Abstract

PIP: The author presents his observations on 842 IUD insertions done between 1976-80. Patients were between 16-52, and 74.35% were nulliparous; all patients were treated with paracervical block with lidocaine prior to IUD insertion. 2.49% experienced light painful sensations during insertion; only in 2 cases was the pain strong. The percentage of 2.49% compares very favorably with that of 17% in nulliparous women and 6% in multiparous women reported in the literature; undoubtedly the anesthesia contributed to keep vasovagal reactions within the limit of 2 cases of total, 4 cases of moderate, and 32 cases of slight lipothymia. Out of 335 patients interviewed 3 months after IUD insertion 78.8% were not experiencing any pain, and 63.97% had no metrorrhagia; duration of menstruation was unchanged in 56% of cases, and prolonged in 37% of cases; menstrual loss was mainly unchanged, and menstrual pain increased in 32% of cases. Of the 842 IUDs inserted, 412 were removed, and half of them during the first 24 months of use; only 13.3% of patients had a medical reason for removal, and 9.71% of devices were removed because of partial expulsion. There were 14 unplanned pregnancies, or a Pearl index of 1.5; 1 pregnancy was ectopic. Continuation rate was 38.83%, and patients' satisfaction was 60.09%; 47.12% of removed IUDs were immediately replaced with a new device.