Foreign body of the uterus
A foreign body of the uterus is the presence of a foreign object in the wall or cavity of the uterus. Quite often, intrauterine contraceptives (IUDs) or parts thereof (plastic hangers, metal fragments, threads), fetal bone fragments, surgical ligature and other foreign objects or fragments can be found in the uterine cavity.
The content of the article:
Symptoms of a foreign body of the uterus
Diagnosis of a foreign body of the uterine cavity
Removal of a foreign body from the uterus
Foreign body of the uterus
Sometimes a foreign body in the uterus is encapsulated, and for a long period of time does not make itself felt. However, often a secondary object can move under the influence of muscle contraction, migrate to the retroperitoneal space or the abdominal cavity. As a result, there is a perforation of the uterine wall, which has a very negative effect on this organ. After infection of a foreign body, the uterus is affected by an inflammatory process that cannot be cured with active therapy.
In clinical gynecology, timely removal and detection of foreign bodies of the uterus is of great importance. Otherwise, their presence can provoke the development of many dangerous complications.
Symptoms of a foreign body of the uterus
In most cases, the foreign body of the uterus is manifested by changes in menstrual function — bloody discharge, metrorrhagia, menorrhagia. As a rule, a foreign fragment causes secondary infertility, chronic endometritis, and the development of pyometra. Initially, the uterus does not suffer from these items, everything changes with time.
If fragments of the IUD get into the uterine cavity, it passes without symptoms.
Pain syndrome can occur after the uterine wall ruptures under the influence of parts of the IUD. After that, the particles can flood the entire cavity, the uterus will be subjected to numerous injuries. A neighboring organ also suffers from this. The uterine wall can be completely perforated (the IUD extends beyond the uterine wall) and partially (the IUD is embedded in the myometrium). After that, the foreign object immigrates to the area of the omentum, bladder, rectosigmoid angle, appendicular process, retroperitoneal space, appendages of the uterus, small or caecum.
If we talk about fetal bone remains, they can be detected during the examination of secondary infertility, menstrual disorders, long-term endometritis. That is why it is recommended to repeat such a procedure regularly at least once a year. In this category of women, termination of pregnancy at 13-14 weeks is often observed, followed by repeated curettage of the uterine cavity and the appearance of bleeding.
Silk or dacron ligatures are mainly detected in patients with pyometra, endometritis, gynecological or obstetric interventions (conservative myomectomy, cesarean section, etc.). This causes secondary infertility, purulent whiteness and the like. The uterus is very badly damaged in this case.
Diagnosis of a foreign body of the uterine cavity
In gynecology, the main method of detecting nonresident bodies in the uterus is hysteroscopy. There are also other instrumental methods of research (laparoscopy, examination on a chair, ultrasound, probing), but they are auxiliary in nature.
A foreign fragment during a gynecological examination can be detected using a probe. Probing has one significant drawback. With its help, it will not be possible to determine the exact location of the body, its size and shape, relation to neighboring organs and walls of the uterus, character, and the like.
To detect intrauterine contraceptives, transabdominal or transvaginal ultrasound is suitable, they are more informative. Fragments of the IUD often “attack” the uterine cavity or settle in the thickness of the myometrium. The ultrasound procedure is considered ineffective in the process of searching for bone remains and ligatures that have entered the uterine cavity.
The nature of the foreign body in the uterus has a decisive influence on the hysteroscopic picture. Foreign bodies, after a long stay in the uterus, can be covered with intrauterine synechiae, endometrium and salts. In addition, these objects in the uterine wall can form bedsores in the uterine wall.
Only hysteroscopy allows you to determine the exact location of a foreign body. Without this method of research, it is simply impossible to remove a foreign object, under the influence of which the uterus eventually ceases to perform the functions assigned to it.
Bacteriological examination of the smear also plays a very important role in this process. This technique is designed to select an adequate antibiotic therapy. The sensitivity of the microflora to the drug is taken as a basis.
With the help of an overview radiography, foreign bodies located in the abdominal cavity are detected.
Removal of a foreign body from the uterus
Special endoscopic instruments are used to remove foreign bodies from the uterus. With their help, foreign objects lying in the uterine cavity are precisely pulled through the hysterocope channel. Some clinics practice the removal of foreign fragments without a hysterocope, which is very dangerous. Such an operation can lead to deformation and fragmentation of foreign bodies, which will instantly provoke injuries to the walls of an organ such as the uterus.
Sometimes hysteroscopy is performed in combination with laparoscopy. This applies to situations where a complete or partial perforation of the uterine wall is detected.
Curettage of the uterine cavity is indicated in cases of ingrowth of foreign bodies into the thickness of the endometrium. As a result, the detected fragments will be deleted. As medical practice shows, sometimes to remove foreign bodies, doctors resort to colpohysterotomy (the uterus is dissected through the vagina).
If foreign bodies have gone beyond the uterus and penetrated into the abdominal cavity or neighboring organs, it is necessary to perform a laparotomy, and with an audit of the organs concerned.
There are cases when the presence of foreign fragments in the uterus causes massive infection and perforation. As a result, a hysterectomy should be performed. After the operation, antimicrobial treatment is prescribed to kill all infections that remain in the uterine cavity.
There is a special prevention of finding foreign bodies in the uterus, the essence of which is to carefully monitor the condition of the uterine cavity, especially after abortions, removal of IUDs and gynecological operations.
