Sources:
1. Dou Qin.Analysis of the clinical effect of immediate intrauterine device insertion after abortion[C]//Yulin Medical Association.Proceedings of the 3rd National Medical Research Forum (2).Renai Community Health Service Center, Longquanyi District, Chengdu;,2023:6.
2. Wang Yanhua.Effectiveness analysis of carboprost methyl ester suppositories and misoprostol tablets for intrauterine device removal in postmenopausal women[J].Da Doctor,2023,8(01):35-37.
3. Fu Tsunami, Wang Kai, Zhang Xuan, et al.One case of intestinal necrosis caused by the migration of metal birth control rings into the abdominal cavity[J].Chinese Journal of Modern Surgery,2022,26(04):317-318.
When it comes to the term "IUD", many people will be unfamiliar with it, and the knowledge about the removal of the IUD is even less so, no, a woman who has had an IUD placement and does not remove it in time has an accident.
During the Spring Festival of the Year of the Rabbit, Xiao Ting, who was working outside, returned home and had a long-lost "mother-daughter talk" with her mother, and during the chat, Xiao Ting learned that her 54-year-old mother had been menopausal for 3 years, and Xiao Ting also thought to herself: "No wonder every time I talk to my mother on the phone, I hear her and my father arguing, and I feel that my mother's temper has also rushed a lot." ”
To Xiaoting's surprise, her mother had placed a "birth control ring". But Xiaoting always thought that only foreigners would use it as a contraceptive measure. Xiaoting immediately searched for information related to "birth control rings" on the Internet:
The "IUD" is also known as an intrauterine device, and its contraceptive principle is to change the intrauterine environment, destroy sperm and fertilized eggs, and further interfere with the implantation of fertilized eggs. "Birth control ring" was mostly used in the female population in the mainland in the last century, and it was the main contraceptive measure at that time, accounting for as much as 70%~80%.
The birth control ring has a service life, usually the life of the metal ring is 20 years, the V-ring made of silicone and rubber is only 7~10 years, and the copper T-ring is only 10~15 years, so the "birth control ring" can not stay in the female body for too long.
Seeing this, Xiaoting hurriedly asked her mother, "Mom, how long have you had the birth control ring?" The mother thought for a moment and said directly: "After giving birth to you by caesarean section, I asked the doctor to do this for me, it should have been almost 25 years now." ”
After listening to this, Xiao Ting asked worriedly: "Then you have not experienced any discomfort after so many years?" The mother saw Xiao Ting's thoughts, so she hurriedly responded that there was no particularly obvious discomfort.
But Xiaoting knew that her mother's words were white lies, and they all said that "mother's love is silent", and she usually carried it alone when she was sick. However, when Xiaoting retrieved relevant information, she learned that the birth control ring should be removed within a year after menopause, so she ignored her mother's excuse and resolutely decided to accompany her to the hospital after the year.
However, before they could go to the hospital, Xiaoting's mother had an accident. On the fourth day of the Lunar New Year, Xiaoting's family went to visit a relative's house for the New Year, but on the way because the ground was icy and very slippery, Xiaoting's mother stumbled and almost fell. But that night, she suddenly had abdominal pain and vomited all the food she had eaten during the day.
Seeing this scene, Xiaoting hurriedly drove her mother to the local hospital. The doctor's examination found that Xiaoting's mother's lower abdomen was obviously distended, but the upper abdomen was relatively empty and tender. The doctor immediately performed a CT scan of her abdomen, and the results showed that her intestines were significantly dilated, and there was a small amount of fluid in the pelvis, and a ring-shaped high-density shadow could be seen in the middle.
This shadow is most likely the IUD. Xiaoting is also superstitious: sure enough, the "Murphy's Law" has been fulfilled, and thinking about things in a bad way is really bad.
The doctor then diagnosed "adhesive intestinal obstruction due to the displacement of the IUD". In other words, the IUD runs from the uterus to the abdominal cavity, and "makes a big fuss" in it, making the intestines stick together. Does this sound like it's really going to happen? It's actually possible.
Because the structure of the female pelvis is different from that of men, it is not completely closed, and there is a gap at the end of the fallopian tube, through which the female pelvis and abdomen are connected to the outside world. The IUD also enters the abdominal cavity through this gap.
The most basic treatment for any type of intestinal obstruction is to first give fluids to correct the water and electrolyte imbalance caused by heavy vomiting. Adhesive intestinal obstruction alone can be improved by non-surgical treatment. Just when Xiaoting breathed a sigh of relief for this, she was told by the doctor that her mother's situation was not so simple.
In the subsequent abdominal puncture, the doctor found that a large amount of bloody fluid flowed out of the puncture needle, and the doctor realized at this moment that Xiaoting's mother was very likely to have this extremely serious intestinal obstruction, so he decided to electively operate on her...
In order to further clarify the diagnosis, the doctor re-did an abdominal CT and a blood routine for Xiaoting's mother, and finally found that part of her small intestine was nested in the contraceptive ring, thus forming a dangerous strangulated intestinal obstruction, which is an indication for surgery, otherwise it will be life-threatening.
The small IUD can have such serious consequences, so with the development of contraception in recent years, the IUD has become a relic of the times.
But in fact, the common complication of the IUD is intrauterine displacement, which is mostly embedded in the myometrium, which is commonly known as "growing into the flesh", or downward displacement. Cases like Xiaoting's mother, where the IUD is displaced into the abdominal cavity and intestinal obstruction occurs due to a single abdominal force, are relatively rare, but not impossible. Therefore, the IUD must be taken.
The director of the Department of Gynecology also reminded that the currently recognized age for taking the ring is within 2 years after menopause, so try not to take the ring after 2 years. Because after menopause, the uterus shrinks, but the size of the IUD remains the same, which increases the risk of ring displacement and incarceration. Data show that the difficulty of removing the ring will increase by 18%~35% after 2 years of menopause, and 4.7% of women will even fail to remove the ring.
Removal is generally non-invasive: a uterine probe is used to enter the genital tract and then the IUD is hooked out. For rings that have "grown into the flesh", the cervix is dilated first, and then carefully removed.
There are two types of problems that can arise after the removal of the ring:
1. Pain. The pain caused by the removal of the ring is similar to menstrual cramps and is caused by damage to the lining of the uterus. However, the birth of the "painless ring removal" technology has also brought good news to women who do not tolerate pain.
2. Bleeding. There may be a small amount of bloody discharge 1~2 days after the removal of the ring, which is a normal phenomenon. However, if there is prolonged bleeding, you should go to the hospital.
In the end, the doctor performed laparotomy and bowel anastomosis on Xiaoting's mother under general anesthesia, that is, the necrotic small intestine was removed because of the IUD, and the two ports were connected, and the IUD was successfully removed. After this ordeal, Xiaoting's mother is also a lot haggard. Therefore, in order to prevent similar accidents, it is recommended that women who have had IUDs have their IUDs removed within 1 year after menopause.