Implanon Removals
Professor Gab Kovacs
Implanon has been available for patient use since May 2001. In
the last four years over 271,000 women have chosen Implanon as their
method of contraception.
Whilst the majority of insertions have been uneventful there has
been some publicity about some non-insertions. It is important to
ensure that the Implanon rod is inserted superficially, that the
rod is not left in the inserter after insertion, and that it is
easily palpable superficially in the forearm after insertion.
As some of the rods have been in in-situ for more than three years,
many doctors and specialists will be asked to remove and change
these over in the coming months.
It is estimated that in 2005 there will be nearly 35,000 women
who will request having an Implanon rod removed from their arm following
the technique taught in the Implanon insertion sessions.
As long as the rod is easily palpable this should be very simple.
If the Implanon rod cannot be palpated
Our very strong advice to doctors and specialists is that if the
rod cannot be palpated, do not attempt to remove it.
If the rod is not palpable, you should first advise the patient
to use a back-up method of contraception until the presence of the
implant can be confirmed. This, in the first instance should be
done by an ultrasound examination, but it is important that the
person who is doing this is someone with expertise with Implanon
localisations.
Through our networks we have established a number of referral centres,
which are “centres of experience” for localisation of
Implanon in the upper arm. The clinicians at these centres are either
sub-specialist ultrasonologists, or radiologists with an interest
in the removal of foreign bodies More
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Attempts to remove an Implanon rod, which is not palpable, will
result in a frustrating experience both for the patient and the
operator.
If you do not know who has special experience in Implanon removals
in your particular area, the State office of Family Planning Australia
will be able to assist or if you have queries, you can contact the
Organon Implanon Information Line on: 1800 644546.
In a case of an uncomplicated Implanon removal, a new Implanon
rod can be inserted through the same incision at the very same time
using the well recognised Implanon insertion techniques.
© RANZCOG
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