Non-Palpable Contraceptive Implant Evaluation and Removal: A Protocol That Can Be Adopted for Practice in Low-Middle...

Area of Science:

• Family Planning and Contraception
• Medical Device Removal Protocols
• Global Health

Background:

• Four main types of contraceptive implants exist: Jadelle, Levoplant, Nexplanon, and Implanon, varying in composition, duration of use, and radiopacity.
• Implant removal can be challenging when implants are non-palpable due to insertion errors, migration, or increased subcutaneous fat.
• The rising use of long-acting reversible contraceptives (LARCs) necessitates standardized procedures for difficult implant removals.

Purpose of the Study:

• To present a step-by-step protocol for the identification and removal of non-palpable contraceptive implants.
• To provide a standardized approach adaptable for clinical practice, particularly in low- and middle-income countries (LMICs).
• To establish a foundation for broader clinical guidelines and training programs for implant removal.

Main Methods:

• Detailed description of a protocol for locating non-palpable implants.
• Emphasis on localization before attempting removal to ensure patient safety.
• Adaptable methodology for diverse clinical settings, especially LMICs.

Main Results:

• A systematic protocol for identifying and removing non-palpable contraceptive implants is demonstrated.
• The protocol is designed for practical application in various healthcare settings.
• The approach aims to improve the safety and efficacy of implant removal procedures.

Conclusions:

• A standardized protocol is essential for managing difficult contraceptive implant removals.
• This protocol offers a practical solution for identifying and removing non-palpable implants, enhancing patient care.
• The methodology can be integrated into training programs to improve provider skills in LMICs and globally.