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  • Title: [Comparative changes of exocervical exfoliative cytology in intrauterine device users].
    Author: Mossa B, Polli R, Lo Preiato A.
    Journal: Minerva Ginecol; 1986; 38(1-2):81-4. PubMed ID: 3960380.
    Abstract:
    The widespread use of IUDs has led to a series of questions on their possible hazards; however, research in this field is inconclusive. It has been suspected that IUD usage can cause varying degrees of dysplasia in some patients, but up to now most of the research has had conflicting results. Therefore, a study of the modifications of the exocervical epithelium induced by prolonged IUD usage was conducted in Italy on 1000 women who had used the device between 1976-1982. As a control group another 1000 women who had used either another method of contraception or no method at all were used. The age of the patients was restricted to 20-35 years. The sample was fixed with alcohol solution and colored according to the Papanicolaou technique. All of the exocervical epithelium modifications that could have constituted a scaly metaplasia, dyscariosis, mild dysplasia, medium dysplasia, or carcinoma in situ were registered. Out of a total of 1000 IUD users, lesions of various types were found in only 34 cases. There was never a cellular modification from metaplasia or from dyscariosis to dysplasia, while the only case of carcinoma in situ was diagnosed after a deponent cytology for light dysplasia. Out of these 34 cases, 80% of the lesions showed up within the 1st 2 years following the application. This holds true with virtually all types of lesions. The findings show that there is a slight rise in the incidence of lesions in IUD users. According to the results, the scaly metaplasia was 1.3 times greater, dyscariosis 1.4 times greater, and mild dysplasia 3.5 times greater in IUD users than in the control group. There is a slightly greater risk of lesions among IUD users, but this risk does not seem to be enough to advise against their use. However, women who use IUDs should have more frequent regular medical examinations because of the slight increase in risk.
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