Abstract

PIP: A study undertaken to discover whether the incidence and types of intrauterine bacterial growth in IUD users differed from those in nonusers is described. The study 1)compared the early development of infection in IUD users and nonusers, and 2) looked for a correlation between known serious pelvic infection and IUD use. Of 235 patients seen for gynecologic examination (131 IUD users and 104 nonusers), 21 users for 6 months or more and 1 user for less than 4 months had foul-smelling leukorrhea, irregular bleeding, or both. Endometrial cultures were positive in 67% of users, and in 62% of the nonusers. 11 long-term IUD users more than 6 months and 1 nonuser had anaerobic organisms (p less than .01). Of 31 patients admitted for tubo-ovarian or pelvic abcesses, 17 were IUD users, of whom 9 required hysterectomy. Earlier recognition of foul-smelling mucoid discharge on the IUD tail, or abnormal bleeding, or both, as a sign of early pelvic infection, followed by removal of the IUD and institution of appropriate antibiotic therapy, might prevent the more serious sequelae of pelvic inflammation.