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How to detect and remove deep or nonpalpable contraceptive implants ? A technical note.

Gautier Chene1, Ana Gjorgjievska-Delov2, Anthony Atallah3

  • 1Department of Gynecology, Hôpital Femme Mère Enfant, HFME, 59 boulevard Pinel, University hospital of Lyon, 69500 Bron, France; EMR 3738 CICLY, University Claude Bernard of Lyon 1, 69000 Lyon, France.

Journal of Gynecology Obstetrics and Human Reproduction
|September 17, 2025
PubMed
Summary

Removing deep subcutaneous contraceptive implants, estimated at 1/1000, presents challenges. This technical note details strategies for the safe localization and removal of these deep implants.

Keywords:
Contraceptive implantDeep implantEtonogestrel implantNexplanon® removalUltrasound

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Area of Science:

  • Medical Devices
  • Contraception
  • Surgical Procedures

Background:

  • Deep subcutaneous contraceptive implants pose removal challenges.
  • Implant malposition occurs despite device and site modifications.
  • An estimated 1 in 1000 implants are placed too deep for easy removal.

Purpose of the Study:

  • To describe effective strategies for locating deep contraceptive implants.
  • To outline methods for the safe removal of deep subcutaneous contraceptive implants.

Main Methods:

  • Review of techniques for ultrasound-guided localization.
  • Description of surgical approaches for removal of deeply embedded implants.
  • Discussion of potential complications and their management.

Main Results:

  • Successful identification of strategies for safe localization.
  • Demonstration of effective removal techniques for deep implants.
  • Minimization of risks associated with deep implant removal.

Conclusions:

  • Safe and effective strategies exist for managing deep contraceptive implants.
  • These techniques can improve patient outcomes and reduce procedural difficulties.
  • Further dissemination of these methods is recommended for clinical practice.