Women's perceptions with use of Implanon® contraceptive device at a primary healthcare facility in KwaZulu-Natal

Background: Early 2014, subdermal contraceptive implant was introduced in South Africa, Implanon® NXT, aiming to expand the method mix, increase effectiveness and availability to long-acting contraceptives. The initial uptake was extremely high, but concerns have been raised with treatment failure and high number of removals reported. Aim: The study focuses on describing women's perceptions with use of Implanon® at a primary health care (PHC) facility in KwaZulu-Natal. Setting: This study was conducted at a selected primary health care (PHC) facility in KwaZuluNatal. Methods: A quantitative, descriptive study design was used. Through purposive sampling, a sample of 60 women from 15 to 50 years old were recruited. Data were gathered through a structured questionnaire and analysed using SPSS 24 software. Results: Study findings show that slightly above half of respondents, 32 or 58.1% expressed satisfaction towards the implant, 20 or 40.9% had stopped using the implant as a result of its major implications. It was found that an edge above half of respondents continued using the implant 28 or 50.9%, while close to half had abandoned it (27 or 49.1%). Some respondents reported that they were experiencing heavy menstrual bleeding and low sex drive as serious unwanted side effects forcing them to stop using Implanon®. Conclusion: Side-effects and poor screening, counselling and support are major reasons for early removal. It is imperative to develop an effective screening tool and to re-train healthcare workers on Implanon® NXT. Contributions: This article contributes to increase awareness of women's perceptions about Implanon® contraceptive.

Eritema nodoso asociado al uso de anillo vaginal anticonceptivo / Erythema nodosum associated with the use of contraceptive vaginal ring

El eritema nodoso (EN) es la forma de paniculitis más común. Este trastorno representa una reacción de hipersensibilidad frente a diferentes antígenos, así como múltiples enfermedades sistémicas y fármacos, aunque en la mayoría de casos se desconoce la causa. Nuevos fármacos se añaden a la lista de involucrados en la etiopatogenia del eritema nodoso conforme van pasando los años, siendo uno de ellos los anticonceptivos hormonales orales combinados. El objetivo de este trabajo es proponer una relación entre los estrógenos de cualquier método anticonceptivo como puede ser el anillo vaginal combinado y la aparición del eritema nodoso.

Erythema nodosum (EN) is the most common form of panniculitis. This disorder represents a hypersensitivity reaction in front of different antigens, as well as multiple systemic diseases and drugs, although in most cases the cause is unknown. New drugs are added to the list of those involved in the etiopathogenesis of erythema nodosum as the years go by, one of them being combined oral hormonal contraceptives. The objective of this study is to propose a relationship between estrogens from any contraceptive method such as the combined vaginal ring and the appearance of erythema nodosum.

Ultrasonography of intrauterine devices

The intrauterine device (IUD) is gaining popularity as a reversible form of contraception. Ultrasonography serves as first-line imaging for the evaluation of IUD position in patients with pelvic pain, abnormal bleeding, or absent retrieval strings. This review highlights the imaging of both properly positioned and malpositioned IUDs. The problems associated with malpositioned IUDs include expulsion, displacement, embedment, and perforation. Management considerations depend on the severity of the malposition and the presence or absence of symptoms. Three-dimensional ultrasonography has proven to be more sensitive in the evaluation of more subtle findings of malposition, particularly side-arm embedment. Familiarity with the ultrasonographic features of properly positioned and malpositioned IUDs is essential.

