The intrauterine device: a bacteriologic study of the endometrial cavity

Bacterial and histologic studies were performed on endometrium obtained by 2 methods in 2 different groups of patients wearing the IUD. The first group consisted of 75 patients schedules to have elective vaginal hysterectomies in association with culporrhaphy for symptomatic uterine and vaginal relaxation. The second group was made up of 253 patients who elected to use the IUD as a contraceptive. Cultures were obtained transfundally after hysterectomy in the first group and transcervically in the second. The incidence of sterile endometrial cultures was significantly greater when the transfundal method was employed. Using this method of obtaining cultures it was found that positive endometrial cultures were obtained from all uteri in which the IUD had been inserted within the previous 24-hour period. The incidence of positive endometrial cultures rapidly diminished at the time after insertion increased so that after 1 month had elapsed since insertion of the IUD all the endometrial cavities examined were sterile . The results of the study confirm the statements of others that the occurrence of clinical infection of the upper genital tract in patients having the IUD with nylon threads protruding into the vagina is usually due to an unrelated cause such as coital infection. Even when the threads passes through contaminated endocervical mucus sterile cultures were obtained from the portion of the threads within the endometrial cavity as well as from the loop itself. (AUTHORS MODIFIED)