Bennis H, Berraho K, Kouarty I, Omrani H, Filali A, Saadi N, El Alami M H, Bezad R, Chraibi C
Service de Gynécologie Obstétrique, Maternité Universitaire des Orangers, Rabat, Maroc.
Rev Med Liege. 2011 Mar;66(3):153-8.
The intrauterine contraceptive device (IUCD) is frequently used. The use of IUCD can be responsible of serious complications as transuterine migration. In this study, we evaluate the physiopathology, the strategy of diagnosis and treatment of the IUCD translocation.
We conducted a retrospective study of nine cases of IUCD migration having occurred between 2004 and 2009. We discussed the age, the type of IUCD, the risk factors, the mechanisms of migration, the circumstances and methods of diagnosis, the treatment and the evolution of IUCD migration. Mean age of the patients was 35 years. The risk factors were: multiparity, anteversus uterus, scarred uterus, IUCD postpartal insertion, inexperience of the operator. Most patients were asymptomatic. Two patients had urinary symptoms. The diagnosis of an extrauterine device was confirmed by abdominal X-ray and ultrasound results in all patients. The endoscopic treatment was successful in 66% of cases. All patients had an uneventful recovery. Transuterine migration remains one of the least common but most serious complications associated with the use of an IUCD. This complication could be controlled if thorough gynaecological exam was performed, if risk factors were delineated, if the IUCD was technically well inserted and a rigorous surveillance was performed.
宫内节育器(IUCD)被广泛使用。IUCD的使用可能导致诸如子宫内移位等严重并发症。在本研究中,我们评估了IUCD移位的病理生理学、诊断和治疗策略。
我们对2004年至2009年间发生的9例IUCD移位病例进行了回顾性研究。我们讨论了患者年龄、IUCD类型、危险因素、移位机制、诊断情况和方法、治疗以及IUCD移位的演变。患者的平均年龄为35岁。危险因素包括:多产、子宫前倾、瘢痕子宫、产后放置IUCD、操作者经验不足。大多数患者无症状。两名患者有泌尿系统症状。所有患者经腹部X线和超声检查均确诊为宫外节育器。内镜治疗66%的病例成功。所有患者恢复顺利。子宫内移位仍然是与使用IUCD相关的最不常见但最严重的并发症之一。如果进行全面的妇科检查、明确危险因素、技术上正确放置IUCD并进行严格监测,这种并发症是可以控制的。