Information is presented on the management of women referred to a sexual health service during a 1-year period for management of a non-palpable contraceptive implant or of a palpable implant considered unsuitable for routine removal.
52 women were referred. Thirty-four implants were non-palpable and their depth on ultrasound. 17 were fully or partly palpable and their depth ranged from 3 mm or less to 5.6 mm. 9 had had previous failed attempts at removal. Three implants were located at sites other than the medial aspect of the arm.
Forty-seven implants were removed at a one-stop clinic appointment using ring forceps. The mean time for removal from making the incision to complete extraction was 4.8 minutes. Three cases judged to be of higher risk were removed under local anesthesia in theatre through a 15 mm incision. These included the only case where removal was attempted unsuccessfully in the outpatient clinic. Seven of the implants were Nexplanon®, including four cases seen during the last month of data collection.
The study concluded that removal with the technique described is rapid. Preliminary indications suggest that the introduction of Nexplanon has not resolved the problem of deep implant insertion.
Reference: https://srh.bmj.com/content/40/2/126
