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The relationship between the uterus and the IUD was studied selectively with hysterosalpingograms in 18 menorrhagic women previously treated with Meclofenamic acid (M Ac.), a well known anti-inflammatory drug. Major anomalies (embedding, perforation, rotation) were found in 28.6% of those patients who responded positively to M Ac. In contrast, major anomalies were found in 63.6% of those patients who responded negatively to the drug. It is proposed that the negative response to M Ac. might be due to severe macroscopic disturbances of the uterine wall-IUD relationship. The degree of response to M Ac. might contribute to the decision to remove the IUD from menorrhagic women.
In addition, 84.7% anomalies (deformities, embedding, perforation) in the uterine-IUD relationship were found in 13 women with a T-shape IUD device. The fact that those anomalies are related to the tip of the horizontal arm justifies future studies using shortened arms to diminish hypermenorrhea induced by T-shape devices or attempts to use IUDs which do not have the conventional plastic frame, as in the Cu-Fix IUD which has been mentioned as particularly useful to prevent bleeding side effects and pain induced by conventional IUDs. The Cu-Fix IUD consists of 6 sleeves made of pure (99.99%) copper, each sleeve with a length of 5 mm and an outer diameter of approximately 2.2 mm, threaded on surgical 00 monofilament polypropylene (ProleneR, Ethicon). The total area of exposed copper is approximately 390 mm2. The sleeves are prevented from sliding off the suture by 2 smaller copper tubules crushed on the thread in both ends of the IUD structure. This thread-type, copper-bearing device has been designed to overcome the most common IUD-related problems, bleeding and pain.
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Accepted: June 20, 1989
Received: January 31, 1989
© 1989 Published by Elsevier Inc.