Intrauterine device(IUD)migrating to the bladder is rare,especially the migration far away from the uterus into the bladder wall.Due to no obvious clinical symptom in the early stage and being far away from the uterus,the IUD totally embedded in the bladder wall is prone to misdiagnosis and delay in treatment.We reported one case of such migration,aiming to improve the clinical management of the IUD totally embedded in the bladder wall.
Female ; Humans ; Urinary Bladder/surgery* ; Uterus ; Pelvis ; Intrauterine Devices/adverse effects*

Objective: To evaluate different methods' efficacy of controlling acute bleeding and managing long-term menstruation in patients with heavy menstrual bleeding (HMB) associated with antithrombotic therapy. Methods: The clinical data of 22 cases with HMB associated with antithrombotic therapy admitted to Peking University People's Hospital from January 2010 to August 2022 were analyzed, aged 39 years old (26-46 years). Changes in menstrual volume, hemoglobin (Hb), and quality of life were collected after control of acute bleeding and long-term menstrual management. Menstrual volume was assessed by pictorial blood assessment chart (PBAC), and quality of life was assessed by menorrhagia multi-attribute scale (MMAS). Results: (1) Treatment of acute bleeding: of the 22 cases with HMB associated with antithrombotic therapy, 16 cases were treated in our hospital and 6 in other hospital for emergency bleeding; of the 16 cases treated in our hospital, 3 underwent emergency intrauterine Foley catheter balloon compression due to severe bleeding (Hb decreased by 20 to 40 g/L within 12 hours). Of the 22 cases with antithrombotic therapy-related HMB, 15 (including 2 cases with severe bleeding) underwent emergency aspiration or endometrial resection, and intraoperative placement of levonorgestrel-releasing intrauterine system (LNG-IUS) followed by a significant reduction in bleeding volume; 3 cases had controlled acute bleeding after rivaroxaban dose reduction and continued observation; 2 cases were given gonadotropin-releasing hormone agonists to control acute bleeding in other hospital, of which 1 case was temporarily treated with periodic blood transfusion, and the other one patient underwent total hysterectomy; and 2 cases had temporary amenorrhea with oral mifepristone after intrauterine balloon compression or oral norethindrone. (2) Long-term menstrual management: of the 22 cases with antithrombotic therapy-related HMB, 15 had LNG-IUS placement and 12 had LNG-IUS placement for 6 months, and menstrual volume was significantly reduced [PBAC scores were 365.0 (272.5-460.0) vs 25.0 (12.5-37.5), respectively; Z=4.593, P<0.001], Hb was significantly increased [91.5 g/L (71.8-108.2 g/L) vs 128.5 g/L (121.2-142.5 g/L); Z=4.695, P<0.001], and quality of life was significantly improved [MMAS scores were 415.0 (327.5-472.5) vs 580.0 (570.0-580.0), respectively; Z=-3.062, P=0.002] before placement compared with 6 months after placement. Three rivaroxaban dose reduction patients' PBAC scores decreased by 20 to 35 but remained >100, and perceived quality of life did not change significantly. Two cases with temporary amenorrhea treated with oral mifepristone felt significantly improved quality of life, and the MMAS scores increased by 220 and 180, respectively. Conclusion: Intrauterine Foley catheter balloon compression, aspiration or endometrial ablation could be used to control acute bleeding in patients with antithrombotic therapy-related HMB, and LNG-IUS for long-term management could reduce menstrual volume, increase hemoglobin, and improve the quality of life of patients.
Female ; Humans ; Adult ; Menorrhagia/etiology* ; Fibrinolytic Agents/adverse effects* ; Levonorgestrel/adverse effects* ; Amenorrhea/drug therapy* ; Mifepristone/therapeutic use* ; Quality of Life ; Rivaroxaban/therapeutic use* ; Hemoglobins ; Intrauterine Devices, Medicated/adverse effects* ; Contraceptive Agents, Female

