| Molding of the uterus following intrauterine contraceptive device removal: documentation by hysterosalpingography. | |
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MedLine Citation:
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PMID: 3438967 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Intrauterine contraceptive devices (IUDs) distort the uterine cavity. We report 2 cases of endometrial molding demonstrated by hysterosalpingography (HSG) following removal of an IUD. Other processes may cause filling defects in the uterine cavity including inflammatory synechiae (Asherman's syndrome), tuberculosis, endometrial hyperplasia, and polyps. Whenever filling defects are seen, the history of IUD usage should be determined. The presence of an IUD can impart an irregular wavy outline (molding) to the uterine cavity. The authors present 2 cases of characteristic endometrial molding documented by hysterosalpingography (HSG) following IUD removal. Case 1 involved a 29-year-old gravida 0 para 0 woman evaluated for primary infertility. A Copper 7 IUD had been removed 6 months prior to evaluation. HSG study revealed symmetrical contour defects in the lateral uterine wall where the tips of the IUD were embedded. In Case 2, that of a 28-year-old gravida 8 para 0, there had been multiple spontaneous abortions following 2 therapeutic pregnancy terminations. The cause was thought to be cervical incompetence, but cerclage was unsuccessful. HSG revealed intrauterine adhesions which were treated by hysteroscopy and lysis. A Lippes Loop was inserted to maintain the uterine cavity and prevent adhesion recurrence. When the IUD was removed 6 weeks later, HSG showed endometrial deformity caused by the loop. The persistence of changes in the uterus up to 1 year after IUD removal suggests that molding is not a temporary phenomenon. The molding process is presumably due to some element of scarring and fibrosis. Persistent uterine irregularity or molding may be a contributing factor in some patients with secondary infertility by inhibiting implantation of the embryo. This observation contradicts the widespread assumption that the IUD has no lasting effects on fertility once removed. |
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Authors:
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C A Viglione; J T Cuttino; R L Clark |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Urologic radiology Volume: 9 ISSN: 0171-1091 ISO Abbreviation: Urol Radiol Publication Date: 1987 |
Date Detail:
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Created Date: 1988-03-28 Completed Date: 1988-03-28 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 7909483 Medline TA: Urol Radiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 188-90 Citation Subset: IM; J |
Affiliation:
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Department of Radiology, University of North Carolina School of Medicine, Chapel Hill. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Female Humans Hysterosalpingography* Intrauterine Devices* Uterine Diseases / radiography Uterus / pathology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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