IUD’s like Lippes Loop (LL), intended for long term use are retained for years and menopausal ladies often present with LL in situ either deliberately or forgotten. We report a case of Lippes Loop removal inserted 45 years back in a woman complaining of post menopausal bleeding. The inserted LL thread was incidentally discovered during clinical examination and Ultrasonography. We also reviewed literature to determine the evidence for and against removal of an inert IUD.

Lippes Loop Inserted 45 Years Back: The Dilemma to Remove It or Leave It in situ. A Case Report with Review of Literature.

Lippes loop and the first IUDs: lessons from a bygone era.

Early intrauterine contraceptive devices (IUCDs) like Lippes Loop were intended for long-term use until menopause and hence often retained for years, and many patients present well into menopause still bearing a Lippes Loop either deliberately or forgotten. We present a case of a 65-year-old postmenopausal female patient presented with complaints of spotting per vagina since 20 days, associated with white discharge per vagina. Ultrasound abdomen showed calcified endometrium with IUCD in the cervical canal. Hysteroscopy was done. As IUCD could be visualized but could not be removed, hence hysterectomy was done.

/pdf/a-rare-case-of-bicornuate-uterus-with-embedded-intrauterine-4852hnoloy.pdf

A Rare Case of Bicornuate Uterus with Embedded Intrauterine Contraceptive Device

Background The intrauterine device (IUD) as a potential source of uro-gynecologic infection has raised concern for decades While a causal link between IUD and pelvic inflammatory disease has been refuted, the relationship between IUDs and urinary tract infections (UTIs) remains incompletely understood Methods We used a PubMed, CINAHL, and Cochrane Library search strategy to identify studies evaluating UTI occurrence and microbial signatures among women exposed to IUD We evaluated the question, "what is currently known about the IUD as an exposure risk for UTIs?" Results Nine studies met inclusion criteria and were summarized in this structured, scoping review Studies to date have not reported a significant association between IUD exposue and UTI occurence While all nine studies acknowledged the breadth of contraceptive methods, none evaluated the impact of different IUD types (ie, copper vs hormone-eluting) on UTI incidence Conclusion Small sample sizes and inconsistent UTI definitions limit the current literature Future studies should rigorously define the UTI phenotype and evaluate the association of UTI with IUD exposure accounting for known covariates

Intrauterine devices as an exposure risk for urinary tract infections: A scoping review.

Kehrer, Ferdinand Adolf (1837–1914)

Forty years ago Jack Lippes, M.D., hand made the first models of his "Double-S" intrauterine contraceptive device (IUD). Subsequently the Lippes Loop became the standard against which other IUDs came to be compared. Though millions of loops have been used, they have mostly been supplanted by copper-bearing, T-shaped devices. Due to the implant nature of IUDs, on occasion a patient presents well into menopause still bearing a Lippes Loop or other early IUD. Although there is no established causal evidence linking IUDs retained after menopause and cancer or other significant problems, such retention does confuse the diagnosis of post-menopausal bleeding and makes difficult such procedures as endometrial biopsy and ultrasonic endometrial evaluation. When contraception is no longer an issue, it is prudent to remove IUDs since they may cloud future necessary evaluations.

Dr. Lippes and his loop. Four decades in perspective.

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Dr. Lippes and his loop. Four decades in perspective.