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Re: 25 YEAR OLD LIPPES LOOP From: rbraun@indyunix.iupui.edu Fri Apr 11 12:34:53 1997 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: rbraun@indyunix.iupui.edu: "Re: Advice re: Men in OB/GYN" Previous message: rbraun@indyunix.iupui.edu: "Re: Rubella Susceptible" In reply to: EboDoc@aol.com: "Re: 25 YEAR OLD LIPPES LOOP" I don't think there are any studies out there one way or the other. My gut response (read feelings based on 33 years experience) is if it ain't broke, don't fix it. If it is causing no problems, I wouldn't even attempt to remove it in the office. Usually the patient comes to you for some kind of symptom and then you find the IUD. Often the IUD won't be the cause of the symptoms. Recent case: 70 y/o african-american G7 P7 came to clinic for PMB. She had an IUD insered in 1966. Review of records showed it had been inserted by a young second year resident named Braun. Utilizing a Novak curette, the Birnberg Bow was removed with ease. Pipelle revealed insufficient tissue for diagnois. She persisted with PMB. SIS(Saline infusion sonogram) revealed an endometrial polyp and submucosal leiomyoma. Hysteroscopy confirmed and polypectomy was done. This lady had no symptoms from the IUD, but she did have other pathology causing her to have symptoms. I see no reason to remove an asymptomatic IUD that has been in place for years. I think it is wrong to take a patient to the operating room and remove one "just because it is there." No literature, no RCT's for Wooley, just my opinion. Dan -- @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@ R. Daniel Braun, MD FACOG "Money will buy you a fine dog Clinical Professor OB/GYN but only love will make it Indiana University School of Medicine wag its tail" Indianapolis, IN Richard "Kinky" OBGYN.net, International Rep. U.S. Friedman Kinky Friedman for President @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@ On Thu, 10 Apr 1997 EboDoc@aol.com wrote: > Thank-you for all the great responses. The question that i would like to > pose > is "do we need to remove a plastic inert type iud just because it is there?" > My read on the situation is that a office retreival or attempt is reasonable > but why go furthur if the benefit is not clear. There are no hard data > papers > that I could find per medline on the subject. I'd like to hear from more of > the > IUD trained crowd. > thanks > ebodoc > Ed Ryan M.D. > Next message: rbraun@indyunix.iupui.edu: "Re: Advice re: Men in OB/GYN" Previous message: rbraun@indyunix.iupui.edu: "Re: Rubella Susceptible" In reply to: EboDoc@aol.com: "Re: 25 YEAR OLD LIPPES LOOP"

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