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Spontaneous vaginal expulsion of Hulka clips
M D Gooden1, J F Hulka, G M Christman
1Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill.
Background:
Laparoscopic Hulka clip application is a common method of outpatient sterilization in women. We present a patient who experienced spontaneous expulsion of two Hulka clips.
Case:
A 21-year-old woman was seen 17 months after sterilization because of spontaneous, asymptomatic passage of two Hulka clips into the vagina. The passage of one clip went unnoticed by the patient. Radiographic studies confirmed the migration and absence of two Hulka clips previously placed on the left fallopian tube.
Conclusion:
In rare circumstances, Hulka clips can migrate from the abdominal cavity and be expelled spontaneously, possibly by transuterine passage. This migration may occur without the patient's knowledge.