Removal of a non-palpable broken contraceptive implant

Remoção de implante contracetivo não palpável e fragmentado

António de Pinho^1,2, Cristina Oliveira³, Cristina Carrapatoso⁴

Serviço de Ginecologia e Obstetrícia. Centro Hospitalar do Tâmega e Sousa. Penafiel, Portugal

¹ Médico Interno de Formação Específica de Ginecologia e Obstetrícia, Serviço de Ginecologia e Obstetrícia, Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal.

² Assistente Convidado, Departamento de Biomedicina, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.

³ Assistente Hospitalar Graduada de Ginecologia e Obstetrícia, Serviço de Ginecologia e Obstetrícia, Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal.

⁴ Assistente Hospitalar Graduada Sénior de Ginecologia e Obstetrícia, Serviço de Ginecologia e Obstetrícia, Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal.

Endereço para correspondência | Dirección para correspondencia | Correspondence

ABSTRACT

The authors present a case of a non-palpable contraceptive implant removal. Imagiology techniques as an upper arm radiograph can be used to locate non-palpable implants, which can be either migrated, damaged or both. Broken implants are an unusual occurrence but, as shown through our case, this complication may not be associated with an impairment of the contraceptive efficacy.

Keywords: contraception; hormonal contraception; contraceptive agents.

A 37-year-old caucasian woman, G3P2A1, attended our medical center for contraceptive implant removal. The etonogestrel-releasing implant had been inserted into the nondominant arm 40 months earlier, after removal of a previous one using standard technique. Patient referred good tolerance, lighter and infrequent menstrual periods and effective contraception. During examination, the rod was not palpable so a two-dimensional x-ray was performed to locate the implant (Figure 1). Two separated parallel fragments were identified with total length of approximately 4 centimeters. Under sterile conditions and local anesthesia, we have successfully removed the fragments through one longitudinal incision of 10 mm. The two pieces were revealed corresponding to one complete implant (Figure 2 ). Patient denied history of arm trauma or injury. Broken contraceptive implants are a rare phenomenon, especially in absence of trauma ^1-3. In this patient, as in previous rare related cases, implant contraceptive efficacy was not affected even though the reported complication².

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REFERÊNCIAS

1. Bentley J. Experience and removal of damaged implants. J Fam Plann Reprod Health Care. 2013;39(3):233-234.         [ Links ]

2.Tomás-Tello MD, Hodgson G. Two cases of broken Implanon(®). J Fam Plann Reprod Health Care. 2010;36(4):255.

3.Torres R, Mendes N, Machado AI, Marques C. In situ breakage of Implanon®-two cases of a rare occurrence. Contraception. 2013;88(1):189-191.

Endereço para correspondência | Dirección para correspondencia | Correspondence

António de Pinho

Serviço de Ginecologia e Obstetrícia

E-mail: antonioapdepinho@hotmail.com

Recebido em: 11-07-2020. Aceite para publicação: 12-07-2020.