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Uterine histopathologic changes after Cu-Fix intrauterine device insertion
D Reinprayoon1, S Taneepanichskul, S Niruthisard
1Department of Obstetrics and Gynaecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Insights
The Cu-Fix intrauterine device (IUD) insertion showed minor uterine histopathologic changes, primarily a local foreign body reaction in the endometrium. No pelvic infections were observed in patients undergoing cervical carcinoma-in-situ treatment.
Area of Science:
- Gynecologic Pathology
- Reproductive Medicine
- Medical Device Research
Background:
- Uterine histopathologic changes following intrauterine device (IUD) insertion require thorough investigation.
- The Cu-Fix IUD is a specific type of contraceptive device with a nylon knot for anchoring.
- Understanding the local tissue response to IUDs is crucial for patient safety and device efficacy.
Purpose of the Study:
- To evaluate the histopathologic alterations in the uterine lining after the insertion of the Cu-Fix intrauterine device (IUD).
- To assess the local tissue reaction at the site of IUD anchoring.
- To determine the incidence of pelvic infection in patients with an IUD following cervical treatment.
Main Methods:
- Histopathologic examination of uterine tissues from ten patients who underwent cold conization for cervical carcinoma-in-situ.
- Patients were fitted with a Cu-Fix IUD and scheduled for hysterectomy six weeks post-conization.
- Preoperative ultrasonography was used to confirm IUD placement.
Main Results:
- Ultrasonography confirmed IUD anchoring at the uterine fundus in all patients.
- One patient exhibited slight mononuclear cell infiltration in the myometrium at the nylon knot anchoring site.
- Endometrial infiltration of mononuclear cells and plasma cells was observed during the proliferative phase, indicating a local foreign body reaction in all patients.
- No signs or symptoms of pelvic infection were reported by any patient.
Conclusions:
- The Cu-Fix IUD insertion is associated with a localized foreign body reaction in the endometrium.
- Histopathologic changes observed were minimal and did not lead to pelvic infections.
- The study supports the safety profile of the Cu-Fix IUD in this specific patient cohort.
Abstract:
A study of uterine histopathologic changes after the insertion of the Cu-Fix intrauterine device (IUD) was carried out at the Obstetrics and Gynecology Department, Faculty of Medicine, Chulalongkorn University. Ten patients, who had cold conization for a suspicious Papanicolaou smear, were fitted with the Cu-Fix IUD. All patients were diagnosed as having carcinoma-in-situ of the cervix and were scheduled for hysterectomy at 6 weeks postconization. Preoperative ultrasonography showed the IUD anchoring at the uterine fundus, which corresponded with posthysterectomized findings. At the anchoring site of the nylon knot, which serves as a small retention body in the fundus, slight mononuclear cells infiltration in the myometrium was found in only one patient. However, in the endometrium, there was infiltration of mononuclear cells as well as a few plasma cells during the proliferative phase of the cycle. Evidence of local foreign body reaction was found in all patients. No patient had symptoms or signs of pelvic infection.