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Experiences of localization and removal of non-palpable subdermal contraceptive implants with ultrasound.
Obstet Gynecol Sci 2019; 62(3):166-172OG

Abstract

Objective

The aim of this study was to present experiences in localization and removal of non-palpable subdermal contraceptive implants with ultrasonography.

Methods

Medical records from January 1, 2016, to April 30, 2018, were retrospectively reviewed for 21 patients who were referred to a single institution and had an impalpable implant despite following the removal instruction. In all the cases, more than one attempt was made to remove the implant before referral. The rod was detected using radiography and ultrasonography. In all the cases, localization of the single implant was achieved with ultrasonography. The distal depth of the rod was measured, and skin marking was made following the echogenicity. The implants were subsequently removed under anesthesia.

Results

In 18 cases, the rods were localized using ultrasonography and successfully removed under local anesthesia. In the other three cases, removal with local anesthesia failed. Although the rod was detected successful with ultrasonography, the implants were removed under general anesthesia in the operating room. The depth from skin to rod, measured with ultrasonography, was >12.0 mm in all the cases and located deep in the muscular layer in the failure cases. The depth of the implants positively correlated with the time spent for removal (r=0.525; P=0.015).

Conclusion

High frequency ultrasonography is a highly accurate tool for localization and measurement of the skin-to-rod depth. It is also useful for removing non-palpable implants. If the depth of the implant is >12.0 mm, removal of the implant in the operating room under general anesthesia is recommended.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea.Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea. Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea.Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31139592

Citation

Kim, SooHyun, et al. "Experiences of Localization and Removal of Non-palpable Subdermal Contraceptive Implants With Ultrasound." Obstetrics & Gynecology Science, vol. 62, no. 3, 2019, pp. 166-172.
Kim S, Choi YS, Kim JS, et al. Experiences of localization and removal of non-palpable subdermal contraceptive implants with ultrasound. Obstet Gynecol Sci. 2019;62(3):166-172.
Kim, S., Choi, Y. S., Kim, J. S., Kim, S., & Cho, S. (2019). Experiences of localization and removal of non-palpable subdermal contraceptive implants with ultrasound. Obstetrics & Gynecology Science, 62(3), pp. 166-172. doi:10.5468/ogs.2019.62.3.166.
Kim S, et al. Experiences of Localization and Removal of Non-palpable Subdermal Contraceptive Implants With Ultrasound. Obstet Gynecol Sci. 2019;62(3):166-172. PubMed PMID: 31139592.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Experiences of localization and removal of non-palpable subdermal contraceptive implants with ultrasound. AU - Kim,SooHyun, AU - Choi,Young Sik, AU - Kim,Jeong Sook, AU - Kim,Sungjun, AU - Cho,SiHyun, Y1 - 2019/04/17/ PY - 2018/06/11/received PY - 2018/08/28/revised PY - 2018/10/21/accepted PY - 2019/5/30/entrez PY - 2019/5/30/pubmed PY - 2019/5/30/medline KW - Contraceptive methods KW - Device removal KW - Female contraception KW - Ultrasound imaging SP - 166 EP - 172 JF - Obstetrics & gynecology science JO - Obstet Gynecol Sci VL - 62 IS - 3 N2 - Objective: The aim of this study was to present experiences in localization and removal of non-palpable subdermal contraceptive implants with ultrasonography. Methods: Medical records from January 1, 2016, to April 30, 2018, were retrospectively reviewed for 21 patients who were referred to a single institution and had an impalpable implant despite following the removal instruction. In all the cases, more than one attempt was made to remove the implant before referral. The rod was detected using radiography and ultrasonography. In all the cases, localization of the single implant was achieved with ultrasonography. The distal depth of the rod was measured, and skin marking was made following the echogenicity. The implants were subsequently removed under anesthesia. Results: In 18 cases, the rods were localized using ultrasonography and successfully removed under local anesthesia. In the other three cases, removal with local anesthesia failed. Although the rod was detected successful with ultrasonography, the implants were removed under general anesthesia in the operating room. The depth from skin to rod, measured with ultrasonography, was >12.0 mm in all the cases and located deep in the muscular layer in the failure cases. The depth of the implants positively correlated with the time spent for removal (r=0.525; P=0.015). Conclusion: High frequency ultrasonography is a highly accurate tool for localization and measurement of the skin-to-rod depth. It is also useful for removing non-palpable implants. If the depth of the implant is >12.0 mm, removal of the implant in the operating room under general anesthesia is recommended. SN - 2287-8572 UR - https://www.unboundmedicine.com/medline/citation/31139592/Experiences_of_localization_and_removal_of_non-palpable_subdermal_contraceptive_implants_with_ultrasound L2 - https://ogscience.org/DOIx.php?id=10.5468/ogs.2019.62.3.166 DB - PRIME DP - Unbound Medicine ER -