Presence Of Intrauterine Contraceptive Device Research Articles

Synergistic effect of amphotericin B and tyrosol on biofilm formed by Candida krusei and Candida tropicalis from intrauterine device users.

The presence of intrauterine contraceptive devices (IUDs) provides a solid surface for attachment of microorganisms and an ideal niche for the biofilm to form and flourish. Vaginal candidiasis is often associated with the use of IUDs. Treatment of vaginal candidiasis that develops in connection with IUD use requires their immediate removal. Here, we present in vitro evidence to support the use of combination therapy to inhibit Candida biofilm. Twenty-three clinical Candida isolates (10 C. krusei and 13 C. tropicalis) recovered from endocervical swabs obtained from IUD and non-IUD users were assessed for biofilm-formation ability. The rate of isolation of Candida did not differ significantly among IUD and non-IUD users (P = 0.183), but the biofilm-formation ability of isolates differed significantly (P = 0.02). An in vitro biofilm model with the obtained isolates was subjected to treatment with amphotericin B, tyrosol, and a combination of amphotericin B and tyrosol. Inhibition of biofilm by amphotericin B or tyrosol was found to be concentration dependent, with 50% reduction (P < 0.05) at 4 mg/l and 80 μM, respectively. Hence, a combination effect of tyrosol and amphotericin B was studied. Interestingly, approximately 90% reduction in biofilm was observed with use of 80 μM tyrosol combined with 4 mg/l amphotericin B (P < 0.001). This represents a first step in establishing an appropriate antibiofilm therapy when yeasts are present.

In vitro actinomycete biofilm development and inhibition by the polyene antibiotic, nystatin, on IUD copper surfaces

The presence of intrauterine contraceptive devices (IUDs) gives a solid surface for attachment and an ideal niche for biofilm to form and flourish. Pelvic actinomycosis is often associated with the use of IUDs. Treatment of IUD-associated pelvic actinomycosis requires the immediate removal of the IUD. Therefore, this article presents in vitro evidence to support the use of novel antibiotics in the treatment of actinomycete biofilms. Twenty one clinical actinomycetes isolates from endocervical swabs of IUD wearers were assessed for their biofilm forming ability. An in vitro biofilm model with three isolates, Streptomyces strain A4, Nocardia strain C15 and Nocardia strain C17 was subjected to treatment with nystatin. Inhibition of biofilm formation by nystatin was found to be concentration dependent, with MBIC50 values in the range 0.08–0.16 mg ml−1. Furthermore, at a concentration of 0.16 mg ml−1, nystatin inhibited the twitching motility of the isolates, providing evidence for a possible mechanism of biofilm inhibition.

Accuracy of saline infusion sonohysterography in diagnosis of uterine intracavitary pathology

Objective: To assess the accuracy of saline infusion sonohysterography versus transvaginal sonography in detecting intracavitary uterine pathology. Method: We reviewed ultrasonography reports of 29 patients who had undergone saline infusion sonohysterography for evaluation of the endometrial cavity. These patients were suspected of having uterine cavity pathology by transvaginal sonography. They underwent operative hysteroscopy or hysterectomy or both after sonohysterography. The findings at each stage were compared. We also assessed the reliability of transvaginal sonography in detecting intracavitary disease. Results: The findings were as follows: polyps were diagnosed in 23 patients and myoma in 2 patients; presence of intrauterine contraceptive device (IUD) was noted in 2 patients, and findings were normal in 2 patients. Polyps were accurately diagnosed in 21 (91.3%) of the patients. In two patients, there was a false diagnosis of polyps based on sonohysterography. The presence of intracavitary myoma and IUD were correctly diagnosed. Of two patients with normal sonohysterography, one had polyps diagnosed histopathologically. By simple transvaginal sonography, polyps were correctly diagnosed in only 8 (34%) of the patients. Intracavitary pathology could not be identified. Conclusion: Saline infusion sonohysterography is a simple, noninvasive procedure. Our study suggests that it is highly sensitive in diagnosing intracavitary uterine pathologies. Saline infusion sonohysterography can be beneficial in guiding the physician toward the selection of procedures that cause relatively less morbidity.

