Intrauterine contraceptive devices: vaginal cytology, pathologic changes and clinical implications.

A review is presented of the vaginal cytology, pathologic changes and clinical implications of intrauterine contraceptive device (IUD) usage, with special reference to IUD-related actinomycosis. The laboratory diagnosis of Actinomyces in routinely stained cervicovaginal smears is discussed, including the cytopathology of actinomycosis and the cytomorphologic, histochemical and immunofluorescence identification of the organism. The differential diagnosis of Actinomyces organisms in vaginal smears is detailed. The clinicopathologic correlation and histopathology of actinomycosis are presented, as is a discussion of its management. Finally, the IUD-related cytopathologic cellular changes are described and illustrated.