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Re: Ring IUDFrom: rchudacoff@mylinuxisp.comSat Jan 5 13:31:42 2008
As far as efficacy...now much better can it be than 99.9%. If it is so much more difficult to place please tell me advantage. Richard Chudacoff, MD, FACOG -sent from my Treo 650 -----Original Message----- From: novamed@greenmail.ch (Novamed) Subj: Ring IUD Date: Sat Jan 5, 2008 12:22 pm Size: 4K To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net> Dear ladies and Gentlemen (I am sorry for my English.) I read your Website. I am Gynaecologist and I am convinced still today, that Ring IUD is better then T-shaped IUD. In Europe nobody believes that. It is really true, that is very difficult to insert, you need a Dilatation and of course an anaesthesia, the risk of infection is high. Please send me your opinion about my opinion even this is very different and be very critical with me I will thank you. 1. We suppose the ring bearing Cooper, and can be inserted linear it would be better without the risk of infection, because the Ring have no spikes no parts witch can provide side effects, and I think the side effects by ring IUD are coming mostly from subclinical infection, because the inserting process is very traumatically and this influence also the expulsion rate that we can not define because we are not following the subclinical cases, only the manifest Infections. 2. I mean subclinical Infection with sometimes exacerbation from laboratory sign as higher CRP and leucocytosis witch examination we don’t make as a routine if somebody has an IUD, we make only if somebody have several clinical manifestation, and so we can never find out, what is happening in other cases, and I can also not exclud transitoric infections relating with insert procedure. Another Problem everybody believes the Ring has a high Expulsion rate. That is not true. If you are inserting posplacentar of course you have a high expulsionsrate I found in an UNO-study the SSR 16,5 % . that is really high, but they forget to tell, if you compare two different IUD`you have to look after the same condition. Postplacentar every IUD has a highy expulsionsrate. Already I found a Mexican study they even sutured the T-shaped IUD on the uterin wall und the expulsion rate was more higher 22,8%. For two years ago I have never seen a Ring IUD, and even I didn't hear about Ring IUD. I made a lot of searching in Internet, and I found the Ring of Graefenberg, after that the Ota and Yusei Ring, and after that a study about Springcoil and G. Clarck Patent witch are not a closed Ring. 3. My opinion about the Ring, the ring is the most ideal shape if you are looking after the anatomy, what now you can describe with hysteroscopie. At the end of a hysteroscopy you can see the following picture. Between the anterior wall and posterior wall you can see a hiatus shaped as a half moon. This has a convex plan, or concav because the version of uterus too not only because of felxion.The IUD self has an orisontal plan it doesn’t matter witch IUD are You think about. Now think about a T-shaped IUD as the two plans are meeting together in cavum uteri what is happened ? Now think about a Ring IUD as the two plans are meeting together in cavum uteri what happened ? And now you can answer the following question for yourself related to the following study. I found a study in Hungary with Springcoil If you are interested I will send you please give me a massage. The Springcoil as you know is an opening Ring it is not closed ring. I found an extraordinary high total expulsion rate the question is why? The Answer is simple if you are thinking about the hysteroscopic picture. An opened ring has two arms. What is happening, if the Uterus wall exercise a pressure on the arm. The arm will be dislocated. The dislocated arm exercise a pressure on the uterin wall. What will be happen constantly pressure ischaemie pain, the opened ring must be removed. If the ring is closed it will be much better then the shaped IUD because a closed ring can better adapt to the two different plan. Now you have the answer why it comes sometimes rarely that you have to remove an absolutly good placed ultrasound controlled T-shaped IUD. and you have the answer why the Gynefix has an expulsion rate almost zero. Of course you have more experience in this thema. Please give me your experience and your opinion about my three points.. I am waiting with great interest and impatiently your answer it doesn't matter how it is. Sincerely Dr.G.Gyrffy --- message truncated ---
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