OBJECTIVE: To evaluate the efficacy and adverse effects of levonorgestrel-releasing intrauterine system (Mirena) in the treatment of adenomyosis. METHODS: The clinical data of 75 patients with adenomyosis who had Mirena insertion in Women's Hospital,Zhejiang University School of Medicine from September 2013 to December 2013 were retrospectively analyzed. The patients were followed up to 39 months. The efficacy and adverse effects were assessed. RESULTS: Pictorial Blood Loss Assessment Chart (PBAC) scores were decreased significantly after Mirena insertion both in patients with menorrhea (118±13 vs. 29±33, <0.01) and normal menstruation (82±15 vs. 14±13, <0.01); the patients with menorrhea showed a more significant decrease in PBAC score than those with normal menstruation (90±35 vs. 69±19,<0.01). The visual analogue scale (VAS) score decreased significantly after Mirena insertion compared with pre-treatment[7(6,7) vs. 1(0,2), <0.01]. The expulsion of Mirena occurred in 18 cases (24.0%); 9 cases (12.0%) had no effect and 28 cases (37.3%) had changes of menstruation patterns. Multivariate Cox regression analysis showed that the expulsion of Mirena was not associated with post-treatment VAS score, PBAC score before and after treatment or menstrual stabilization time (all >0.05). CONCLUSIONS Mirena is effective and safe in the long term management of adenomyosis, but about one third patients may require further treatment because of the expulsion or ineffectiveness of Mirena.
Adenomyosis ; Female ; Humans ; Intrauterine Devices, Medicated ; adverse effects ; standards ; Levonorgestrel ; administration & dosage ; adverse effects ; standards ; Retrospective Studies

Abortion, Induced ; adverse effects ; Adult ; Device Removal ; Embolization, Therapeutic ; Female ; Humans ; Intrauterine Devices ; Pregnancy ; Uterine Artery ; Uterine Rupture ; etiology

Intrauterine contraceptive device (IUCD) is relatively safe but still with some serious risks. Uterus perforation is rare and would be fatal. A case of Cu-7 IUCD invading into the sigmoid colon through uterine perforation caused by a pelvic blunt trauma was presented. Our case showed that uterus perforation by an IUCD could induce utero-sigmoid fistula which is likely to be missed. Imaging is required when the patients with IUCD present abdominal pain, particularly with a history of trauma.
Adult ; Colon, Sigmoid ; injuries ; Female ; Foreign-Body Migration ; complications ; Humans ; Intrauterine Devices ; adverse effects ; Uterine Perforation ; etiology ; Wounds, Nonpenetrating ; etiology

The use of intrauterine devices (IUDs) have been widespread since the 1960s. In 2002, the World Health Organization estimated that approximately 160 million women worldwide use IUDs. However, IUDs are associated with short-term complications such as vaginal bleeding, pelvic discomfort, dyspareunia and pelvic infection. Herein, we report the case of a woman who had recurrent urinary tract infection (UTI) due to the use of an IUD, even after treatment. The patient developed four episodes of UTI within a seven-month period after IUD insertion. During each episode of UTI, extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli (E. coli) was cultured from the patient’s midstream urine. The IUD was finally removed, and culture of the removed IUD was positive for ESBL-producing E. coli. An infected IUD as a source of recurrent UTI should be considered in women with IUD in situ who develop recurrent UTI even after treatment.
Adult ; Anti-Bacterial Agents ; therapeutic use ; Escherichia coli Infections ; drug therapy ; etiology ; Female ; Humans ; Intrauterine Devices ; adverse effects ; Microbial Sensitivity Tests ; Recurrence ; Treatment Outcome ; Urinary Tract Infections ; drug therapy ; etiology ; microbiology ; Uropathogenic Escherichia coli ; enzymology ; beta-Lactamases ; metabolism

OBJECTIVE: An ex vivo study found a copper-containing intrauterine device (IUD) to be safe for women undergoing an MRI examination at a 3.0-T field. No significant artifacts caused by the metallic implant were detected. However, there are still no in vivo data about these concerns. The aim of this study was to evaluate 3.0-T magnetic field interactions of copper-containing IUDs in vivo. MATERIALS AND METHODS: Magnetic field interactions and potential adverse events were evaluated in 33 women using a questionnaire-based telephone survey. Two experienced radiologists performed artifact evaluation on MR images of the pelvis. RESULTS: Eighteen patients were eligible for the survey. One patient reported a dislocation of the IUD after the MR examination. All other patients had no signs of field interactions. No IUD-related artifacts were found. CONCLUSION: MRI at 3.0-T is possible for women with copper-containing IUDs. However, consulting a gynecologist to check the correct position of the IUD and exclude complications after an MR examination is highly recommended. High-quality clinical imaging of the female pelvis can be performed without a loss in image quality.
Adult ; Artifacts ; *Copper ; Female ; Hot Temperature ; Humans ; *Intrauterine Devices, Copper/adverse effects ; Magnetic Fields ; Magnetic Resonance Imaging/adverse effects/*methods ; Middle Aged ; Pelvis

OBJECTIVETo provide suggestion for MDAEs monitoring with analyzing the features of the 1028 reports of MDAEs.