Estudio PIENSA: efecto de la asesoría sobre la elección de anticonceptivos hormonales combinados en mujeres chilenas / PIENSA study: effect of advice on the choice of combined hormonal contraceptives in Chilean women

Objetivos: Evaluar la asesoría acerca de los anticonceptivos hormonales combinados de auto administración por parte de profesionales de la salud y cómo influye en el cambio o elección del método a utilizar. Método: Durante la consulta ginecológica habitual, se registra la elección del método anticonceptivo (MAC) combinado de auto administración (píldora, anillo o parche transdérmico) previa a la asesoría del médico y posterior a esta. El registro se realiza por medio de una encuesta que debe llenar la paciente y otra a completar por el médico. Resultados: Luego de la asesoría, de las 867 mujeres participantes un 11,6 por ciento variaron su opción de MAC elegido previamente. La píldora, originalmente el método más elegido, disminuyó en las preferencias, aunque continuó siéndolo y las otras opciones aumentaron. La píldora anticonceptiva bajó en un 13,4 por ciento desde su elección inicial, el anillo vaginal y el parche transdérmico incrementaron su elección en un 63,6 y 56,7 por ciento respectivamente. Conclusión: Las píldoras son el MAC hormonal combinado preferido por las mujeres participantes. Sin embargo entregándo una información estandarizada se produce un impacto en la elección anticonceptiva, favoreciendo los métodos menos tradicionales y de uso prolongado como son el anillo vaginal y parche transdérmico.

Objectives: To evaluate the impact of health care professional counseling in the choice of combined self-administered contraceptive method. It also assesses how such advice influences in the final contraceptive choice or how it changes from the original. Method: During routine gynecological consultation, the patient's self-administered contraceptive method (pill, vaginal ring and transdermal patch) preference was registered. This was done before and after physician counseling, through a survey filled by both the patient and the physician. Results: After counseling, of the 867 women who participated, 11.6 percent changed their previously chosen contraceptive. The pill, originally the chosen method of the majority of women, decreased in terms of preference; although the pill continued to be the preferred contraceptive method, preference for other methods increased. The contraceptive pill decreased 13.4 percent in the preference rating, while the choice of the vaginal ring and the transdermal patch increased by 63.65 and 56.7 percent respectively. Conclusion: The pill is women's preferred combined self-administered contraceptive method. Nevertheless during counseling, a standardized information impacts in the contraceptive choice increasing the preference of less conventional methods as transdermal patch and vaginal ring.

Contracepção em mulheres com condições clínicas especiais. Critérios médicos e elegibilidade / Contraception in women with special clinical conditions. Medical criteria and eligibility

O planejamento familiar é importante para a saúde física, mental e social das mulheres e de suas famílias. O planejamento de uma gravidez em mulheres portadoras de condições médicas especiais tem importância ainda maior, uma vez que a garantia de uma gestação saudável e de feto viável se torna extremamente dificultada. Infelizmente, algumas condições médicas inviabilizam o uso de métodos contraceptivos de forma segura. Apesar de inúmeros estudos terem demonstrado a segurança e efetividade do uso de contraceptivos hormonais em mulheres saudáveis, ainda não dispomos de dados completos no que se refere às mulheres portadoras de condições clínicas especiais. Esta revisão, baseada em evidências científicas e no American College of Obstetrics and Gynecology Practice Bulletin, traz informações para auxiliar os médicos e as mulheres portadoras de condições clínicas especiais a fazer uma opção quanto à seleção do método contraceptivo. Esta revisão traz informações sobre novas tecnologias para planejamento familiar, incluindo contracepção hormonal oral, contraceptivo de emergência, contracepção injetável, anel vaginal, implantes subdérmico e transdérmico e dispositivo intrauterino.

Pregnancy planning is important for the physical, mental, and social health of women and families. For women with underlying medical disorders, pregnancy planning assumes even greater importance, because ensuring a healthy woman and healthy child becomes more challenging. Unfortunately, some medical conditions also complicate the ability to use reliable contraception safely. Although numerous studies have addressed the safety and effectiveness of hormonal contraceptive use in healthy women, data are far less complete for women with underlying medical problems or other special circumstances.Using the best available scientific evidence and based on the American College of Obstetrics and Gynecology Practice Bulletin, this review provides information to help clinicians and women with coexisting medical conditions to make decisions regardingthe selection and appropriateness of various hormonal contraceptives. The review includes recent advances in the development of oral contraception, emergency contraception, injectable contraception, vaginal rings, subdermal implants, transdermal contraception andintrauterine devices.

