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AW: Ring IUDFrom: novamed@greenmail.chSun Jan 6 05:27:01 2008
Dear Mister Chudacoff ! Thank you for Question.Unfortunatly I recevied only a truncated message, but I think I understood your Question, about the advantages. The adventages are the folowing: 1. A Ring IUD can be introduced at first as a linear shaped IUD, and in second time can be closed completely, as a complet Ring as for example as the Graefenbergs-Ring in three steps.The Ring can be used ,also as Hormon-IUD. 2. The Ring-IUD is much more longer as a shift of a T-shaped IUD. That means the effective Substence can be devided, consequently it means you can reduce the diameter of the inserting tube more as T-shaped inserting tubes. 3.Intracavitary transfoming ring procedure/instrument is safed from accidentely injury fo the uterus wall, or corner of the tube.No gynecological experience is necessery to insert it, hausdoctor can aslo insert, if gyneacological condition are OK. No chance to perforate.There is no spike in cavity under procedure. 4.No ultrasound control is necessary after inserting. 5.You can insert also in extremly anteversioflexio. 6. By bearing metall variant there is another know-how near the great amount of effective substences, to make the Pearl Index better. 7. To reduce the contamination chance there is another know-how. 8.The shape as ring is better as another shape, for example T-shaped used today.You can yourself understand why it is better without any clinical study, if you ar thinking of the hysterscopic picture, what are you almost always seeing. At the End of a hysteroscopic intervention you can see a half moon shape. That means two different plans are meeting together intracavitary.A convex plan with the plan of the ring witch horisontal is. Let me give you a primitiv example. The ring is sitting on the hill.This hill is covered with the anterior wall of the uterus.We suppose now the ring is not closed, opened.The anterior unterus wall execise a pressure ont he opened ring.One End of the Ring will be moved in direction of lower pressure, the negativ results are extremly.(See Springcoil study-total expulsionsrate over 60%).If you close the ring completely for example Yusei ring expulsaionsrate 1,9%. Dont forget Yusei ring is not an optimal ring,because this is a doublering with spikes.If you are thinking again about the hysteroscopic picture you will understand why the spikes are a handicap.Also you can understand now why sometimes an optimal situated ultrasound controlled T-shaped IUD must be removed, because of the outstanding pieces, because of pressure and contrapressure produced from the shape of cavity.Because the cavitiy of the uterus has her own schap-memory also, not only the IUD.Now you can understand why the Gynfix from Wildemeersch has almost an Expulsionsrate almost zero. I am convinsed that the Expulsionsrate 1,9% founded from the japanese are related the most of them with sublinical Infection as the results of Grafenberg too.Because they are both of them extracorporary rings with high infection rate by insert.(Mister Watson was more lucky none of the rings was expulsed) Any medical questions and critic are welcome.(Demonstration Modell is ready, know-how from instrument only by seecret agreement possible after europeean law to keep discretion of firminterest) Sincerely Dr.G.Gyoerffy ________________________________ Von: ob-gyn-l@obgyn.net im Auftrag von rchudacoff@mylinuxisp.com ________________________________ Gesendet: Sa 05.01.2008 21:33 An: Multiple recipients of list OB-GYN-L Betreff: Re: Ring IUD 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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