Forgotten intrauterine devices (IUDs), particularly those retained for decades, can lead to complications in postmenopausal women, including bleeding and chronic pelvic pain. The Lippes Loop IUD, widely used from the 1960s to the 1980s, is now rarely encountered. We present the case of a 68-year-old woman with a forgotten Lippes Loop IUD who presented with chronic pelvic pain and postmenopausal bleeding. The patient was uncertain whether her IUD had been spontaneously expelled or removed. During a laparoscopic hysterectomy performed for postmenopausal bleeding, an intra-pelvic Lippes Loop IUD was discovered embedded in the cul-de-sac and successfully removed. The patient tolerated the procedure well, and her postoperative period was uneventful. Her symptoms resolved completely at follow-up. Removal of a retained IUD is highly recommended, particularly in postmenopausal women. Patients with an IUD presenting with postmenopausal bleeding and pelvic pain should be closely evaluated. We emphasize the importance of adequate counseling, regular follow-up for IUD users, and timely removal once the device has expired or is no longer indicated."

Clinicians faced with common diagnoses such as pelvic pain or recurrent urinary tract infection (rUTI) may not consider less frequent etiologies, such as a delayed erosion of an intrauterine device (IUD). Given that modern IUDs are not approved for more than 10 years, early or midcareer clinicians unfamiliar with the earlier versions of these devices may not consider that a long-retained foreign object may be the source of symptoms in an older woman. We report a case of an IUD placed 50 years ago that eroded into the bladder, causing recurrent UTI and pelvic pain. Thankfully, minimally invasive laparoscopic techniques available now-to date unreported-enable surgical management while limiting morbidity, which is especially important in an elderly population.

This case report discusses a 77-year-old female patient who presented to an outpatient clinic with urinary symptoms and recurrent UTIs. Imaging revealed a foreign body, which was later confirmed as a retained intrauterine device (IUD) that had caused a vesicouterine fistula (VUF). The patient had a medical history of cervical cancer treated with radiation therapy, during which her IUD's string could not be located, leading to the decision to proceed with radiation therapy without removing the IUD. The patient opted to manage her condition medically rather than undergo surgical removal due to concerns about worsening the vesicouterine fistula. This case highlights the potential risks and complications of retained IUDs, and the importance of careful consideration and communication among clinical teams and patients when managing these situations.

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.

Background. Intrauterine contraceptive devices (IUDs) are widely utilized all over the world owing to their low cost and high efficacy. Uterine perforation is a rare complication that may occur at IUD insertion resulting in extrauterine location of the IUD. Traditionally, surgical removal of dislocated IUDs has been recommended. Case. A 68-year-old patient who had an IUD (Lippes loop) inserted 32 years ago and whose routine examination incidentally revealed a dislocated IUD in the abdominal cavity. The patient remained asymptomatic during three years of follow-up and the IUD was left in place. Conclusion. Asymptomatic patients, whose vaginal examinations and ultrasonography or X-ray results reveal a dislocated IUD, may benefit from conservative management.

We report a case of vesicocervical fistula following intrauterine device (Lippes loop) erosion following insertion 45 years ago. Vesicocervical fistula was suspected clinically. Ultrasound and magnetic resonance imaging confirmed the presence of a foreign body. Biopsy and magnetic resonance imaging were performed to rule out malignancies of the urogenital tract. The fistula was managed by laparotomy, hysterectomy, and bladder flap closure. We report this case because of its rarity.