Affiliation:
1. Klinika za ginekologiju i akušerstvo, Klinički centar Srbije, Beograd
2. Klinika za endometriozu i pelvični bol, Bolnica „Vilhelminen”, Beč, Austrija
Abstract
Introduction. The last decade of the usage of intrauterine contraception has
been marked by the application of levonorgestrel-releasing hormonal devices.
A hormonal intrauterine device (IUD) releases a certain amount of
progestogen, whose effect on endometrium is such that, apart from preventing
unwanted pregnancy, also regulates the menstrual bleeding by reducing the
quantity and the duration of haemorrhage. This effect of hormonal IUDs has
led to their additional indications and use, so that nowadays these IUDs are
used not only as contraceptives but for therapeutic purposes as well. Case
Outline. After examination and treatment in an out-patient department, a
38-year-old woman was referred to our hospital due to suspected spontaneous
uterine perforation caused by hormonal IUD (Mirena?) one month after its
application. Clinical and sonographic examinations were unable to determine
the uterine perforation or the exact IUD location. Radiographic examination
confirmed the presence of the IUD in the abdomen, so it was decided to
operate on the patient. Perforation in the isthmus of the uterus and to the
right was identified intraoperatively. By exploration of the genital organs
and the abdominal cavity, the IUD was finally located in the omentum.
Conclusion. Even in cases of adequate indications for hormonal IUD
application, the doctor?s experience and complying with all the principles of
appropriate insertion, we should always consider the possibility of the
occurrence of serious complications, which sometimes may even require
surgery. The extragenital position of IUD, as in this case, may create
serious difficulties in the detection of location. A possible development of
asymptomatic complications additionally emphasizes the necessity of regular
check-ups of all IUD users.
Publisher
National Library of Serbia
Cited by
2 articles.
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