A Rare Case of Bicornuate Uterus with Embedded Intrauterine Contraceptive Device

Abstract

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.

Spontaneously Expelled Lippes Loop IUD After 40 Years of Use: A Case Report and Review of the Literature

“… 5–7 In postmenopausal women, it is related to chronic pelvic pain, pyometra, and abnormal uterine bleeding. 7 , 13–15 …”

“…The pain might result from the embedment of the uterine wall by the device, recurrent pelvic inflammatory disease, and chronic inflammatory response of the endometrium or uterine contraction to expel the device. 1 , 6 , 7 , 10 …”

“…This was possible because the patient did not suffer embedment or perforation, which is more commonly reported. 1 , 6 , 7 , 16 …”

“…It is not easy to remove Lippes loop IUDs retained for several years. 7 , 17 Lippes loop IUDs tend to accumulate small deposits of calcium causing corrosion in the plastic. This compromises the strength of the device and tail rendering it liable to fracture and breakage.…”

“… 1 , 5 There are controversies about whether to remove or conservatively managed dislocated or retained IUDs without complaints. 5 , 7 …”