What is a Foreign Body in the Uterus?
Intrauterine contraceptives (IUD) and their fragments, fetal bone fragments, and various ligatures are referred to foreign bodies in the uterus.
Symptoms of Foreign Bodies in the Uterus
The clinical picture of foreign bodies in the uterus is most often manifested by various disorders of the menstrual function (menorrhagia, menometrorrhagia, acyclic blood discharge). With a long stay of a foreign body in the uterus, secondary infertility, the phenomenon of chronic endometritis or pyometra are possible. A foreign body in the uterus (fragments of the IUD) may remain asymptomatic.
The pain syndrome accompanies uterine perforation of the IUD and its further migration to neighboring organs with possible perforation. Migration of the IUD to the epiploon, rectosigmoid angle of the large intestine, retroperitoneal space, bladder, to the cecum, to the appendix, to the small intestine, to the appendages of the uterus is not excluded.
Bone fragments usually become an accidental finding in patients with irregular menstruation, prolonged endometritis or secondary infertility. With careful collection of anamnesis, abnormal pregnancies are detected in a large period (13-14 weeks or more), complicated, as a rule, by prolonged bleeding, sometimes with repeated curettage of the uterus cavity.
Ligatures, usually silk or polyester, are detected in patients with chronic endometritis and pyometra with caesarean section or conservative myomectomy in history. These patients complain of persistent purulent discharge from the genital tract, which are not susceptible to massive antibiotic therapy, and secondary infertility.
Diagnosis of Foreign Bodies in the Uterus
Foreign bodies are removed from the uterus during hysteroscopy using special endoscopic instruments. It is not recommended to try to remove the IUD without visible whiskers blindly, with various devices. Such attempts usually lead to deformation and fragmentation of the IUD, and sometimes to the perforation of the uterus. If uterine perforation is suspected, IUDs jointly perform hysteroscopy and laparoscopy.
If, according to ultrasound data, fragments of the IUD are determined in the myometrium, and during hysteroscopy and laparoscopy, you should not try to extract these fragments
In the postoperative period after removal of a foreign body from the uterus, antibacterial therapy is recommended, taking into account the sensitivity of flora to the drug.
Treatment of Foreign Bodies in the Uterus
Foreign bodies are removed from the uterus during hysteroscopy using special endoscopic instruments. It is not recommended to try to remove the IUD without visible whiskers blindly, with various devices. Such attempts usually lead to deformation and fragmentation of the IUD, and sometimes to the perforation of the uterus. If uterine perforation is suspected, IUDs jointly perform hysteroscopy and laparoscopy.
If, according to ultrasound data, fragments of the IUD are determined in the myometrium, and during hysteroscopy and laparoscopy, you should not try to extract these fragments
In the postoperative period after removal of a foreign body from the uterus, antibacterial therapy is recommended, taking into account the sensitivity of flora to the drug.