Most often the foreign bodies involved are the contraceptive devices such as copper T and the like. They are usually inserted in place by a qualified practitioner but often due to neglect and memory loss they get left behind for a longer duration. This causes ulceration of the endometrium and can give rise to serious ascending infections with inflammatory tubo-ovarian masses. The presence of the foreign body may also cause menorrhagia.
The other alternatives are instruments or other things that might be left behind during the procedure of an abortion. Serious intra-uterine infections usually lead to pelvic abscess from acute salpingo-oophoritis. Here perforation of the uterus can also occur during dilatation and curettage; and medical termination of pregnancy.
Other perforating injuries like during hysteroscopic operations also contribute to this. These things must not be taken lightly and must be attended to immediately.
Treatment- removing the foreign bodies under anesthesia. If infection is present a swab is taken and the correct chemotherapy given. It must be kept in mind that adnexal involvement will not respond to chemo. Large persistent masses with recurrent fever and constitutional upset call for laparotomy and their surgical removal. In the younger women it is possible to conserve the uterus and part of the ovary. However when the pelvic organs are grossly disorganized by the pelvic inflammatory disease, total hysterectomy and bilateral salpingo-oophorectomy is the only logical answer.