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Self-administered vaginal lidocaine gel for pain management with intrauterinedevice insertion: a blinded, randomized controlled trial A major barrier to intrauterinedevice use is fear of pain during insertion. Trials exploring analgesic interventions for intrauterinedevice insertion have yielded mixed results, and no standardized pain management guidelines currently exist for this procedure. In an abortion-related study, self-administered lidocaine gel over a prolonged time interval showed (...) promise as a method of pain control.The objective of the study was to assess pain control with intrauterinedevice insertion after patient-administered lidocaine gel compared with placebo.We conducted a randomized, blinded trial of women undergoing levonorgestrel or copper intrauterinedevice insertion in an outpatient gynecology clinic between July 2016 and April 2017. Participants self-administered either 20 mL of 2% lidocaine gel or placebo gel vaginally at least 15 minutes prior to intrauterine
Systemic effects of levonorgestrel-releasing intrauterinedevices Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g
Interventions to ease intrauterinedevice (IUD) insertion: a systematic review Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email
IntrauterineDevice Expulsion After Postpartum Placement: A Systematic Review and Meta-analysis To estimate expulsion rates among women with postpartum intrauterinedevice (IUD) placement by timing of insertion, IUD type, and delivery method.We searched PubMed, Cochrane Library, and ClinicalTrials.gov from 1974 to May 2018.We searched databases for any published studies that examined postpartum placement of a copper IUD or levonorgestrel intrauterine system and reported counts of expulsions. We (...) with cesarean delivery (adjusted RR 5.19, 95% CI 3.85-6.99). Analysis of expulsion rates at less than 4 weeks postpartum also indicated that the levonorgestrel intrauterine system was associated with a higher risk of expulsion (adjusted RR 1.91, 95% CI 1.50-2.43) compared with CuT380A.Postpartum IUD expulsion rates vary by timing of placement, delivery method, and IUD type. These results can aid in counseling women to make an informed choice about when to initiate their IUD and to help institutions
Paracervical Block for IntrauterineDevice Placement Among Nulliparous Women: A Randomized Controlled Trial To investigate whether a 20-mL buffered 1% lidocaine paracervical block decreases pain during intrauterinedevice (IUD) placement.In a randomized, single-blind, placebo-controlled trial, women were assigned to receive either a 20-mL buffered 1% lidocaine paracervical block or no block before IUD placement. The primary outcome was pain with IUD placement measured on a 100-mm visual analog
Adolescents and Long-Acting Reversible Contraception: Implants and IntrauterineDevices e130 VOL. 131, NO. 5, MAY 2018 OBSTETRICS & GYNECOLOGY Adolescents and Long-Acting Reversible Contraception: Implants and IntrauterineDevices ABSTRACT: The phenomenon of adolescent childbearing is complex and far reaching, affecting not only the adolescents but also their children and their community. The prevalence and public health effect of adolescent pregnancy reflect complex structural social problems (...) and an unmet need for acceptable and effective contra- ceptive methods in this population. In 2006–2010, 82% of adolescents at risk of unintended pregnancy were currently using contraception, but only 59% used a highly effective method, including any hormonal method or intrauterinedevice. Long-acting reversible contraceptives (LARC) have higher efficacy, higher continuation rates, and higher satisfaction rates compared with short-acting contraceptives among adolescents who choose to use them
Immediate postpartum levonorgestrel intrauterinedevice insertion and breast-feeding outcomes: a noninferiority randomized controlled trial Immediate postpartum levonorgestrel intrauterinedevice insertion is increasing in frequency in the United States, but few studies have investigated the effect of early placement on breast-feeding outcomes.This study examined the effect of immediate vs delayed postpartum levonorgestrel intrauterinedevice insertion on breast-feeding outcomes.We conducted (...) this noninferiority randomized controlled trial at the University of Utah and the University of New Mexico Health Sciences Centers from February 2014 through March 2016. Eligible women were pregnant and planned to breast-feed, spoke English or Spanish, were aged 18-40 years, and desired a levonorgestrel intrauterinedevice. Enrolled women were randomized 1:1 to immediate postpartum insertion or delayed insertion at 4-12 weeks' postpartum. Prespecified exclusion criteria included delivery <37.0 weeks' gestational
Reducing Pain During IntrauterineDevice Insertion: A Randomized Controlled Trial in Adolescents and Young Women To estimate the effect of a 1% lidocaine paracervical nerve block on pain during intrauterinedevice (IUD) insertion compared with a sham block in adolescents and young women.We conducted a multisite, single-blind, sham-controlled randomized trial in adolescents and young women having a 13.5-mg levonorgestrel IUD inserted. Enrollment occurred at three family planning clinics
Endoscopic Treatment of IntrauterineDevice Migration into the Bladder with Stone Formation Background: An intrauterinedevice is commonly used for contraception globally. Although intrauterinedevice placement is an effective and safe method of contraception, migration into the bladder with stone formation is a rare and serious complication. The management approaches for an intrauterinedevice embedded in the bladder include endoscopic procedures and open surgical removal. In this study, we (...) report the case of a patient with recurrent urinary tract infection associated with intrauterinedevice migration and urolithiasis, who successfully underwent endoscopic treatment combined with laser fragmentation. Case Presentation: A 22-year-old woman presented to our hospital with a 1-month history of lower abdominal pain, hematuria, and pain on urination. Transvaginal ultrasound showed a hyperechoic lesion in the bladder. A plain abdominal radiograph showed the presence of a T-shaped intrauterine
