ORIGINAL RESEARCH article
Front. Reprod. Health
Sec. Menopause
Volume 7 - 2025 | doi: 10.3389/frph.2025.1576265
This article is part of the Research TopicTransitioning Through Menopause: Contraceptive Choices and Sexual Well-beingView all articles
A risk-based preoperative evaluation method and management strategy for removing intrauterine contraceptive devices(IUCDs) in postmenopausal women
Provisionally accepted
- 1Longquan People's Hospital, Lishui, China
- 2Zhejiang Quhua Hospital, quzhou, China
- 3Longquan Traditional Chinese Medicine Hospital, longquan, China
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A huge population base with intrauterine contractive devices (IUCDs) due to closely related to China's family planning national policy, which also brings huge economic burden and technological challenges to the safety removal of IUCDs in postmenopausal women. It is very important how to develop a risk scoring system for removal of IUCDs (RSSR-IUCDs), which is used to evaluate the preoperative risk of removal and management strategy for IUCDs of postmenopausal women. Methods: A systematic case retrospective analysis was conducted on 320 enrolled women who underwent IUCD removal surgery. After screening, stratifying high-risk factors, and final multi-factor Logistic Stepwise Regression Analysis, a model named as RSSR-IUCDs was constructed and tested by Hosmer Lemeshow Fit test, and ROC curve was plotted to further analyze its predictive accuracy of the failure of IUCDs removal. Results: Seven high-risk factors were finally selected, namely duration of menopause, IUCDs retention time, the history of uterine surgery, the shape of IUCDs, IUCDs position, uterine size, and uterine position. And a RSSR-IUCDs was developed and showed a goodness fit ( 2 =236.558, P=0.000). The score range of RSSR-IUCDs (Minimum-Maximum) was 0-40. The ROC curve of RSSR-IUCDs displayed when the ideal cut-off value was 20 points, the sensitivity and specificity of the first failure to removal of IUCDs were 69.60% and 95.60% respectively. Conclusions: The RSSR-IUCDs is a scientific, reasonable and feasible evaluation system, which is expected to become a guiding scoring system in accordance with clinical practice for postmenopausal women before the removal of IUCDs.
Keywords: intrauterine contraceptive devices(IUCDs), postmenopausal women, removal, Risk Scoring System for Removal of IUCDs(RSSR-IUCDs), strategy, Management
Received: 13 Feb 2025; Accepted: 15 Jul 2025.
Copyright: © 2025 Li, zheng, liu and Pan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: ZiJun Li, Longquan People's Hospital, Lishui, China
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