Influence of removal of intrauterine contraceptive devices on colonisation of the cervix by actinomyces-like organisms.

An overall prevalence rate of actinomyces-like organisms (ALO) in cervical smears from intrauterine contraceptive device (IUCD) users of 3% (79/2, 734) was found, with a rate of 2% and 22.6% for copper and inert IUCD users. Although the users of the inert IUCDs were older, and their devices had been in situ longer, these factors did not account for the significant difference between the two types of IUCD. Fifty-five patients were counselled and given a leaflet on ALO. Fourteen IUCD users with ALO positive smears who had their devices removed had mild or moderate pelvic pain or discharge. Six others who were asymptomatic had the IUCD removed at their own request. All fifty-five patients were re-examined six months to one year later, and a smear was repeated. Only one woman required later removal of the IUCD because of dyspareunia with pelvic tenderness. After removal of the IUCD, and without antibiotic therapy, in 100% (20/20) of the women, ALO colonisation was no longer found six to twelve months later. This applied even to seven women who had had a new copper IUCD inserted immediately after removal of the index device.