METHODSWith retrospective case study, this paper analyzed 1 028 MDAE reports in Guiyang during 2012.

RESULTSThe intrauterine device (IUD) caused the higher proportion of adverse events with serious degree. Monitoring consciousness of grassroots users needs to be improved. The quality of the reports should be enhanced.

CONCLUSIONSMore attention should be paid to monitoring on IUD. The level of MDAEs monitoring should be improved through carrying out targeted training and publicity, establishing and improving MDAEs monitoring network.

Equipment Safety ; Intrauterine Devices ; adverse effects ; Product Surveillance, Postmarketing ; Retrospective Studies

OBJECTIVEProvide the suggestion for MDAEs monitoring and the reference to strengthen the medical device administration by analyzing the 1900 reports of MDAEs.

METHODWith retrospective case study, analyze 1900 MDAE reports in Henan province in 2008. RESULT Orthopedic implants and the intrauterine device (IUD) caused the higher proportion of adverse events with serious degree. The scope that the reports covered needs to be raised.

CONCLUSIONFurther focus monitoring on orthopedic implants and the IUD should be strengthened. The medical device adverse events monitoring should be promoted by improving regulations, training and publicity.

Equipment Failure ; statistics & numerical data ; Intrauterine Devices ; adverse effects ; Prostheses and Implants ; adverse effects ; Retrospective Studies

OBJECTIVETo observe the efficacy of Xiaoyan Zhixue Capsule (XYZXC) in treating uterus abnormal menorrhagia caused by intrauterine device (IUD) and to study its mechanism.

METHODSIUD users with menorrhagia were randomly divided into two groups, the XYZXC treated group and adrenosoem (AC-17) control group. Endometrial tissue of XYZXC treated group before and after treatment were taken out to observe its morphologic change with optic and electronic microscope. Animal experiment was done to observe the effect of XYZXC in eliminating inflammation of patierts, and the relevant parameters were monitored.

RESULTSClinical efficacy: (1) Total effective rate of the treated group was 90.3%, that of control group was 43.5%, comparison between them showed significant difference (P<0.01). (2) Morphological examination of endometrial tissue showed the inflammation in the treated group abated after treatment with the contractible function of helicine artery strengthened. Experimental study showed: (1) The auricular swelling of mice was inhibited by 40.5% in the treated group, the effect was equivalent to that of hydrocortisone (46.9%). (2) Compared with the control group, the plasma 6-keto-PGF1alpha and D-Dimer level in the treated group were markedly lower, and TXB2/6-keto-PGF1alpha ratio and plasma endothelin level were markedly higher (P<0.05 or P<0.01). ET contents in large dosage TCM group was significantly raised (P<0.05). (3) XYZXC could increase amplitude of contraction of the uterus smooth muscle as well as the uterus activity in rats in vivo.

CONCLUSIONXYZXC has obvious anti-inflammatory and hemostatic effects, it has marked effect in treating IUD caused pre- and post-menstruation menorrhagia, the possible mechanism may be: (1) Modulating the synthesis of prostaglandin; (2) Antagonizing the IUD caused fibrinolytic hyperfunction; (3) Promoting the synthesis of ET; (4) Increasing the contractility and activity of uterus smooth muscle.

Adult ; Animals ; Anti-Inflammatory Agents, Non-Steroidal ; therapeutic use ; Capsules ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Hemostatics ; therapeutic use ; Humans ; Intrauterine Devices ; adverse effects ; Menorrhagia ; drug therapy ; etiology ; Mice ; Phytotherapy ; Rats ; Rats, Sprague-Dawley ; Rats, Wistar ; Uterine Contraction ; drug effects