is not routinely performed in dogs at the Veterinary Teaching Hospital, FUNAAB, while most cases are performed for management of reproductive tract diseases. Further data are required to authenticate or disprove the findings in this study.Keywords: Adenocarcinoma, Elective, Ovariohysterectomy, Prevalence, Pyometra

Infertility: an out-of-the-box cause of postmenopausal endometrial thickening

The presence of intrauterine foreign bodies (IFBs) is a rare condition that may lead to chronic endometritis through local inflammation. According to literature, IFB may be the cause of 0.02%...

ENDOMETRIAL OSSIFICATION: A RARE OCCURRENCE WITH REVIEW OF LITERATURE

Endometrial ossification is a rare occurrence seen in reproductive age group. Patients usually present with complaints of menorrhagia and secondary infertility. We report a case of endometrial ossification in a 28-year-old female who presented with abdominal pain and menorrhagia. On transvaginal ultrasonography, a hyperechoic area within the uterine cavity, suggestive of an intrauterine foreign body was noted. Histopathological examination of the endometrial curettage showed bony spicules with chronic inflammatory cell infiltration. Key words: Bony, Endometrial, Infertiltiy, Menorrhagia, Ossification, Spicules

Early-Onset Invasive Candidiasis in Extremely Low Birth Weight Infants: Perinatal Acquisition Predicts Poor Outcome.

Neonatal invasive candidiasis (IC) presenting in the first week of life is less common and less well described than later-onset IC. Risk factors, clinical features, and disease outcomes have not been studied in early-onset disease (EOD, ≤7 days) or compared to late-onset disease (LOD, >7 days). All extremely low birth weight (ELBW, <1000 g) cases with IC and controls from a multicenter study of neonatal candidiasis enrolled from 2001 to 2003 were included in this study. Factors associated with occurrence and outcome of EOD in ELBW infants were determined. Forty-five ELBW infants and their 84 matched controls were included. Fourteen (31%) ELBW infants had EOD. Birth weight <750 g, gestation <25 weeks, chorioamnionitis, and vaginal delivery were all strongly associated with EOD. Infection with Candida albicans, disseminated disease, pneumonia, and cardiovascular disease were significantly more common in EOD than in LOD. The EOD case fatality rate (71%) was higher than in LOD (32%) or controls (15%) (P = .0001). The rate of neurodevelopmental impairment and mortality combined was similar in EOD (86%) and LOD (72%), but higher than in controls (32%; P = .007). ELBW infants with EOD have a very poor prognosis compared to those with LOD. The role of perinatal transmission in EOD is supported by its association with chorioamnionitis, vaginal delivery, and pneumonia. Dissemination and cardiovascular involvement are common, and affected infants often die. Empiric treatment should be considered for ELBW infants delivered vaginally who have pneumonia and whose mothers have chorioamnionitis or an intrauterine foreign body.

Endometrial Synovial-like Metaplasia Associated With Levonorgestrel-releasing Intrauterine System.

The levonorgestrel-releasing intrauterine system (L-IUS) is widely used in contraception and in the treatment of menorrhagia, dysmenorrhea, adenomyosis, and endometriosis. L-IUS is also increasingly considered in the management of endometrial neoplasia and its precursors. Histologic changes in the endometrium can be due to the effects of high-dose progestogen or may be caused by the local irritant or mechanical effects of an intrauterine foreign body. In the present study, we describe a novel endometrial alteration associated with L-IUS that most closely resembles synovial metaplasia reported at other extra-articular anatomic sites. Eleven cases were identified with a mean age of 49.6 yr. In most patients L-IUS was used for management of menorrhagia or endometrial hyperplasia. Endometrial synovial-like metaplasia was always a focal finding and was associated with areas of surface epithelial erosion. The synovial-like cells showed a distinctive palisaded arrangement with orientation perpendicular to the endometrial surface. Multinucleate cells were present in 2 cases, but granulomas were not identified. The synovial-like cells were vimentin immunoreactive and a variable proportion of cells expressed CD68. Only focal CD10 staining was seen and there was no expression of estrogen receptor, progesterone receptor, or cytokeratin. In summary, L-IUS may be associated with a distinctive synovial-like metaplastic alteration which most likely represents a stromal reaction to an intrauterine foreign body following endometrial surface erosion. The synovial-like cells appear to comprise histiocytes and modified fibroblasts or stromal cells similar to this process in other sites.

