ABSTRACT
Ultrasound and short-wave diathermy are widely used in physiotherapy to induce heating of deep tissues, since this causes a concomitant increase in local blood flow. A metallic implant in the treated field is generally regarded as a contra-indication to diathermy because of the risk of thermodamage to surrounding tissues. It is not certain, however, if copperbearing IUDs contain sufficient metal as to constitute a risk. In order to exclude the possibility that diathermy might lead to intra-uterine burns in women using copperbearing IUDs a technique was devised of measuring temperatures in the copper wire of an IUD in situ during short-wave an ultrasonic therapy. The results indicate diathermy to be perfectly safe in women whit copper-bearing IUDs.
PIP: Physicians at the hospital in Tonder, Denmark performed a dilation and curettage (D&C) procedure on 8 44-58 year old women who were experiencing perimenopausal bleeding problems. Prior to the D&C, the physicians 1st inserted a glass/ethanol thermometer with a Multiload copper 250 IUD attached then a thermometer with no copper IUD attached into the uterus to measure the temperature during short wave or ultrasonic diathermy. Since diathermy induces therapeutic tissue temperatures and increases blood flow, it is used to treat several conditions in women of childbearing age. So the physicians wanted to determine if diathermy in women bearing copper IUDs results in thermogenic damage to the uterine lining. Short wave diathermy at recommended dose intensity of minode 3 (maximum 400 W) resulted in a small increase in intrauterine temperature when a noncopper bearing thermometer was used (36.4 degrees Celsius-37 degrees Celsius). The corresponding temperatures for the thermometer with a copper bearing IUD attached were slightly higher (36.8 degrees Celsius-37.6 degrees Celsius) perhaps due to the metallic content of the thermometer. Ultrasonic diathermy at recommended dose intensity of 1.5 W/square cm) resulted in an insignificant increase in intrauterine temperature (patient 1, 36.1 degrees Celsius-37 degrees Celsius; patient 2, 36.5 degrees Celsius-37.3 degrees Celsius.) The physicians suggested that this minute rise may reflect ultrasonic diathermy's insufficient penetration of the uterine cavity. None of these temperatures reached the level needed to induce a protective increase in blood flow (38.1 degrees Celsius). Indeed none reached harmful levels. Therefore diathermy at dose intensities within the normal therapeutic range can be safely used to treat women with copper bearing IUDs.