Complications associated with the unsuspected presence of intrauterine contraceptive devices

This paper presents three case reports of women whose gynecologic difficulties centered around the unsuspected presence of an IUD. A 42-year-old black woman complained of menorrhagia of 1-year duration following IUD insertion at the local Planned Parenthood Clinic. She also had fibroid tumors of 10-years duration. Examination revealed no loop thread. A uterine sound detected an IUD in place. X-ray showed both a plastic and a metallic IUD in the uterus. Under general anesthesia a Saf-T-coil and Majzlin spring were removed. Her menarrhagia continued and back pain developed. X-ray showed another IUD present. A Lippes loop, size D, was removed and symptoms subsided. Review of her history revealed that she had returned to the Planned Parenthood clinic on 2 occasions where it was assumed the previously inserted IUD had been expelled and without x-ray confirmation another and different device was inserted. A 35-year-old woman, para 1-0- 3-1, complained of infertility of 18 months. She had become pregnant 5 years previously while using a Birnberg bow. After abortion she had used oral contraceptives until 18 months previously. Hysterosalpingogram revealed a Birnberg bow in the uterus. After removal, pregnancy promptly followed. It is believed the Birnberg loop had not been removed at the time of abortion or had been replaced while the patient was under general anesthesia without informing her. A 26-year-old woman complained of infertility for 8-9 months. An abortion had been performed 4 years previously. Later she had used an IUD and then foam contraceptives. A metallic IUD in the uterine cavity was shown by hysterosalpingography, A Hall-Stone ring was deeply imbedded in the uterine wall and removed with difficulty. Her physician stated he had inserted a Hall-Stone ring after the abortion 4 years previously and later was unable to confirm its presence with a uterine probe. He therefore inserted another similar device. No x-rays were taken. He removed 1 device later. It is thought a communication gap may accur between the patient and the physician after an IUD is inserted during general anesthesia or while the patient has amnesia from analgesics. The hysician may assume an IUD has been expelled when no thread is visible at the cervix. Insertion of a probe into the uterus is an unreliable method of detecting an IUD. X-ray confirmation is needed. A hysterogram may be required for exact localization.

Uterine uptake of (6,7- 3 H) oestradiol in the presence of intrauterine contraceptive device in cyclic and pregnant rats.

ABSTRACT Uterine uptake of tritiated oestradiol was studied on each of the 4 days of the oestrous cycle and of the first 5 days of pregnancy in rats fitted unilaterally with an intrauterine contraceptive device (IUD). The uptake (dpm/g wet weight) was maximal in the control horn on Day 3 of the cycle and pregnancy. On an average the IUD-bearing horn accumulated more radioactivity than the control horn both during the cycle and pregnancy. It is postulated that the IUD either induces formation of or activates the uterine receptors which specifically bind oestrogen, resulting in an increased exposure of the IUD-bearing horn to endogenous oestrogen. A possible relevance of this finding to the contraceptive effects of the device through the mediation of prostaglandin release is discussed.

Hysteropneumopelvigraphy in Chronic Presence of Intrauterine Contraceptive Devices: A New Method of Investigating Complicated Cases

Hysteropneumopelvigraphy in Chronic Presence of Intrauterine Contraceptive Devices: A New Method of Investigating Complicated Cases

THE EFFECT OF THE INTRAUTERINE CONTRACEPTIVE DEVICE ON THE MAST CELL CONTENT OF THE HUMAN UTERUS

Amongst the varieties of procedures which have been adopted for controlling birth rate, the intra-uterine contraceptive device (IUCD) has a very prominent place. The IUCD has been found to be effective as a contraceptive device in several studies (1 — 4) and several theories have been proposed to explain its mechanism of action. Recently it has been suggested that the presence of IUCD in the rat uterus leads to an increase in the local mast cell population, and this may be an important factor in its mechanism of contraceptive action (5). It was further proposed that increase in number of mast cells might be directly responsible for prevention of nidation, as injection of comp. 48/80 a compound which is known to disrupt mast cells, at times allowed conception to take place even in the presence of the device. In view of the importance of the problem, the mast cell population in human uterus after insertion of the IUCD was studied.