Hysteroscopic View of Endometrial Atypia: A Review of Two Cases

Abstract Background: Hysteroscopy enables direct visualization of the endometrial cavity via the cervix with an endoscope and a light source. Diagnostic and therapeutic indications include: abnormal uterine bleeding; postmenopausal endometrial thickening; removal of endometrial polyps; resection of submucosal myomata; incision of uterine septa; directly visualizing and removing intrauterine foreign bodies; hysteroscopic sterilization; recurrent miscarriages; endocervical lesions; lysis of uterine synechiae; abnormal hysterosalpingography; and infertility. Cases: Case 1: A 73-year-old postmenopausal female presented with right lower-quadrant abdominal fullness, and she had a thickened endometrium (9.4 mm) on noted on ultrasound. An outpatient endometrial biopsy was attempted but was unsuccessful because the patient had cervical stenosis. She underwent hysteroscopy and dilation and curettage (D&C). Hysteroscopy revealed the presence of lesions in the endometrial cavity, and samples of these lesions showed f...

Pelvic peritonitis during biologic therapy for rheumatoid arthritis: a case report and review of the literature.

IntroductionInfections are recognized as major complications during therapy with biologics and other immunosuppressant drugs. The respiratory tract, bone, joint, skin, and soft tissues are well known sites of infection in patients with rheumatoid arthritis (RA) treated by biologics or other immunosuppressants. It is known that patients with intra-abdominal infections may develop tuberculous peritonitis during biologic therapy. However, non-tuberculous pelvic peritonitis is rare.Case descriptionA case of a 46-year-old patient with RA developed pelvic peritonitis during therapy with MTX, tacrolimus (TAC), and golimumab (GLM). The patient visited our hospital due to a fever and general malaise. Physical findings included lower abdominal tenderness and rebound tenderness. Abdominal computed tomography (CT) images showed an intrauterine foreign body and ascites. The contraceptive ring was removed. Streptococcus agalactiae and Streptococcus constellatus were cultured from the removed contraceptive ring. She was started on an antimicrobial agent, flomoxef (FMOX), at 2 g/day. The FMOX dosage was increased to 3 g/day from the 3rd day of disease and continued for 10 days. Her fever disappeared from the 4th disease day, and her inflammatory response then gradually decreased. No exacerbation of symptoms occurred even after the FMOX treatment was stopped, and the patient was discharged on the 14th disease day.Discussion and evaluationMTX and biologics were being administered at the time of onset of peritonitis. The peritonitis was diagnosed on the basis of the gynecological evaluation and CT imaging findings that were typical of peritonitis. The patient was in an immunosuppressed state during administration of anti-rheumatic drugs, and the peritonitis was thought to have developed due to an ascending infection via the long-term presence of the intrauterine contraceptive ring which had an attached string.ConclusionsBefore starting biological agents, patients must be questioned regarding the presence of an intrauterine foreign body.

Rice Grain in Uterine Cavity: Rare Presentations in Rural Nepalese Postmenopausal Farmer with Uterovaginal Prolapse

ABSTRACT Background Foreign bodies are less common in uterine cavity than vagina, and are less frequently seen in older women than prepubertal or premenarchal girls. When found in the uterus, these foreign bodies are usually forgotten intrauterine contraceptive device or retained fetal bones, objects which were introduced in the former case or the remnants of conceptus parts that was inadvertently retained as in the latter circumstances. Here, we are going to concentrate in foreign body that made its way into the uterine cavity unaided. Aim To study rice grain as retained intrauterine foreign body in women with prolapsed uterus. Methods Collection of series of cases of rice grain in the uterine cavity of women exposed to vaginal hysterectomy and pelvic floor repair for uterine prolapse from the year 2004 till date, from the Department of Obstetrics and Gynecology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal. Results The rice grains as foreign body were entirely seen in postmenopausal multiparous women with the long standing cases of major degree of uterovaginal prolapse, chronicity affirmed by cervical hypertrophy and keratinization. These intrauterine rice grains, 1 to 3 in numbers were found at various level within the uterine cavity with resultant pyometra formation and urinary retention posing surgical difficulties in two cases. Conclusion Possibilities of rice grain as foreign body must be kept in mind in the complicated cases of uterovaginal prolapse posted for hysterectomy. How to cite this article Baral J, Rana A, Gurung G. Rice Grain in Uterine Cavity: Rare Presentations in Rural Nepalese Postmenopausal Farmer with Uterovaginal Prolapse. J South Asian Feder Menopause Soc 2014;2(2):79-82.

