Deep/Impalpable Contraceptive Implants
Referral Criteria for the Management of Deep or Impalpable Contraceptive Implants
Women presenting for removal of a contraceptive implant where the device is impalpable, deep enough to cause concern that standard removal will not be possible, or where there have been previous attempts at removal.
If the implant is impalpable please consider pregnancy testing, advise use of additional contraceptive precautions and arrange x-ray of the arm (for Nexplanon) or ultrasound to determine if the device is present. If the device is not seen on x-ray a CXR is also recommended in case of intravascular migration.
Please refer patients with deep or difficult to remove implants to:
Dr Dianna Sells
Community Contraception and Sexual Health
Cumberland Centre
Damerel Close
Plymouth, Devon PL1 4JZ
Information to Include when referring:
Duration of use
Where and by whom it was fitted
Results of any x rays or scans
References
Faculty of Sexual and Reproductive Healthcare Clinical Guidance. Progestogen Only
Implants February 2014
Date Reviewed 08/01/2020
Date of Next Review 08/01/2021
Authors Dr Frances Fuller, Associated specialist in Sexual Health, the Hub, RCHT
Dr Issy Boyd, RMS GP sifter
Version No. 3.2