Ex-vivo forces associated with intrauterine device placement and perforation: a biomechanical evaluation of hysterectomy specimens.
Ex-vivo forces associated with intrauterine device placement and perforation: a biomechanical evaluation of hysterectomy specimens.
复制标题
DOI：
10.1186/s12905-021-01285-6
复制
发表时间：
2021-04-07
期刊：
影响因子：
--
通讯作者：
Turok DK
中科院分区：
文献类型：
--
作者：
Duncan J;Fay K;Sanders J;Cappiello B;Saviers-Steiger J;Turok DK
子宫切除标本的生物力学分析评估了与放置宫内节育器相关的力。这些包括使用两种常用的市售宫内节育器放置器械和金属子宫探条造成子宫穿孔所需的压缩力。我们在一个学术中心获得子宫切除标本。所有标本均为绝经前妇女的良性病变，采用任何手术方法切除。在切除后一小时内，我们将子宫标本稳定在专门为此分析设计的仪器中。由一名经验丰富的临床医生执行所有实验操作，并使用瓦格纳FDIX-25测力计测量力。研究者在抓钩上施加牵引力，以近似放置宫内节育器期间使用的力。通过使用制造商的两种市售产品的放置工具和金属声音来确定对子宫底部的最大压缩力。16名患者提供了子宫切除术标本。使用负载宫内节育器时未发生完全穿孔;在一次观察中，LNG IUS进入子宫肌层。塑料宫内节育器放置杆在所有尝试中均弯曲，并且未覆盖宫底的子宫浆膜。金属子宫探条在所有标本中均造成完全穿孔（p <0.001）。左炔诺孕酮宫内节育器放置器产生的平均最大力最低，为12.3 N（SD ± 3.8 N），其次是铜T380 A宫内节育器放置器，为14.1 N（SD ± 4.0 N），金属音最高，为17.9 N（SD ± 7.6 N）（p < 0.01）。在该离体模型中，金属子宫音导致完全穿孔，而宫内节育器放置器械不会。本研究已获得机构审查委员会（IRB 0059096）批准。
This biomechanical analysis of hysterectomy specimens assesses the forces associated with intrauterine device placement. These include compressive forces required to cause uterine perforation with two commonly available commercial intrauterine device placement instruments and a metal uterine sound. We obtained hysterectomy specimens at a single academic center. All specimens resulted from excision for benign conditions in premenopausal women by any operative method. Within one hour of excision, we stabilized uterine specimens in an apparatus specifically designed for this analysis. A single, experienced clinician performed all experimental maneuvers and measured forces with a Wagner FDIX-25 force gauge. The investigator applied traction on a tenaculum to approximate force used during an intrauterine device placement. The maximum compressive force to the uterine fundus was determined by using manufacturers’ placement instruments for two commercially available products and a metal sound. Sixteen individuals provided hysterectomy specimens. No complete perforations occurred while using loaded intrauterine devices; in a single observation the LNG IUS entered the myometrium. The plastic intrauterine device placement rod bowed in all attempts and did not perforate the uterine serosa at the fundus. A metal uterine sound created a complete perforation in all specimens (p < .001). The lowest mean maximum force generated occurred with the levonorgestrel intrauterine system placement instrument 12.3 N (SD ± 3.8 N), followed by the copper T380A intrauterine device placement instrument 14.1 N (SD ± 4.0 N), and highest for the metal sound 17.9 N (SD ± 7.6 N) (p < 0.01). In this ex-vivo model, metal uterine sounds caused complete perforation and intrauterine device placement instruments did not. This study received Institutional Review Board (IRB0059096) approval.
登录
查看更多内容
影响因子：
2.9
作者：
Dermish, Amna;Turok, David K.;Sanders, Jessica N.
通讯作者：
Sanders, Jessica N.
影响因子：
33.7
作者：
Curtis, Kathryn M.;Tepper, Naomi K.;Whiteman, Maura K.
通讯作者：
Whiteman, Maura K.
DOI：
10.1016/j.ijgo.2015.12.004
发表时间：
2016-07-01
影响因子：
3.8
作者：
Christenson, Kamilee;Lerma, Klaira;Blumenthal, Paul D.
通讯作者：
Blumenthal, Paul D.
影响因子：
2.9
作者：
Hubacher, David;Kavanaugh, Megan
通讯作者：
Kavanaugh, Megan
影响因子：
2.9
作者：
Heinemann, Klaas;Reed, Suzanne;Do Minh, Thai
通讯作者：
Do Minh, Thai