[A review on the impact of IUD in cervical cytology: Mardin Region Data].
OBJECTIVE
The aim of the study was to provide an overview to infectious and reactive cytological effects of intrauterine devices, which are one of the most widely used methods of contraception, with the results we obtained in the Mardin region.


METHODS
We evaluated together the pap smears of the 300 intrauterine device (+) and 300 intrauterine device (-) patients sent to the pathology department in the period of 2010-2011. Genital infection rates and frequency of reactive-dysplastic cellular changes were statistically compared between the groups together with the literature data.


RESULTS
In the intrauterine device (+) group, 2 (+) and more severe inflammation was observed in 66.3% of cases. Bacterial vaginosis (26%), candida (12%) and trichomonas vaginalis (8%) were recorded as the most common infectious agents, followed by actinomyces (4%). Between the groups of intrauterine device (+) and (-), no significant difference was observed in terms of the incidence of squamous cell abnormalities, except ASC-US (p=0.02). In the intrauterine device (+) group, the presence of atypical glandular cells and reactive findings was significantly higher than the control group. After the removal of the intrauterine device, 61 cases that had control smears showed regression, with a rate of %75.4 (n=46).


CONCLUSIONS
The local irritative and inflammatory effect of intrauterine devices basically causes reactive and regenerative changes mostly in glandular cells. Intrauterine devices disrupt the genital flora and significantly increase the frequency of genital infection by creating a foreign body reaction.
İstanbul Üniversitesi, Tıp Fakültesi, Patoloji Anabilim Dalı, İstanbul, Türkiye. isikakgun@hotmail.com
Işık İkbal
Iİ
Bariş
Ayşe Nur
AN
Keleş
D000293:Adolescent; D000328:Adult; D002177:Candidiasis / Q000453:epidemiology / Q000473:pathology; D016022:Case-Control Studies; D002584:Cervix Uteri / Q000473:pathology*; D005260:Female; D006801:Humans; D015994:Incidence; D007249:Inflammation / Q000453:epidemiology* / Q000473:pathology*; D007434:Intrauterine Devices / Q000009:adverse effects*; D008875:Middle Aged; D014247:Trichomonas Vaginitis / Q000453:epidemiology / Q000473:pathology; D016585:Vaginosis, Bacterial / Q000453:epidemiology / Q000473:pathology; D055815:Young Adult