Study of cervical papanicolaou smear in intrauterine contraceptive device users in a tertiary care hospital

Background: The use of intrauterine contraceptive device (IUCD) generally has been known to be safe and effective but tends to have some side effects. Reproductive tract infection is one of the major complications caused by prolonged usage of an IUCD. Cervical smears have shown an increase in inflammation, inflammatory epithelial changes, or metaplastic cells among the IUCD users as compared to nonusers. There is also a predisposition to higher rate of infections such as Actinomyces, atypical squamous cells of undetermined significance, and low-grade squamous intraepithelial lesion. Aims and Objectives: The aim of this study was to study changes in cervical cytology in IUCD users and to assess the risk of epithelial cell abnormalities among IUCD users compared to nonusers. Materials and Methods: A 2-year cross-sectional study was carried out to screen Papanicolaou (Pap) smears in women of the reproductive age group who were categorized as IUCD and non-IUCD users. Results and Observations: A total of 1100 (550 + 550) Pap smears from IUCD and non-IUCD users were analyzed. Among IUCD users, 544 cases (98.90%) were adequate for reporting including 533 cases (97.98%) showing negative for intraepithelial lesion or malignancy (NILM) and 11 cases (2.02%) showing epithelial cell abnormality (ECA). In non-IUCD users, 541 cases (98.36%) were adequate for reporting. Among these, 538 cases (99.44%) showed NILM and 3 cases (0.56%) showed ECA. Conclusion: In IUCD users, the prevalence of infections and ECA is higher than non-IUCD users.