Skip to main content
British Medical Journal (Clinical Research Ed.) logoLink to British Medical Journal (Clinical Research Ed.)
. 1981 Apr 11;282(6271):1189–1191. doi: 10.1136/bmj.282.6271.1189

Bacteriological colonisation of uterine cavity: role of tailed intrauterine contraceptive device.

R A Sparks, B G Purrier, P J Watt, M Elstein
PMCID: PMC1505233  PMID: 6788128

Abstract

Intrauterine contraceptive devices (IUCDs) are thought to cause pelvic inflammatory disease by allowing vaginal bacteria to pass into the uterus along the tail of the device. In this study the uterine cavities of 22 women using an IUCD were examined by a multiple biopsy technique. All five uteruses with a tailless IUCD were sterile but 15 out of 17 with a tailed device contained bacteria. The bacteria had not reached the fundus and most were commensals. The bacteria were not introduced by insertion of the IUCD as bacteria were present in several cases long after insertion. No differences in bacterial count were found between monofilamentous and multifilamentous devices. Bacteria were cultured from only four devices, which suggested that the bacteria adhere to the endometrium and not to the device. The bacteria in the cavity represent interference by the tail with the protective mechanisms of the uterus, which explains the increase in pelvic inflammatory disease in IUCD users.

Full text

PDF
1189

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Booth M., Beral V., Guillebaud J. Effect of age on pelvic inflammatory disease in nulliparous women using a copper 7 intrauterine contraceptive device. Br Med J. 1980 Jul 12;281(6233):114–114. doi: 10.1136/bmj.281.6233.114. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Elstein M., Birnberg C., Mills W., Eckstein P. Pelvic inflammation and the intrauterine contraceptive device. Proc R Soc Med. 1967 Apr;60(4):397–398. [PMC free article] [PubMed] [Google Scholar]
  3. Eschenbach D. A., Harnisch J. P., Holmes K. K. Pathogenesis of acute pelvic inflammatory disease: role of contraception and other risk factors. Am J Obstet Gynecol. 1977 Aug 15;128(8):838–850. doi: 10.1016/0002-9378(77)90051-5. [DOI] [PubMed] [Google Scholar]
  4. Golditch I. M., Huston J. E. Serious pelvic infections associated with intrauterine contraceptive device. Int J Fertil. 1973;18(3):156–160. [PubMed] [Google Scholar]
  5. Ishihama A., Nishijima M., Wada H. Bacteriological study on the users of intrauterine contraceptive devices. Acta Obstet Gynaecol Jpn. 1970 Apr;17(2):77–80. [PubMed] [Google Scholar]
  6. Kozinn P. J., Pomerance W., Caroline L., Okas A., Taschdjian C. Antimicrobial properties of the endometrium. Obstet Gynecol. 1968 Jun;31(6):840–844. [PubMed] [Google Scholar]
  7. Mishell D. R., Jr, Bell J. H., Good R. G., Moyer D. L. The intrauterine device: a bacteriologic study of the endometrial cavity. Am J Obstet Gynecol. 1966 Sep 1;96(1):119–126. doi: 10.1016/s0002-9378(16)34650-6. [DOI] [PubMed] [Google Scholar]
  8. Osser S., Gullberg B., Liedholm P., Sjöberg N. O. Risk of pelvic inflammatory disease among intrauterine-device users irrespective of previous pregnancy. Lancet. 1980 Feb 23;1(8165):386–388. doi: 10.1016/s0140-6736(80)90942-3. [DOI] [PubMed] [Google Scholar]
  9. Purrier B. G., Sparks R. A., Watt P. J., Elstein M. In vitro study of the possible role of the intrauterine contraceptive device tail in ascending infection of the genital tract. Br J Obstet Gynaecol. 1979 May;86(5):374–378. doi: 10.1111/j.1471-0528.1979.tb10613.x. [DOI] [PubMed] [Google Scholar]
  10. Rebello R., Green F. H., Fox H. A study of the secretory immune system of the female genital tract. Br J Obstet Gynaecol. 1975 Oct;82(10):812–816. [PubMed] [Google Scholar]
  11. Sparks R. A., Purrier B. G., Watt P. J., Elstein M. The bacteriology of the cervix and uterus. Br J Obstet Gynaecol. 1977 Sep;84(9):701–704. doi: 10.1111/j.1471-0528.1977.tb12684.x. [DOI] [PubMed] [Google Scholar]
  12. Tatum H. J., Schmidt F. H., Phillips D., McCarty M., O'Leary W. M. The Dalkon Shield controversy. Structural and bacteriological studies of IUD tails. JAMA. 1975 Feb 17;231(7):711–717. doi: 10.1001/jama.231.7.711. [DOI] [PubMed] [Google Scholar]
  13. WILLSON J. R., BOLLINGER C. C., LEDGER W. J. THE EFFECT OF AN INTRAUTERINE CONTRACEPTIVE DEVICE ON THE BACTERIAL FLORA OF THE ENDOMETRIAL CAVITY. Am J Obstet Gynecol. 1964 Nov 15;90:726–739. doi: 10.1016/0002-9378(64)90934-2. [DOI] [PubMed] [Google Scholar]
  14. Weström L., Bengtsson L. P., Mårdh P. A. The risk of pelvic inflammatory disease in women using intrauterine contraceptive devices as compared to non-users. Lancet. 1976 Jul 31;2(7979):221–224. doi: 10.1016/s0140-6736(76)91025-4. [DOI] [PubMed] [Google Scholar]

Articles from British Medical Journal (Clinical research ed.) are provided here courtesy of BMJ Publishing Group

RESOURCES