Skip to main content Accessibility help
×
Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-23T02:20:57.481Z Has data issue: false hasContentIssue false

Case 90 - A 26-Year-Old Female Presents for Nexplanon Removal with a Non-palpable Device

Published online by Cambridge University Press:  19 November 2021

Todd R. Jenkins
Affiliation:
University of Alabama, Birmingham
Lisa Keder
Affiliation:
Ohio State University School of Medicine, Columbus
Abimola Famuyide
Affiliation:
Mayo Clinic, Rochester
Kimberly S. Gecsi
Affiliation:
Medical College of Wisconsin
David Chelmow
Affiliation:
Virginia Commonwealth University School of Medicine
Get access

Summary

A 26-year-old woman, gravida 1, para 1, presents for removal of an etonogestrel (Nexplanon) contraceptive implant after utilizing it for contraception for 28 months. The device was initially placed by her primary care provider (PCP). In the referral notes, the PCP describes that she was not able to palpate the device. She ordered an ultrasound of the left arm, which confirmed the presence of the Nexplanon implant in the arm. The patient is requesting removal as she now desires another pregnancy. She reports satisfaction with Nexplanon as a contraceptive method. She does report menstrual irregularities since device placement, but since the result was lighter, less frequent menses, these changes were acceptable to her. She reports she has gained approximately 10 lb since the device was placed, but she attributes this to unhealthy eating habits and decreased physical activity. She denies any pain, numbness, tingling, or weakness in her upper extremity. Her past medical history is significant for childhood asthma and surgical history for wisdom tooth extraction. She is taking multivitamins and has no known drug allergies.

Type
Chapter
Information
Surgical Gynecology
A Case-Based Approach
, pp. 275 - 277
Publisher: Cambridge University Press
Print publication year: 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Odom, E, Eisenberg, D, Fox, I. Difficult removal of subnormal contraceptive implants: a multidisciplinary approach involving a peripheral nerve expert. Contraception 2017; 96: 8995.CrossRefGoogle Scholar
Mansour, D, Walling, M, Glenn, D, et al. Removal of non-palpable etonogestrel implants. J Fam Plann Reprod Health Care 2014; 40: 126–32.Google Scholar
Voedisch, A, Hugin, M. Difficult implant removals. Curr Opin Obstet Gynecol 2017; 29(6): 449–57.CrossRefGoogle ScholarPubMed
Jhpeigo, USAID, PSI. Manual for localizing deep implants with ultrasound assistance. 2017. Available at: https://toolkits.knowledgesuccess.org/sites/default/files/manual_for_localizing_deep_implants_with_ultrasound_assistance.pdf. (Accessed July 14, 2020.)Google Scholar
Merck & Co Inc. Highlights of Nexplanon prescribing information. 2019. Available at: http://www.merck.com/product/usa/pi_circulars/n/nexplanon/nexplanon_pi.pdf. (Accessed July 14, 2020.)Google Scholar
Reed, S, Do Min, T, Lange, JA, et al. Real world data on Nexplanon® procedure-related events: final results from the Nexplanon Observational Risk Assessment Study (NORA). Contraception 2019; 100(1): 31–6.CrossRefGoogle ScholarPubMed
Zhang, S, Batur, P, Martin, C, Rochon, P. Contraceptive implant migration and removal by interventional radiology. Semin Intervent Radiol 2018; 35(1): 23–8.CrossRefGoogle ScholarPubMed
French, V, Darney, P. Implantable contraception. In: Glob Libr Women’s Med 2015. Available at: https://www.glowm.com/section_view/heading/Implantable%20Contraception/item/398#35245. (Accessed July 14, 2020.)Google Scholar
Pillai, M, Gazet, AC, Griffiths, M. Continuing need for and provision of a service for non-standard implant removal. J Fam Plann Reprod Health Care 2014; 40(2): 126–32.Google ScholarPubMed
Matulich, M, Chen, M, Schimmoeller, NR, et al. Referral center experience with non-palpable contraceptive implant removals. Obstet Gynecol 2019; 134(4): 801–6.CrossRefGoogle Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×