Preparation and release mechanism of gestodene reservoir-type intravaginal rings / 药学学报

This study taking gestodene (GEST) as a model, investigated the factors affecting reservoir-type intravaginal ring (IVR)'s drug release. This paper reported a gestodene intravaginal ring of reservoir design, comprising a gestodene silicone elastomer core encased in a non-medicated silicone sheath, separately manufactured by reaction injection moulding at 80 degrees C and heating vulcanization at 130 degrees C is reported. The test investigated the factors affecting drug release through a single variable method, taking the drug release rates of 21 days as standards. When changing the thickness of the controlling sheath outside, the ratio of the first day of drug release and mean daily release (MDR), named the relatively burst effect, is closing to 1 with the thickness of controlling sheath increasing, while the 1.25 mm sheath corresponding to 1.04 controlled the burst release effectively; a positive correlation (r = 0.992 2) existed between the average drug release (Q/t) and drug loading (A) within a certain range. The C6-165 controlling sheath with high solubility of GEST is easier to achieve controlled release of the drug; GEST crystalline power is more effective to implement controlled release of drugs among difficent states of the drug. A 1/4 fractional segment core gives a relatively burst effect of 1.76, while the 1/1 and 1/2 are 1.93 and 1.87 separately, at the same drug loading, concluding that use of a fractional segment core would allow development of a suitable GEST reservoir IVR. In summary, GEST reservoir-type IVR could be adjusted by the thickness of controlling sheath, the loading of drug, the material properties of controlling sheath, the dispersion state of drug, the additive composition and structure of intravaginal ring, to control the drug release behavior and achieve the desired drug release rate.

Efficacy of combined contraceptive vaginal ring versus oral contraceptive pills in achieving hypothalamic-pituitary-ovarian axis suppression in egg donor in vitro fertilization cycles

Our study compares the efficacy of the combined contraceptive vaginal ring to oral contraceptive pills [OCPs] for hypothalamic-pituitary-ovarian [HPO] axis suppression in egg donor in vitro fertilization [IVF] cycles. Our retrospective cohort study includes patients from the Center for Assisted Reproduction [CARE] in Bedford, Texas undergoing IVF cycles as egg donors from January 2003 through December 2009. Twenty-five and thirty-nine women were treated with OCPs and the combined contraceptive vaginal ring, respectively. Statistical analyses were performed using the SigmaStat Software package [Systat, Chicago, IL]. Data were analyzed by t or Mann-whitney test and Chi-square of Fisher exact test. Statistical significance was set at p<0.05. Prior to gonadotropin initiation, endometrial thickness and serum estradiol were 5.6 +/- 2.6 mm and 33.6 +/- 19.9 pg/ml in the OCP group and 6.0 +/- 2.4 mm and 36.6 +/- 24.3 pg/ml in the combined contraceptive vaginal ring group, respectively [p=0.49 and p=0.33]. Average serum FSH and LH were 1.7 +/- 1.9 and 1.7 +/- 2.5 mIU/ml in the OCP group and 1.7 +/- 1.6 and 1.2 +/- 1.4 mIU/ml in the combined contraceptive vaginal ring group, respectively [p=0.45 and p=0.95]. No significant differences were found for gonadotropin requirement, peak estradiol, maximal endometrial thickness, number of oocytes retrieved, number of normally fertilized embryos, number of cryopreserved embryos, or live birth rates. The combined contraceptive vaginal ring is effective for HPO axis suppression n in egg donor IVF cycles and associated with cycle characteristics similar to those observed with OCP treatment. The combined contraceptive vaginal ring may provide an important advantage over OCPs due to improved patient compliance

