Comparative contraceptive effectiveness of levonorgestrel-releasing and copper intrauterine devices: the European Active Surveillance Study for Intrauterine Devices

Heinemann, Klaas; Reed, Suzanne; Moehner, Sabine; Minh, Thai Do

doi:10.1016/j.contraception.2015.01.011

Cited by 117 publications

(81 citation statements)

References 17 publications

(30 reference statements)

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“…Although uterine perforation can occur at the time of insertion, serious complications rarely occur. In a large cohort, uterine perforation risk was found to be six-fold higher in lactating women [3]. An immobile or retroverted uterus or a uterus with a myometrial defect may be classified as other patient-related risk factors.…”

Section: Discussionmentioning

confidence: 99%

Colonic perforation due to the migration of an intrauterine device (IUD): surgical management for acute abdomen

Günakan¹,

Buluş²,

Polat³

2018

Ortadogu Tıp Derg

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ÖzRahim içi araç(RİA) sık kullanılan makul ve geri dönüşümlü bir kontrasepsiyon yöntemidir. Çalışmamızın amacı RİA'ya bağlı ciddi bir komplikasyonu literature tartışması eşliğinde sunmaktır.Otuz yaşında 3 paritesi olan ve 3 yıldır bakırlı RİA'sı olan kadın akut abdomen, vajinal akıntı ve 38.8 O C ateş ile değerendirildi. Laboratuvar testlerinde C-Reaktif Protein ve beyaz küre yüksekliği mevcuttu. Radyolojik olarak, endometrial kavite sınırları dışında RİA ve bilateral komplike hiperintens pelvik kitleler rapor edildi. Hastaya diagnostik laparatomi yapıldı. Pelvik apseye bağlı frozen pelvis durumu olduğu gözlendi. Altta yatan nedenin ise rektosigmoid bileşkeye migrate olan ve perforasyona sebep olan RİA olduğu saptandı. Hastaya subtotal histerektomi, sol salfingoogforektomi yapılıp ve loop kolostomi açıldı. 10 günlük takibin ardından hasta komplikasyonsuz taburcu edildi.RİA düşük komplikasyon oranıyla kolay uygulanabilir bir kontraseptif yöntemdir. Uzun dönemde inflamatuvar durumlara yol açarak uterus bütünlüğünü bozabilir. Abdominal kaviteye migrasyon karın ağrısı olan hastalarda özellikle akılda tutulması gereken ciddi bir RİA komplikasyonudur. A 30 year-old woman with 3 parities with a copper IUD for 3 years was evaluated for anacute abdomen, vaginal dischargeand a38.8 O C fever.Laboratory tests revealed elevation of white blood count and C-reactive protein (CRP). Radiologically, the IUD was seen to be localised outside the borders of the endometrial cavity, and bilateral complicated hyperintense pelvic masses were evident. Subsequently, the patient underwent a diagnostic laparotomy. A frozen pelvis caused by a pelvic abscess was revealed. The underlying reason for this was the IUD that had migrated to the rectosigmoid junction, resulting in a perforation. Subtotal hysterectomy, left salphingooophorectomy and loop colostomy were performed.After 10 days of follow-up, the patient was discharged without any further complication.IUDs represent an easily applicable contraceptive method with low complication rates. However, over along term, an IUD may cause inflammatory disorders and disturb the integrity of the uterus. Migration into the abdominal cavity is a serious IUD complication that physicians should be aware of, particularly in patients with abdominal pain.

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Section: Discussionmentioning

confidence: 99%

Colonic perforation due to the migration of an intrauterine device (IUD): surgical management for acute abdomen

Günakan¹,

Buluş²,

Polat³

2018

Ortadogu Tıp Derg

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“…1,2 Their use in the United States has increased in recent years, rising from 8.5% in 2009 to 11.6% in 2012. 3 IUDs are highly cost-effective contraceptives.…”

Section: Introductionmentioning

confidence: 99%

Continuation of copper and levonorgestrel intrauterine devices: a retrospective cohort study