Use of intrauterinedevices in nulliparous women Clinical Guidelines Use of intrauterinedevices in nulliparous women Patricia A. Lohr a, ? , Richard Lyus b , Sarah Prager c a British Pregnancy Advisory Service, 20 Timothy's Bridge Road, Stratford Enterprise Park, Stratford on Avon, Warwickshire, CV37 9BF b Homerton University Hospital, London c University of Washington Received 18 August 2017; accepted 23 August 2017 Abstract Five intrauterinedevices (IUDs) are available in the United States (...) : four levonorgestrel-releasing intrauterine systems (two containing 52 mg, one containing 19.5 mg and one containing 13.5 mg) and one copper-bearing device (Copper T 380A). All IUDs have very low typical- use failure rates and high acceptability ratings, yet they are used by a minority of women, with nulliparous women less likely to do so than parous women. The objective of this clinical review is to give evidence-based recommendations for the use of IUDs in nulliparous women
Long-Acting Reversible Contraception: Implants and IntrauterineDevices Long-Acting Reversible Contraception: Implants and IntrauterineDevices - ACOG Menu ▼ Long-Acting Reversible Contraception: Implants and IntrauterineDevices Page Navigation ▼ Number 186, November 2017 (Replaces Practice Bulletin Number 121, July 2011) Committee on Practice Bulletins—Gynecology . This Practice Bulletin was developed by the Committee on Practice Bulletins—Gynecology and the Long-Acting Reversible (...) , incurred in connection with this publication or reliance on the information presented. Long-Acting Reversible Contraception: Implants and IntrauterineDevicesIntrauterinedevices and contraceptive implants, also called long-acting reversible contraceptives (LARC), are the most effective reversible contraceptive methods. The major advantage of LARC compared with other reversible contraceptive methods is that they do not require ongoing effort on the part of the patient for long-term and effective use
Self-Administered Lidocaine Gel for IntrauterineDevice Insertion in Nulliparous Women: A Randomized Controlled Trial To evaluate self-administration of vaginal lidocaine gel to decrease pain with intrauterinedevice (IUD) insertion in nulliparous women.In this randomized, double-blind, placebo-controlled trial, women self-administered 2% lidocaine or placebo vaginal gel 5 minutes before IUD insertion. The primary outcome was change in pain from baseline to IUD insertion on a 100-mm visual
New developments in intrauterinedevice use: focus on the US Many more women in the US today rely upon intrauterinedevices (IUDs) than in the past. This increased utilization may have substantially contributed to the decline in the percentage of unintended pregnancies in the US. Evidence-based practices have increased the number of women who are medically eligible for IUDs and have enabled more rapid access to the methods. Many women enjoy freedom to use IUDs without cost, but for many
Intrauterinedevices and risk of uterine perforation: current perspectives Uterine perforation is an uncommon complication of intrauterinedevice insertion, with an incidence of one in 1,000 insertions. Perforation may be complete, with the device totally in the abdominal cavity, or partial, with the device to varying degrees within the uterine wall. Some studies show a positive association between lactation and perforation, but a causal relationship has not been established. Very rarely (...) , a device may perforate into bowel or the urinary tract. Perforated intrauterinedevices can generally be removed successfully at laparoscopy.
The IntrauterineDevice in Women of Childbearing Age Has A Greater Long-Term Cost-Benefit than Oral Contraception Pills "The IntrauterineDevice in Women of Childbearing Age Has A Greater Lon" by Laura Rogers < > > > > > Title Author Date of Graduation Summer 8-13-2016 Degree Type Capstone Project Degree Name Master of Science in Physician Assistant Studies First Advisor Annjanette Sommers, PA-C, MS Rights . Abstract Unplanned pregnancy remains a major problem in the United States, despite (...) the widespread usage of contraception. Improper and inconsistent usage of short acting reversible contraception contributes to the unplanned pregnancy epidemic. Hormonal and copper intrauterinedevices are safe and cost-effective alternatives, but usage in the Unites States remains low. Recommended Citation Rogers, Laura, "The IntrauterineDevice in Women of Childbearing Age Has A Greater Long-Term Cost-Benefit than Oral Contraception Pills" (2016). School of Physician Assistant Studies . 554. https
Ketorolac for Pain Control With IntrauterineDevice Placement: A Randomized Controlled Trial To evaluate intramuscular ketorolac compared with placebo saline injection for pain control with intrauterinedevice (IUD) placement.We conducted a randomized, double-blind, placebo-controlled trial between July 2012 and March 2014. Patients received 30 mg ketorolac or placebo saline intramuscular injection 30 minutes before IUD placement. The primary outcome was pain with IUD placement on a 10-cm
Interventions for pain with intrauterinedevice insertion. Fear of pain during insertion of intrauterine contraception (IUC) is a barrier to use of this method. IUC includes copper-containing intrauterinedevices and levonorgestrel-releasing intrauterine systems. Interventions for pain control during IUC insertion include non-steroidal anti-inflammatory drugs (NSAIDs), local cervical anesthetics, and cervical ripening agents such as misoprostol.To review randomized controlled trials (RCTs