Intrauterine foreign body presenting as a rectal bezoar and causing chronic diarrhea

Intrauterine foreign body presenting as a rectal bezoar and causing chronic diarrhea

Intrauterine foreign bodies, other than contraceptive devices and systems, may affect fertility – Report of two very different cases

Objectives To present two cases in which foreign bodies in the uterine cavity had a contraceptive effect for the duration of their presence in utero. Case One case of endometrial osseous metaplasia and another case with unabsorbed suture material after a caesarean section resulted in foreign bodies acting like an intrauterine contraceptive. Ultrasound was used to diagnose the conditions, and hysteroscopy to remove the foreign bodies. Conclusion Foreign intrauterine bodies should be considered in cases of infertility.

Secondary infertility with intrauterine foreign body: A case report.

A 37-year-old woman with a history of Caesarian section visited our hospital for infertility treatment. She had been treated with 2 years of timing intercourse and 6 attempts of intrauterine insemination with ovarian stimulation by clomiphene citrate following an infertility evaluation at another private clinic. Several bright dots were observed in the myometrium of the uterine cervix by transvaginal ultrasound examination, and the cavity of uterine body could not be visualized due to acoustic shadow. Hysteroscopic examination diagnosed residual silk from the Caesarian section as a foreign body of the uterine cavity. After the removal of the foreign body by hysteroscopic surgery and laparoscopic adhesiolysis around the uterus, the patient became pregnant by timing intercourse. Foreign bodies of uterine cavity are a rare cause of infertility, but in cases of secondary infertility with a history of Caesarian section, hysteroscopy may be a useful examination and the removal of foreign bodies can restore fertility.

Pregnancy Complicated by an Intrauterine Foreign Body

Journal of Ultrasound in MedicineVolume 27, Issue 3 p. 493-495 Case Report Pregnancy Complicated by an Intrauterine Foreign Body Melanie M. Glover MD, Melanie M. Glover MD Department of Obstetrics and Gynecology, Wright State University Boonshoft School of Medicine, Dayton, Ohio USA.Search for more papers by this authorRan Neiger MD, Ran Neiger MD [email protected] Department of Obstetrics and Gynecology, Wright State University Boonshoft School of Medicine, Dayton, Ohio USA.Search for more papers by this authorJiri D. Sonek MD, Jiri D. Sonek MD Department of Obstetrics and Gynecology, Wright State University Boonshoft School of Medicine, Dayton, Ohio USA.Search for more papers by this authorChristopher S. Croom MD, Christopher S. Croom MD Department of Obstetrics and Gynecology, Wright State University Boonshoft School of Medicine, Dayton, Ohio USA.Search for more papers by this authorDavid S. McKenna MD, David S. McKenna MD Department of Obstetrics and Gynecology, Wright State University Boonshoft School of Medicine, Dayton, Ohio USA.Search for more papers by this authorGary Ventolini MD, Gary Ventolini MD Department of Obstetrics and Gynecology, Wright State University Boonshoft School of Medicine, Dayton, Ohio USA.Search for more papers by this author Melanie M. Glover MD, Melanie M. Glover MD Department of Obstetrics and Gynecology, Wright State University Boonshoft School of Medicine, Dayton, Ohio USA.Search for more papers by this authorRan Neiger MD, Ran Neiger MD [email protected] Department of Obstetrics and Gynecology, Wright State University Boonshoft School of Medicine, Dayton, Ohio USA.Search for more papers by this authorJiri D. Sonek MD, Jiri D. Sonek MD Department of Obstetrics and Gynecology, Wright State University Boonshoft School of Medicine, Dayton, Ohio USA.Search for more papers by this authorChristopher S. Croom MD, Christopher S. Croom MD Department of Obstetrics and Gynecology, Wright State University Boonshoft School of Medicine, Dayton, Ohio USA.Search for more papers by this authorDavid S. McKenna MD, David S. McKenna MD Department of Obstetrics and Gynecology, Wright State University Boonshoft School of Medicine, Dayton, Ohio USA.Search for more papers by this authorGary Ventolini MD, Gary Ventolini MD Department of Obstetrics and Gynecology, Wright State University Boonshoft School of Medicine, Dayton, Ohio USA.Search for more papers by this author First published: 01 March 2008 https://doi.org/10.7863/jum.2008.27.3.493 Address correspondence to Melanie M. Glover, MD, Perinatal Partners, LLC, Miami Valley Hospital, Berry Building, 1 Wyoming St, Dayton, OH 45409 USA. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Volume27, Issue3March 2008Pages 493-495 RelatedInformation

