AI Summary & Key Takeaways
AI InsightA surgical intervention may cause more adhesions rather than preventing adhesion formation.
📌 3 Key Takeaways
Abstract
OBJECTIVE: To evaluate the diagnostic methods, management and treatment for intrauterine devices being displaced into the abdominal cavity. Design: Retrospective clinical study Setting: This retrospective study was conducted between 1980 and 2004 at the Süleyman Demirel University, Faculty of Medicine, Department of Obstetrics and Gynecology and Isparta Women’s and Children’s Hospital. Patients: Eleven patients with displaced intra-abdominal intrauterine device Main Outcome Measures: Eleven patients with displaced intra-abdominal intrauterine device were evaluated with respect to the demographic characteristics, clinical manifestation, state of current IUD use, duration of IUD use and type of clinical management. RESULTS: The mean age was 36.8±1.8 years, and the mean duration of IUD use was 61.82 ±75.93 months. The diagnostic method was ultrasonography in 5 cases, X-ray examination in 5 cases and cystoscopy in 1 case. The IUD location was the rectosigmoid in 4 cases (36%), the ligamentum latum in 2 cases (18%), the small bowel in 3 cases (27%), vesicouterine space in 1 case (9%) and the bladder in 1 case (9%). The type of IUDs was Cu-T 380A in 7 patients (63%), Lippes- Loop in 2 patients (18%) and Multiload 375 in 2 patients (18%). 45% of the patients were asymptomatic. Removal was performed by laparoscopy (n=8, 72%), laparotomy (n=2, 18%), laparotomy+cystostomy (n=1, 9%). CONCLUSIONS: Although we removed all the intraabdominal intrauterine devices, the removal of an asymptomatic displaced IUD is controvertial. A surgical intervention may cause more adhesions rather than preventing adhesion formation.
Özet
Objektif: Abdominal kaviteye deplase olmuş rahimiçi araçların (RİA) teşhis, takip ve tedavi yöntemlerini değerlendirmek. Planlama: Retrospektif çalışma. Ortam: Bu retrospektif çalışma 1980-2004 yılları arasında Süleyman Demirel Üniversitesi Kadın Hastalıkları ve Doğum Kliniği ile Isparta Kadın ve Çocuk Hastalıkları Hastanesi’nde yapıldı. Hastalar: İntraabdominal RİA’lı 11 hasta. Değerlendirme Parametreleri: İntraabdominal RİA’lı 11 hastanın demografik özellikleri, klinik bulguları, RİA kullanım süreleri ve klinik yaklaşım tiplerini araştırmak. SONUÇ: Ortalama yaş 36.8±1.8 yıl, ortalama RİA kullanım süresi 61.82 ±75.93 ay idi. Tanı yöntemi 5 olguda ultrason, 5 olguda X-ray, ve 1 olguda sistoskopi idi. RİA yerleşim yeri 4 (%36) olguda rektosigmoid, 2 (%18) olguda ligamentum latum, 3 (%27) olguda ince barsaklar, 1 (%9) olguda vezikouterin boşluk, 1 (%9) olguda mesane idi. RİA tipi 7 (%63) olguda Cupper-T 380 A, 2 (%18) olguda Lippes-loop, 2 (%18) olguda Multiload 375 idi. Olguların % 45’i asemptomatik idi. RİA çıkarılması 8 (%72) olguda laparoskopi, 2 (%18) olguda laparotomi, 1 (%9) olguda laparotomi+sistostomi ile gerçekleştirildi. YORUM: Her nekadar tüm intraabdominal RİA’ları çıkarmış olsak da asemptomatik deplase RİA’ları çıkarmak yoruma açıktır. Cerrahi yaklaşım adhezyon oluşumunu önlemeden ziyade arttırabilmektedir.