Foreign body of a uterus

Description:

Foreign body of a uterus – the existence of an alien subject in a cavity or a wall of a uterus which is followed by a complex of pathological disturbances. Foreign bodys of a uterus can prove bleedings, a chronic endometritis, a pyometra, a pain syndrome, secondary infertility. Foreign bodys of a uterus by means of ultrasonography, hysteroscopies, sounding are found. Removal of foreign bodys of a uterus can be made in the course of hysteroscopy, a scraping of a cavity of the uterus, a laparoscopy; in the complicated cases the hysterectomy can be required.
In a cavity of the uterus existence of freely lying or grown intrauterine contraceptives and their parts (threads, a plastic coat hanger, metal obyolomk), operational ligatures, bone fragments of a fruit quite often is found. Sometimes the foreign bodys which got into a uterus are encapsulated and a long time do not prove. In other cases foreign bodys can move at reduction of muscles, cause perforation of a wall of a uterus and migrate in an abdominal cavity or retroperitoneal space. Infection of foreign bodys of a uterus causes chronically current inflammatory process which is not giving in to active therapy.
The problem of detection and removal of foreign bodys of a uterus in clinical gynecology has the relevance in connection with probability of development of a wide range of dangerous complications.

Symptoms of a foreign body of a uterus:

Clinically foreign bodys of a uterus usually prove changes of menstrual function - menorrhagias, metrorrhagias, bloody allocations. In case of long stay in a uterus foreign bodys cause a chronic endometritis, secondary infertility, sometimes – development of a pyometra. Existence of fragments of Naval Forces can be asymptomatic.
Emergence of a pain syndrome, as a rule, indicates perforation of a wall of a uterus by parts of Naval Forces and can lead to further migration of objects and injuries of the next bodies. Peryoforation of a wall of a uterus can be partial (Naval Forces is implemented into a myometrium) and full (Naval Forces completely or somewhat goes beyond a uterus wall). At migration of foreign bodys from a uterus they can be found in the field of an epiploon, a rectosigmoid corner, a bladder, an appendicular shoot, appendages of a uterus, retroperitoneal space, in a blind or small bowel.
Bone residues of a fruit most often accidentally are found in the patients inspected concerning a long endometritis, disturbances of a menstrual cycle, secondary infertility. In the anamnesis at this category of women abortion the term of 13-14 and more weeks, as a rule, complicated by bleeding and a repeated scraping of a cavity of the uterus comes to light.
Mylar or silk ligatures usually come to light at patients with the endometritis, a pyometra postponed obstetric or gynecologic interventions (Cesarean section, a conservative myomectomy, etc.). In this regard patients are disturbed purulent bleach, secondary infertility.

Diagnosis:

The main method of detection of a foreign body of a uterus which the gynecology has today is hysteroscopy. Other tool researches (survey on a chair, sounding, ultrasonography, a laparoscopy) have auxiliary value.
When carrying out a gynecologic research the foreign body in a uterus can be found by means of the probe. A lack of sounding is the impossibility of definition of exact finding of a subject, its character, a form and size, the relation to walls of a uterus and the next bodies.
Performing transvaginal or transabdominal ultrasonography more informatively for detection of intrauterine contraceptives. Fragments of Naval Forces in the form of zones of the increased echogenicity can directly be found in a cavity of the uterus or in the thickness of a myometrium. OUSE diagnosis of bone remains and ligatures in a cavity of the uterus also the maloinformativna is complicated.
The Gisteroskopichesky picture depends on character of a foreign body of a uterus. It is long being in a uterus foreign bodys can become covered by an endometria, intrauterine synechias, salts, and also to form decubituses in a uterus wall. By means of hysteroscopy definition of localization of a foreign body of a uterus and carrying out its aim removal is possible.
The bacteriological research of a smear allows to pick up an adequate antibioticotherapia, based on sensitivity of microflora to drug.
The foreign bodys which are freely lying in an abdominal cavity are found at a survey X-ray analysis.

Treatment of a foreign body of a uterus:

The foreign objects lying in a cavity of the uterus can be precisely taken via the channel of a gisterokop by endoscopic tools. It is not recommended to delete foreign bodys of a uterus blindly as such attempts can lead to fragmentation and deformation of alien objects, and also uterus wall wound.
At detection of partial or full perforation of a wall of a uterus hysteroscopy is combined with carrying out a laparoscopy.
In case of growing of foreign bodys into thickness of an endometria the scraping of a cavity of the uterus with removal of the found fragments is shown. Sometimes for extraction of foreign bodys colpohysterotomies – to a transvaginal section of a uterus resort.
In situations when foreign bodys go beyond a uterus, get into the next bodies or an abdominal cavity the laparotomy with audit of the interested bodies is made.
If existence of a foreign body in a uterus was complicated by perforation and a massive infection, the hysterectomy can be required. In the post-operational period antimicrobic treatment is carried out.
Prevention of finding of foreign bodys in a uterus consists in careful control of a condition of a cavity of the uterus after removal of Naval Forces, performing abortions, gynecologic operations.