Urinary Tract Infection in Postmenopausal Women

Urinary tract infection (UTI) is the most common bacterial infection in women in general and in postmenopausal women in particular. Two groups of elderly women with recurrent UTI should be differentiated regarding age and general status: healthy, young postmenopausal women aged 50 to 70 years who are neither institutionalized or catheterized and elderly institutionalized women with or without a catheter. Bacteriuria occurs more often in elderly functionally impaired women, but in general it is asymptomatic. However, the risk factors associated with recurrent UTI in elderly women are not widely described. In a multivariate analysis it was found that urinary incontinence, a history of UTI before menopause, and nonsecretor status were strongly associated with recurrent UTI in young postmenopausal women. Another study described the incidence and risk factors of acute cystitis among nondiabetic and diabetic postmenopausal women. Independent predictors of infection included insulin-treated patients and a lifetime history of urinary infection. Borderline associations included a history of vaginal estrogen cream use in the past month, kidney stones, and asymptomatic bacteriuria at baseline. Another important factor in postmenopausal women is the potential role that estrogen deficiency plays in the development of bacteriuria. There are at least two studies showing a beneficial effect of estrogen in the management of recurrent bacteriuria in elderly women. One of these studies showed that vaginal estrogen cream reduced vaginal pH from 5.5+/-0.7 to 3.6+/-1.0, restored lactobacillus, and decreased new episodes of UTI. Another study reported similar results using an estriol vaginal ring. However, contradictory results are found in the literature. For example, additional studies found that the use of estriol-containing vaginal pessaries was less effective than oral nitrofurantoin macrocrystals in preventing UTI in postmenopausal women. Two other studies also did not find any benefit in the reduction of UTI by oral estrogen therapy. Unfortunately, the use of estrogen in preventing UTI in postmenopausal women remains questionable. New strategies have been researched for reducing the use of antibiotics in the prevention and treatment of UTI. Two of them are probiotics and cranberry juice or capsules. Although several studies regarding probiotics and cranberry juice or capsules have reported a reduction of episodes of UTI, there is no conclusive evidence that they are useful in the prevention of UTI in postmenopausal women. As for the optimal drug, dosage, and length of treatment for UTI in the elderly, there are no studies comparing these data with the treatment for young women.

Argumentos de rechazo de dispositivo intrauterino y oclusión tubárica bilateral postparto, en usuarias de una unidad de segundo nivel de Cárdenas, Tabasco, México / Rejection arguments of intrauterine device and bilateral tubal occlusion post-childbirth, in users of a second level unit of Cardenas, Tabasco, Mexico

Objetivo: identificar los argumentos de rechazo manifestados por las puérperas derecho-habientes usuarias del Instituto Mexicano del Seguro Social (IMSS), Cárdenas, Tabasco, que rechazan métodos de planificación familiar (MPF) postparto de alta continuidad (dispositivo intrauterino y oclusión tubárica bilateral). Material y métodos: estudio de diseño observacional, prospectivo, transversal y descriptivo. Puérperas, derechohabientes usuarias del IMSS, Cárdenas, Tabasco. Agosto/2006–Marzo/2007. Muestra por conveniencia: pacientes cuyo parto fue atendido en el Hospital General de Zona No. 2 de Cárdenas, Tabasco, captadas durante el pase diario de visita. Variables: edad, estado civil, número de embarazos, vía del parto, argumento de rechazo del MPF. Los datos se obtuvieron por método de encuesta, previo consentimiento informado. Se estimaron estadísticas descriptivas, y se analizó parcialmente el discurso. Resultados: 183 puerperas de 15 a 44 años de edad. Estado civil predominante 140 casadas (76,5%). Media de embarazos 2, moda 2, mínimo 1, máximo 9. Vía de atención del parto: 85 vaginales (46,4%), 98 abdominales (53,6%). Aceptantes de MPF 105 (57,4%), rechazantes 78 (42,6%). 18 manifestaron 1 argumento (23%), 60 declararon más de 1 argumento (77%). Argumento de rechazo manifestado como primera consideración: “mi pareja y/o familia no lo consiente” 34,2%. Explicación brindada con mayor frecuencia como segundo argumento de rechazo: “temor a complicaciones médicas secundarias a éste” 35,6%. Conclusiones: La cobertura de anticoncepción postparto en la unidad es baja. Los argumentos manifestados por las pacientes al rechazar los MPF, muestran que la mujer posee falta de sentimiento de propiedad sobre su cuerpo; y que existe desinformación sobre el uso, indicaciones, beneficios y riesgos de los métodos de planificación familiar...

