Deep/Impalpable Contraceptive Implant Removal

Introduction

This service offers removal of impalpable implants or when there have been previous failed attempts at removal.
This is usually a one stop appointment, an ultrasound will be performed in the clinic to localise the implant and remove it
If the implant is impalpable and has never been able to be palpated, please consider pregnancy testing, advise use of additional contraceptive precautions and arrange x-ray of the arm.
If the device is not seen, a CXR is also recommended in case of intravascular migration.
In the event that the implant is absent on both x-rays, a blood test will be arranged in Derriford for etonorgestrel levels. This cannot usually be managed locally by primary care as the sample is sent to the USA for testing and requires funding by Organon.

Please refer patients with deep or difficult to remove implants to:

Dr Megan Griffiths

Sexual Health in Plymouth (SHiP)

Derriford Hospital

Plymouth, Devon PL6 8DH

Referrals may also be sent by email to ccash@nhs.net

Duration of use
Where and by whom it was fitted
Results of any x-rays
Contraception (if another implant is inserted, please do not insert in the same arm as the "lost" implant to avoid confusion and the need of removal of both implants).

Review date	20 June 2025
Next review date	20 June 2027
GP speciality lead	Dr Melanie Schick
Contributors	Dr Megan Griffiths, Consultant Sexual and Reproductive Health, SHiP, Derifford Hospital.