Laparoscopically Assisted Retrieval of Lost IUCD/Foreign Bodies

Migration of therapeutically implanted intrauterine contraceptive devices and foreign bodies pose challenges in accurate localization and removal through the least invasive method. Laparoscopic removal is the desired method of treatment due to the lessened surgical and anesthetic morbidity and accurate and rapid localization of the devices are imperative in aiding an endoscopic removal. Difficulties in locating the device leads to prolonged intraoperative times and at times culminate in a laparotomy with its attendant increased morbidity. We present a case series where rapid and accurate localization of the devices was achieved by intraoperative usage of the fluoroscopic image intensifier. The image intensifier can view images in real time and can be used intraoperatively, increasing the diagnostic accuracy. We propose that intraoperative imaging by the fluoroscopic image intensifier is a cost effective, rapid, and accurate method of localizing a migrated contraceptive device, thus enabling optimal endoscopic treatment.

Fractured J-Wire Stylet Presenting as an Intrauterine Foreign Body

A 32-year old gravida 0 was noted to have a persistent echo dense reflection on her transvaginal ultrasound after undergoing saline infused sonohysterography during IVF work-up. Diagnostic hysteroscopy discovered a 1-cm remnant of a J-wire embryo transfer catheter embedded in a false passage created just below the apparently normal uterine cavity.

Intrauterine contraception in the year 2001: can intrauterine device use be revived with new improved contraceptive technology?

Intrauterine contraception is the most cost-effective reversible method of contraception today. The method is becoming increasingly attractive to women due to the development of new technologies that not only enhance the performance of the intrauterine device (i.e. efficacy is now close to 100%), but also reduce the rate of expulsion (in the case of the ‘frameless’ GyneFix® intrauterine device (IUD)) and the number of removals for medical reasons. This is important, since the demand for intrauterine devices is likely to increase drastically in the coming years. The size of the intrauterine foreign body with the mini GyneFix has been reduced six-fold since the development of the Lippes Loop®, resulting in an almost total absence of incompatibility problems.Furthermore, intrauterine contraception is entering a new phase with the development of intrauterine systems (IUSs) that deliver potent progestins. The Mirena® intrauterine system, which releases levonorgestrel, has been shown to drastically reduce menstrual bleeding. The FibroPlant™ levonorgestrel IUS has been clinically developed since 1997 and is a further development of the ‘frameless’ anchoring IUD concept. The majority of women presenting with excessive bleeding can be treated by insertion of the IUS, resulting in greatly reduced menstrual blood loss. This is a very important result from both a health and a quality-of-life point of view.The fact that the IUS is also a potent contraceptive is extremely interesting. We believe, therefore, that these new technologies will lead to a re-appraisal of the IUD and could revive the use of intrauterine contraception in all parts of the world, including those regions where IUD use is presently very low.

Candida funisitis: A clinicopathologic study of 32 cases.

We report on 32 cases of Candida funisitis and describe the associated clinicopathologic features. The Candida funisitis was characterized grossly by small, circumscribed, yellow-white nodules on the umbilical cord surface and, microscopically, by subamnionic microabscesses in which fungal organisms were demonstrable. Chorioamnionitis was present in all cases. Twenty-four (75%) of the 32 infants were premature. There were 7 perinatal deaths, all in immature fetuses. Five (16%) of the 32 fetuses had congenital candidiasis. Five (16%) of the mothers had a history of intrauterine foreign body, including intrauterine contraceptive device in three and cervical cerclage in two. The diagnosis of Candida funisitis should prompt a careful examination for fetal infection, even though it is associated with congenital candidiasis in only a minority of the cases.

Endometrial ossification in a postmenopausal woman.

A case of endometrial ossification in a 62 year old woman is reported. The patient presented with increased vaginal discharge. On transvaginal ultrasonography, a hyperechoic area within the uterine cavity,...