title: The incidence of actinomyces-like organisms in Papanicolaou-stained smears of copper- and levonorgestrel-releasing intrauterine devices.
abstract: Actinomyces-like organisms (ALOs) are a common finding in Papanicolaou-stained cervico-vaginal smears (PAP smears) of women using an intrauterine device (IUD). The incidence of ALOs positive PAP smears depends on the type of IUD. Pelvic actinomycosis is a severe disease that may require hysterectomy and salpingo-oophorectomy. In a retrospective study we compared the incidence of ALOs positive PAP smears in users of the new levonorgestrel-releasing intrauterine device (LNG-IUD) (n = 52) with the incidence in Multiload Copper IUD (ML375) users (n = 104). All IUDs had been inserted from 1996-1998. Women with a follow-up period of more than 9 months were included into the final analysis (LNG-IUD: n = 34; ML375: n = 65). The incidence of ALOs in LNG-IUD users (2.9%) was significantly lower than in ML375 users (20%). Clinical consequences of ALOs positive PAP smears are discussed controversially. The low incidence in the LNG-IUD users probably leads to less IUD-removals, reinsertions and less pelvic-inflammatory-diseases.
authors.affiliation: Clinic of Endocrinology, Department of Gynecology and Obstetrics, University Hospital, Zurich, Switzerland. gabriele.merki@fhk.usz.ch
authors.forename: G S
authors.initials: GS
authors.lastname: Merki-Feld
authors.forename: E
authors.initials: E
authors.lastname: Lebeda
authors.forename: B
authors.initials: B
authors.lastname: Hogg
authors.forename: P J
authors.initials: PJ
authors.lastname: Keller
mesh_terms: D000190:Actinomyces / Q000302:isolation & purification*; D000196:Actinomycosis; D005260:Female; D006801:Humans; D007435:Intrauterine Devices, Copper / Q000009:adverse effects*; D007436:Intrauterine Devices, Medicated / Q000009:adverse effects*; D016912:Levonorgestrel; D065006:Papanicolaou Test; D000292:Pelvic Inflammatory Disease / Q000382:microbiology; D014626:Vaginal Smears
chemical_list: D016912:Levonorgestrel