Phillips

Hofler

Modest

et al. 2017

American Journal of Obstetrics and Gynecology

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Background Studies conflict on whether the duration of use of the copper intrauterine device is longer than that of the levonorgestrel intra-uterine device, and whether women who continue using intrauterine devices differ from those who discontinue. Objective We sought to assess continuation rates and performance of levonorgestrel intrauterine devices compared with copper intrauterine devices over a 5-year period. Study Design We performed a retrospective cohort study of 1164 individuals who underwent intrauterine device placement at an urban academic medical center. The analysis focused on a comparison of continuation rates between those using levonorgestrel intrauterine device and copper intrauterine device, factors associated with discontinuation, and intrauterine device performance. We assessed the differences in continuation at discrete time points, pregnancy, and expulsion rates using χ2 tests and calculated hazard ratios using a multivariable Cox model. Results Of 1164 women who underwent contraceptive intrauterine device insertion, 956 had follow-up data available. At 2 years, 64.9% of levonorgestrel intrauterine device users continued their device, compared with 57.7% of copper intrauterine device users (P = .11). At 4 years, continuation rates were 45.1% for levonorgestrel intrauterine device and 32.6% for copper intrauterine device (P < .01), and at 5 years continuation rates were 28.1% for levonorgestrel intrauterine device and 23.8% for copper intrauterine device (P = .33). Black race, primiparity, and age were positively associated with discontinuation; education was not. The hazard ratio for discontinuation of levonorgestrel intrauterine device compared with copper intrauterine device >4 years was 0.71 (95% confidence interval, 0.55–0.93) and >5 years was 0.82 (95% confidence interval, 0.64–1.05) after adjusting for race, age, parity, and education. Copper intrauterine device users were more likely to experience expulsion (10.2% copper intrauterine device vs 4.9% levonorgestrel intrauterine device, P < .01) over the study period and to become pregnant in the first year of use (1.6% copper intrauterine device vs 0.1% levonorgestrel intrauterine device, P < .01). Conclusion We found a difference in continuation rates between levonorgestrel and copper intrauterine device users at 4 years but not at 5 years. Copper intrauterine device users were more likely to experience expulsion and pregnancy.

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“…In terms of safety and efficacy, the LNG-releasing IUD appeared to have a favorable profile compared to alternatives [68]. The hormonal IUDs are highly efficacious, with less pregnancy rates than the copper IUDs [69]. However, discontinuation of treatment has been reported due to dysmenorrhea, pain, device expulsion, pelvic inflammatory disease, and infection [70,71].…”

Section: Non-oral Contraceptionmentioning

confidence: 99%

Oral Contraceptives after Bariatric Surgery

Schlatter

2017

Obes Facts

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Objective: Bariatric surgery offers a highly effective mode of treatment for obese patients. Some procedures such as bypass cause an alteration in normal gastrointestinal tract with possible consequences for the uptake of orally administered drugs. Methods: We assessed the literature to ascertain whether the use of oral drugs and especially oral contraceptives is effective and adequate after bariatric surgery. Results: The bioavailability of drugs could be affected by the solubility and pH of the modified medium after bariatric surgery and by the loss of gastrointestinal transporters. Bariatric surgery could potentially result in a transient change in the absorption of drugs such as analgesics, antibiotics, antiarrhythmics, anticoagulants, psychotropic, and oral contraceptive drugs. Effective contraception is especially critical in the postoperative period, and implants might be representing a safe contraceptive method in women undergoing bariatric surgery. Conclusion: Each drug will have to be evaluated with respect to its site of absorption and its mechanism of absorption, with special attention on parameters influencing the effectiveness of the absorption processes.

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Comparative contraceptive effectiveness of levonorgestrel-releasing and copper intrauterine devices: the European Active Surveillance Study for Intrauterine Devices

Cited by 117 publications

References 17 publications

Colonic perforation due to the migration of an intrauterine device (IUD): surgical management for acute abdomen

Colonic perforation due to the migration of an intrauterine device (IUD): surgical management for acute abdomen

Continuation of copper and levonorgestrel intrauterine devices: a retrospective cohort study

Oral Contraceptives after Bariatric Surgery

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