Migration of Implanon<SUP>®</SUP>: two case reports

Abstract

These two case reports describe migration of Implanon ® (the single-rod contraceptive implant). A review of the literature revealed true migration of Implanon to be rare. A change of practice locally is described.

Gaps in monitoring systems for Implanon NXT services in South Africa: An assessment of 12 facilities in two districts

“…Even though complications are rare, a review of clinical studies of Implanon NXT showed that complications occur in ~1% of insertions. [13] These included deep insertions with fibrous adhesions, and non-palpable or broken implants. [13] The Active Surveillance Form for Sub-Dermal Implants has not been rolled out to the facilities, possibly as the number of data points it contains (24 variables) makes its completion onerous for health providers.…”

“…[13] These included deep insertions with fibrous adhesions, and non-palpable or broken implants. [13] The Active Surveillance Form for Sub-Dermal Implants has not been rolled out to the facilities, possibly as the number of data points it contains (24 variables) makes its completion onerous for health providers. If the purpose of this form is solely pharmacovigilance, fewer and more relevant indicators need to be selected and the form should be used.…”

Axillary migration of an Implanon&reg; contraceptive rod: case report

“…The scar indicates that implantation occurred in the appropriate location in her left arm; however, Implanon is usually inserted through a small puncture using the insertion needle, rather than the type of incision shown in Figure 1. It may be that whoever inserted the Implanon used an idiosyncratic insertion technique (such as that described by Evans et al 3 ), and that this accounts for the unusual placement of the device in our case.…”

“…They abandoned this technique in such cases in favor of inserting the new contraceptive system into the contralateral arm to prevent future migratory events. 3 Prosch et al 4 reported 21 cases of nonpalpable Implanon implants over 4 years in 2008. Only two cases involved substantial migration, both in the cranial direction (4 cm and 8 cm, respectively).…”

Ultrasound-guided removal of Implanon™ devices

“…They were also able to correctly determine the absence of the contraceptive device with a negative predictive value of 85.7%. Hormonal assays (eonogestrel) could also be performed to confirm presence of active implant if US localisation is unsuccessful [8,9]. Some authors have also suggested that MRI may be used as a second-line imaging modality in identifying Implanon™ devices.…”