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Re: 25 YEAR OLD LIPPES LOOPFrom: DrBarrere@aol.comThu Apr 10 13:34:02 1997
About a year ago, I had a patient present to our clinic with the complaints of postmenopausal bleeding. Upon exam, it turned out that she had forgotten that she had an IUD placed about 25 years before, in Jamaica. The strings broke when I attempted to remove it, and I was unable to grab it with a forcep. I scheduled her for an operative hysteroscopy at which time I found a Lippes Loop. I was amazed at how firm, almost petrified, this device had become. It was also quite scarred to the endometrium. I encountered some complications during the procedure (perforation), and as a result of bleeding, ended up performing a TAH. A measure that is a little extreme for removal of an IUD. However, even if I hadn't perforated her uterus, I don't see any way I could have successfully removed this IUD. I don't have a lot of experience removing stubborn IUD's from my clinic population and personally, have never seen the special forceps designed for IUD removal. It seems that this is turning into a lost art, which is quite concerning. I have several patients that desire the IUD (Progestasert) because it is very hassle free. I wonder in we all are going to be having similar problems removing scarred in IUD's in the future. David M. Barrere, M.D. PGY-3 Bethesda Hospitals, Inc. Cincinnati, OH
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