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Comparison of two procedures for routine IUD exchange in women with positive Pap smears for actinomyces-like organisms


Merki-Feld, G S; Rosselli, M; Imthurn, B (2008). Comparison of two procedures for routine IUD exchange in women with positive Pap smears for actinomyces-like organisms. Contraception, 77(3):177-180.

Abstract

BACKGROUND: In the female genital tract, up to 30% of Papanicolaou (Pap)-stained cervicovaginal smears of intrauterine device (IUD) users are positive for actinomyces-like organisms (ALOs). Many clinicians believe that no therapeutic intervention is necessary if women with ALOs are without symptoms. However, there are no recommendations for the procedure in ALO-positive women with need for a routine IUD exchange. STUDY DESIGN: In this retrospective study, the incidence of ALOs was compared in ALO-positive women with a routine IUD exchange according to two new procedures: Group 1 (n=19), insertion of a new IUD immediately after removal of the index device, and Group 2 (n=19) IUD removal and reinsertion after 3-5 days. A Pap smear was obtained at intervals of 6 weeks and 12, 24 and 36 months after reinsertion. RESULTS: The cytological examination carried out after 6 weeks proved to be negative for ALOs in all cases. After 36 months, smears were more often positive for ALOs in women with immediate IUD exchange (73% vs. 33%; p<.17). CONCLUSION: Our results indicate that in ALO-positive women, IUD reinsertion immediately after removal or after an interval of 3-5 days is safe. The interval reinsertion might be of advantage on a long-term basis.

Abstract

BACKGROUND: In the female genital tract, up to 30% of Papanicolaou (Pap)-stained cervicovaginal smears of intrauterine device (IUD) users are positive for actinomyces-like organisms (ALOs). Many clinicians believe that no therapeutic intervention is necessary if women with ALOs are without symptoms. However, there are no recommendations for the procedure in ALO-positive women with need for a routine IUD exchange. STUDY DESIGN: In this retrospective study, the incidence of ALOs was compared in ALO-positive women with a routine IUD exchange according to two new procedures: Group 1 (n=19), insertion of a new IUD immediately after removal of the index device, and Group 2 (n=19) IUD removal and reinsertion after 3-5 days. A Pap smear was obtained at intervals of 6 weeks and 12, 24 and 36 months after reinsertion. RESULTS: The cytological examination carried out after 6 weeks proved to be negative for ALOs in all cases. After 36 months, smears were more often positive for ALOs in women with immediate IUD exchange (73% vs. 33%; p<.17). CONCLUSION: Our results indicate that in ALO-positive women, IUD reinsertion immediately after removal or after an interval of 3-5 days is safe. The interval reinsertion might be of advantage on a long-term basis.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Reproductive Endocrinology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2008
Deposited On:24 Feb 2009 13:50
Last Modified:06 Dec 2017 18:45
Publisher:Elsevier
ISSN:0010-7824
Additional Information:Elsevier full text article
Publisher DOI:https://doi.org/10.1016/j.contraception.2007.11.007
PubMed ID:18279687

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