Intrauterine Device Insertion and Felt Pain
Condition: Intrauterine Device Migration
MeSH terms: Intrauterine Device Migration
Study type: Interventional

Summary: 
      The aim of this study is to compare the pain score between the direct method and the
      conventional method in patients who have undergone copper or hormonal intrauterine devices
      (IUD) for contraception and to find an answer to the question of which method is better.
    

Detailed description: 
      The intrauterine device (IUD) is one of the commonly used methods of contraception due to its
      effectiveness in providing reliable contraception, its ease of application, non-obstruction
      of sexual life, affordability, minimal absolute contraindications, and reversibility. Despite
      this increasing preference, concerns regarding the use of both levonorgestrel-releasing and
      copper IUDs due to the potential pain and fear of pain during insertion, which has hindered
      the adoption of this method.

      Although the conventional method is used for intrauterine device insertion, the authors
      defined the direct method, also known as the torpedo technique, in 2006. IUD practitioners
      have started to prefer this direct method because it is simpler, faster and has fewer
      insertion steps than the conventional technique. However, IUD practitioners should apply the
      most painless and tolerable method to women who choose an IUD for contraception. Therefore,
      in order to understand which method is less painful, patients will be divided into 2 groups
      as those who have IUD inserted with the conventional method and those who have IUD inserted
      with the direct method. At the end of the procedure, participants in both groups will be
      asked to rate the most severe pain they experienced during the procedure according to the
      Visual Analogue Scale (VAS) (from 0 to 10).

      In the conventional method: the anterior lip of the cervix was grasped and pulled with Pozzi
      forceps, and after entering the uterine cavity with a hysterometry the IUD was inserted.

      In the direct method: the anterior lip of the cervix was grasped and pulled with Pozzi
      forceps, and without using hysterometry the IUD was directly inserted.
    

Intervention name(s): Intrauterine Device Insertion
Intervention type(s): Device
Intervention description(s): All womens will be placed in a gynecological position and underwent a bimanual examination to better determine whether the uterus was in the anteverted or retroverted position. Subsequently, a speculum will be inserted, and the cervix will be disinfected with betadine. In the conventional method: the anterior lip of the cervix is grasped and pulled with Pozzi forceps, and after entering the uterine cavity with a hysterometry the IUD is inserted. In the direct method: the anterior lip of the cervix is grasped and pulled with Pozzi forceps, and without using hysterometry the IUD is directly inserted. The strings will be cut approximately 2-3 cm after the cervix, and the Pozzi forceps and speculum will be removed. The accuracy of the IUD placement will be confirmed using pelvic ultrasound. The process will take about five minutes.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Two groups as conventional method and direct method
Masking: Single (Participant)
Primary purpose: Health Services Research
Keywords: Pain; Intrauterine Devices; Conventional Technique; Direct Technique; IUD