The effect of intrauterine contraceptive device on the cervico-vaginal cytology

Abstract

OBJECTIVE: To investigate the cervico-vagjnal cytology, pathologic changes and clinical implications of intrauterine contraceptive device (IUD) usage. STUDY DESIGN: Cellular alterations were investigated in 65-women using IUD and 135 women not using IUD: "Loopal smears" which were taken from 17 women wish to removal of IUD were also investigated. RESULTS: Polymorphonuclear leukocytes (PNL) were found significantly more frequent in IUD users group (87.7%) than in nonusers group (69.6%, p<0.01). Doderlein's bacilli was found significantly lower rate in IUD users group (32.3%) than in nonusers group (55.6%, p<0.01). Nonspecific coccus and intermediate cells were also found significantly different in IUD users than in nonusers group. Clinical feature'of two groups were similar. "Loopal smears" were significantly different from nonusers. While endometrial cells, erythrocytes and macrophages were not seen in IUD nonuser group, they were present in nearly half of "Loopal smears". PNL and glandular cells were found more frequent in "Loopal smear" group than in nonuser group. CONCLUSION: PNL, cornified and precomified epithelial cells, and intermediate cells were most frequent cytologic findings in IUD users group. All cytologic findings of "Loopal smears" were significantly different from nonusers group. We could not detect any significant effect of IUD usage on the development of pelvic infection. If conditions are suitable and there is no important risk factor, IUD usage should be encouraged. The increased PNL at the cervico-vaginal cytology alone should not interpret as a pelvic infection. An awareness of IUD associated cytomorhologic alterations can help in the management of women who use IUD. (Gynecol Obstet Reprod Med 1997; 3:361-365)