Objective: identify the rejection arguments manifested for the puerperae claimant users of the Mexican Institute of Social Security (MISS), Cardenas, Tabasco, that reject family planning methods post-childbirth of high continuity (intrauterine device and bilateral tubal occlusion). Material and methods: study of design observational, prospective, traverse and descriptive. Puerperae, claimant users of the MISS, Cardenas, Tabasco. August/2006-March/2007. Sample for convenience: patients whose childbirth was attended in the General Hospital of Zone No. 2 of Cardenas, Tabasco, captured during the daily pass of visit. Variables: age, civil status, pregnancies number, childbirth way, rejection argument of the family planning methods. Data was obtained for survey method, previous informed consent. Be estimated descriptive statistics, and be analyzed partially the discourse. Results: 183 puerperae of 15 to 44 years-old. Predominant civil status 140 married (76,5%). Pregnancies mean 2, mode 2, minimum 1, maximum 9. Childbirth way: 85 vaginal (46,4%), 98 abdominal (53,6%). Family planning methods acceptors 105 (57,4%) rejection 78 (42,6%). 18 manifested 1 argument (23%), 60 declared more of 1 argument (77%). Rejection argument manifested as fi rst consideration: “my partner and/or family doesn’t consent” 34,2%. Explication offered with major frequency as second rejection argument: “fear to medial complications secondary to it” 35,6%. Conclusions: The covering of family planning post-childbirth in the medical unit is low. The arguments manifested for the patients to reject the FPM, show that the women possess lack of property sentiment over your body; and that exist disinformation over use, indications, benefi ts and risks of the family planning methods...

Dispositivo intrauterino en cavidad abdominal: presentación de un caso y revisión del tema / Intrauterine device in the abdominal cavity

Se presenta un caso de un dispositivo intrauterino (ASA de Lippes) en cavidad abdominal en una paciente a la que se le practica una histerectomía por fibromatosis uterina y que pensaba le había sido retirado hacia 15 años. Cursó asintomática e infertil hasta seis meses antes de la intervención. Se hace una revisión del tema donde se plantea la posibilidad de perforación uterina en el momento de la inserción y/o migración del dispositivo hacia el peritoneo pelviano...

Development of reversible oviductal polyethylene contraceptive plugs / 中国医疗器械杂志

An introduction of the design, features and contraceptive principle of an oviduct contraceptive plug is given in this paper. The plug is made of polyethylene, based on the oviductal morphology. It can be introduced and removed by a hysteroscope and is expected to be a transcervical, implantable and permanent intratubal contraceptive device.

Migración del dispositivo intrauterino / Migration of intrauterine device

Se plantea el caso de una paciente manejada en el servicio de ginecología del Hospital de San José condiagnóstico de perforación postinserción y migración de DIU. Es una eventualidad poco frecuentey la tasa reportada es de 0.87 por cada 1.000 inserciones.1 La perforación postinserción se clasificacomo primaria si los síntomas se presentan de manera inmediata o secundaria cuando la migración esconsecuencia de contracciones reactivas del útero y la sintomatología se manifiesta de manera tardía.2Para su extracción, según su localización y complicaciones conocidas, se requiere personal calificadoy experiencia quirúrgica. A través de la ginecología endoscópica se ha logrado disminuir la extraccióna través de laparotomía. Sin embargo, en ciertas ocasiones, como se expone en este caso, no se lograsu ubicación o se requiere de otros procedimientos reparativos, según los hallazgos o complicacionesencontrados en la intervención.

