Cytologic studies after insertion of intrauterine contraceptive devices (IUD) (author's transl)

Cervical smears of 554 women using IUDs were examined. The following criteria were evaluated: 1. Age distribution, 2. maturation index of the vaginal epithelium, 3. vaginal flora, 4. cytologic criteria of inflammation, 5. period of time between insertion of the IUD and the cytological examination, 6. final cytologic diagnosis. 554 women without IUD and normal gynaecological status served as a control group. It was the goal of the study to find out, firstly if IUDs in situ produce typical and specific changes in the cytologic pattern and secondly if the rate of suspicious and positive findings is increased: In IUD using women the rate of cases with unphysiologic vaginal flora is increased, the rate of inflammatory cytologic specimen is also higher than in the control group. The rate of inflammatory smears decreases with the increasing interval of time between insertion and cytological examination. IUD typical changes could be observed only in so far as in this group the cytologic signs of chronic cervicitis were increased. Inflammatory alterations are the reason for the higher rate of "suspicious" smears in the group of IUD-users. There was no higher rate of praecancerous lesions among the IUD users. The importance of these results for the clinical management are pointed out.