Uso prolongado do implante contraceptivo intrauterino gynefix e seus efeitos sobre a saúde das usuárias / Prolonged use of the intrauterine contraceptive implant gynefix and its effects upon the health of the users

Estudo do uso prolongado do implante contraceptivo GyneFix, no período compreendido entre 19892001. Foram acompanhadas 246 pacientes, com idade de 18-45 anos, média de 28,3 ± 0,5 anos, com paridade d0 a 5 partos, com média de 1,2 ± 0,2 partos que foram distribuídas em períodos de observação de até 2 anos, de a 4 anos, de 4 a 6 anos e acima de 6 anos de uso. A inserção foi realizada por médicos especialmente treinados comeste implante, e os exames de controle foram feitos com 1, 3, 6, 9 e 12 meses após a inserção e, a seguir, anualmente sendo anotados os eventos de gravidez, dor , expulsão, sangramento, processo inflamatório pélvico, dados do exame clínico e laboratorial e outras complicações. Os achados mais frequentes foram a tricomoníase, monilíase, dor a manuseio e palpação uterina, cistite, sangramento uterino prolongado e aumentado. As usuárias, com esses achado foram medicadas e não tiveram o DIU removido. Entre as 210 usuárias, no período de até dois anos, 146 (69,5% não tiveram qualquer queixa e seu exame físico foi normal. Nos períodos seguintes, de 2-4, 4-6 a acima de 6 ano não tiveram qualquer queixa 69,2% , 75% , e 72 %, respectivamente. Do total de 1212 anos/mulher de observação verificou-se uma baixa incidência de efeitos colaterais com o uso deste implante contraceptivo. Este novo DIU apresenta como um dos melhores em uso, confirmando a expectativa dos inventores em relação à expulsão, do sangramento e inflamação, além de uma baixa incidência de gravidez indesejada. Seu principal problema é a expulsão (rara) não percebida pela paciente, apresentando nestes casos o risco de gravidez. Ao mesmo tempo, pode-acrescentar que este implante não altera as condições de saúde da usuária, mesmo após mais de dez anos de uso.

Experiência com o dispositivo intrauterino de levonorgestrel / An experience with the levonorgestrel intrauterine device

Atualização dos dados da pesquisa sobre o dispositivo intrauterino (DIU) liberador de 20 mcg/dia de levonorgestrel (DIU-LNG) comparado com o DIU de cobre, TCu 380A, em estudo multicêntrico da Organização Mundial da Saúde (OMS), desenvolvida na Maternidade Therezinha de Jesús e no CEPECS, para o Centro de Biologia da Reprodução da UFJF. Em 200 mulheres, foram avaliados os índices de continuação, os abandonos, os efeitos colaterais e outros eventos ao longo de 4 anos com 3972 meses/mulher para o TCu 380A e com 3544 meses/mulher de observação com o DIU-LNG. Neste período houve 21 descontinuações com o TCu 380A e 35 com o DIU-LNG. Considerando-se que 19 usuárias pediram para retirar o DIU porque queriam nova gestação o índice de continuação com os dois DIUs é bastante aceitável ( 79% com o DIU de cobre e 65% com o DIU-LNG). Os efeitos colaterais mais freqüentes com o uso do DIU-LNG foram o sangramento irregular e a amenorréia. Trinta usuárias tiveram amenorréia, mas apenas 6 tiveram seu DIU removido por esta causa, as demais aceitaram continuar. Não houve neste período nenhuma gravidez, e apenas 4 pacientes foram perdidas no seguimento. O DIU-LNG por sua alta eficácia e poucos efeitos colaterais é uma promessa de um novo e excepcional método contraceptivo.

GyneFix: um novo dispositivo intrauterino / GyneFix: a new intrauterine device

Experiência de 6 anos, com 178 usuárias do novo dispositivo intrauterino GyneFix é relatada, com o objetivo de verificar se este dispositivo apresenta alguma melhora em relação aos novos DIUs existentes no mercado. Com mais de 6100 meses – mulher de observação, pode-se sugerir que as expectativas do inventor do GyneFix foram em parte concretizadas: não houve descontinuação por dor ou processo inflamatório pélvico e ocorreu uma queda nas expulsões (0,7 por cem mulheres-ano), sendo mantida a eficácia contraceptiva (0,8 por 100 mulheres/ano); no entanto não melhora significativamente o volume de perda sanguínea menstrual em relação ao DIU TCu 380A, e não houve alteração nos estoques de ferro do organismo (medidos pela ferritina sérica) pelo menos nos dois primeiros anos de uso. Deve-se chamar a atenção que a aplicação do Gynefix requer treinamento especial para evitar as falhas nas inserções e resta a preocupação de uma expulsão não percebida pela usuária com a possibilidade de gravidez subsequente.

effects of levonorgestrel releasing intrauterine device on menstrual bleeding pattern, endometrial thickness and uterine vasculature

The study aimed to evaluate the effect of the levonorgestrel releasing intrauterine device [LNG-IUD] on menstrual bleeding pattern, endometrial thickness and uterine vasculature. The study was a prospective controlled study evaluating the effects of LNG-IUD compared with the copper intrauterine device [IUD]. Twenty women carrying LNG-IUS [group I] were compared with thirty women carrying copper IUD in a control group [group II]. Clinical measures of menstrual bleeding, endometrial thickness and Doppler flow of the cervical branch of the uterine artery and spiral artery were evaluated and compared between the two groups. Doppler flow in the cervical branch of the uterine artery did not reveal any changes between the groups I, II [resistance index 0.59 +/- 0.08 and 0.6 +/- 0.09 respectively]. Endometrial thickness was significantly thinner in group I compared with group II [3.9 +/- 1.21 and 7.5 +/- 2.94mm respectively]. Subendometrial flow in the spiral artery was detected in six women only of group I [30%] and in all women of group II [100%]. The present study offers explanation for the change of the menstrual bleeding pattern [specially amenorrhea and oligomenorrhoea] in LNG-IUD users, i.e. a local progestational effect on the endometrium with no change in the uterine vasculature. This adds to the therapeutic value of the device and would lessen the discontinuation rate specially if properly addressed to women in the pre-contraceptive examination

NORPLANT en Nicaragua? NORPLANT es un método en estudio existen muchas alternativas probadas / NORPLANT in Nicaragua? NORPLANT is a method in study many proven alternatives they exist

Proporciona información sobre la reunión realizada por los funcionarios del MINSA y el Fondo de Naciones Unidas para Asuntos de Población y otras Organización para presentar la la introducción del Método Anticonceptivo NORPLANT. En el documento el primer capítulo hace una breve referencia de lo que ha sido a través de las últimas décadas las políticas de control de la natalidad. El segundo capítulo hace una reseña de los métodos anticonceptivos más utilizados en nuestro país. En el tercer capítulo señala con profundidad lo que es el método anticonceptivo NORPLANT. El cuarto capítulo recoge la memoria del foro debate de muchas mujeres interesadas en conocer el método

Nuevo método de esterilización ambulatoria y permanente con técnica histeroscopia, essure / New method of permanent and ambulatory sterilization with histeroscopic technic, Essure

Objetivo: Presentamos nuestra experiencia en la inserción de un nuevo método de esterilización permanente vía histeroscópica, Essure. Se revisa el procedimiento de inserción, complicaciones, tolerancia, grado de satisfacción y aceptación de usuaria. Método: Entre enero y febrero de 2005 se realizaron 5 esterilizaciones con Essure en la Unidad de Ginecología y Obstetricia de Clínica Las Condes. Resultados: Se colocó el dispositivo en ambas trompas exitosamente en todas las pacientes. Rango de tiempo operatorio: 10-30 minutos. No hubo complicaciones intraoperatorias. Todas expresaron buena tolerancia y un alto grado de satisfacción frente al procedimiento de inserción histeroscópico. Lo recomendarían por su rapidez, carácter ambulatorio y ausencia de dolor. Durante el postoperatorio un caso presentó metrorragia leve y algia pélvica moderada. Conclusiones: Nuestra primera experiencia en la inserción del dispositivo intra tubario mostró ser un procedimiento bien tolerado y con buena aceptación por las pacientes.

IUCD theads of acting as uterine foreign body following removal of intrauterine contraceptive device

Most published reports on intrauterine foreign bodies involve retained bony fragments after abortion, causing menstrual disturbances and infertility. But IUCD threads acting as uterine foreign body after removal of the contraceptive device is reported for the first time