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At least 19 recordsLinked to original sources
PubMed1995

Characteristics and experiences of American women electing for early removal of contraceptive implants.

The study describes the experiences of 430 women who had Norplant(R) contraceptive implants removed prior to the five years of method effectiveness. Each subject was surveyed when the implants were inserted and again at the time of removal. Descriptive data are presented concerning perceptions of the method before insertion and after removal, reactions to the contraceptive and experiences associated with the removal procedure. Subjects' use of Norplant implants ranged from 14 days to 40 months, with a mean of 13.3 and median of 13 months. Over 95% reported changes in menstrual bleeding patterns and 95% experienced other non-bleeding related side effects. Non-bleeding side effects were the most frequently indicated reasons for removal, followed by bleeding changes. The mean removal time was 34 minutes with a median of 25 minutes. Over 48% reported experiencing significant pain during the removal procedure, and 27% stated that the pain was greater than expected. Despite electing for early removal of implants,the majority of women surveyed indicated satisfaction with all aspects of the method save its effect on their overall health. Although method-related side effects were intolerable for most subjects, their overall perception of the method was generally satisfactory.

Adolescent↗
PubMed1998

A review of bacteriological culture of removed intrauterine contraceptive devices.

A retrospective review of clinical and microbiological data was made, over an 18 month period, of intrauterine contraceptive devices removed and sent for examination. An association with symptoms at time of removal was found for Streptococcus agalactiae, Streptococcus milleri, enterobacteria and obligate anaerobes. Thirty four per cent of IUDs yielded one or more Actinomycesspecies spp but no correlation with symptoms was found. In the small group of symptomatic patients who were followed up, no difference in outcome was observed between those who were treated with antibiotics and those who were not.

Anti-Bacterial Agents↗
PubMed1987

Molding of the uterus following intrauterine contraceptive device removal: documentation by hysterosalpingography.

Intrauterine contraceptive devices (IUDs) distort the uterine cavity. We report 2 cases of endometrial molding demonstrated by hysterosalpingography (HSG) following removal of an IUD. Other processes may cause filling defects in the uterine cavity including inflammatory synechiae (Asherman's syndrome), tuberculosis, endometrial hyperplasia, and polyps. Whenever filling defects are seen, the history of IUD usage should be determined.

Adult↗
PubMed1995

Ultrasonographically guided intrauterine contraceptive device removal before chorionic villus sampling.

OBJECTIVE: Management of a retained intrauterine contraceptive device with no visible string during early pregnancy presents a dilemma. Because these devices are frequently used by multiparous women, it is not unusual that many women with retained devices are also of advanced maternal age. We describe our experience with ultrasonographically guided first-trimester retrieval of an intrauterine contraceptive device in conjunction with chorionic villus sampling. STUDY DESIGN: Patients with a first-trimester pregnancy and a retained intrauterine contraceptive device where no string was visible were offered ultrasonographically guided retrieval of the device. If the patient had genetic risks and desired prenatal diagnosis, chorionic villus sampling was offered at the same office visit. RESULTS: Six patients underwent intrauterine contraceptive device retrieval, under continuous ultrasonographic guidance, by use of an intrauterine contraceptive device hook. All patients had a posterior or fundal device. One patient had two in situ: a Lippes Loop (Ortho Pharmaceutical Corp., Raritan, N.J.) removed by its string and a Cu-7 (G.D. Searle & Co., Chicago) removed under ultrasonographic guidance. The remaining five patients had a Cu-7. Four of six patients had chorionic villus sampling performed immediately after the intrauterine contraceptive device removal and one patient had chorionic villus sampling 3 weeks later. There were two losses in our series: one after a lengthy procedure and one before documented viability. All infants were structurally normal and born at term. CONCLUSION: First-trimester ultrasonographically guided retrieval of a retained intrauterine contraceptive device may be safely performed in conjunction with chorionic villus sampling.

Adult↗
PubMed2003

The benefits and risks of over-the-counter availability of levonorgestrel emergency contraception.

Removing the prescription requirement for Plan B will help ensure that the product plays a larger role nationally in the reduction of unintended pregnancy and abortion-important public health goals. Over-the-counter (OTC) sale of Plan B should present no serious safety issues. OTC consumers are able to understand and follow the instructions for proper use of Plan B. Efficacy of the OTC product is likely to be the same as, or better than, the prescription product, given more timely access to treatment. Based on the results of a growing body of literature and foreign marketing experience, the risk of unintended health consequences also appears to be minimal. There is no evidence to suggest that American women will abuse Plan B as an OTC product.

Contraceptives, Oral, Synthetic↗
PubMed1994

Localization of contraceptive implant capsules for removal.

Implanted contraceptive capsules occasionally cannot be removed by means of palpation with local dissection, and imaging guidance is necessary. The authors report obtaining a single antero-posterior radiograph of the upper arm followed by sonography to localize the capsule and to allow precise marking of the skin over the capsules. The method can be performed quickly and is inexpensive and effective, allowing the localization and removal procedures to be scheduled independently.

Adult↗
PubMed1998

Correlates and consequences of early removal of levonorgestrel implants among teenaged mothers.

OBJECTIVE: To determine if adolescent mothers who request early removal of levonorgestrel implants differ from those who do not in ways that might predispose them to repeated conceptions and in their concerns about adverse effects. We hypothesized that adolescent mothers who request removal of levonorgestrel implants within 2 years of insertion have more risk factors for repeated pregnancy than those who do not. METHODS: We studied the prevalence of 21 characteristics associated with repeated adolescent pregnancy and 16 adverse effects of levonorgestrel implants in 181 postpartum, adolescent levonorgestrel implant recipients, 66 (36%) of whom had the levonorgestrel implants removed within 20 months of insertion (hereafter, removers). RESULTS: Removers (n = 66) had significantly more risk factors for repeated pregnancy and reported significantly more adverse effects than did those who continued to use levonorgestrel implants (hereafter, users) (n = 115). Concerns about adverse effects rose in tandem with risk factors for repeated pregnancy (r = 0.26; P = .001) and were the most important determinant of levonorgestrel implant removal (relative risk, 9.72; 95% confidence interval, 4.62-19.49). However, the number of risk factors for repeated pregnancy was also a significant, independent predictor of levonorgestrel implant removal (relative risk, 2.34; 95% confidence interval, 1.10-4.66). Following removal, contraceptive use was poor and conception occurred rapidly; 24 (37%) of the removers conceived again within 2 years of the index delivery. CONCLUSIONS: The study hypothesis was supported. Our findings that concerns about the adverse effects of levonorgestrel implants rise in tandem with risk factors for repeated pregnancy suggest that the efficacy of counseling before and after levonorgestrel implant insertion could be improved by addressing those aspects of the user's life that undermine the motivation to use contraception.

Adolescent↗
PubMed1996

Use of computed tomography guidance and mammographic hook wires to remove displaced, embedded contraceptive rods.

Because of dysfunctional uterine bleeding, a patient requested removal of levonorgestrel contraceptive rods. The patient was referred to a general surgeon by her gynecologist who was unable to palpate the rods in the region of implantation in her left upper arm. Initially, the surgeon was able to locate and remove four of the six previously implanted rods. Because these implants are not visible under convention radiography or fluoroscopy, computed tomography was used to locate the remaining two rods. After localization by use of mammographic hook wires, the remaining two rods were successfully removed surgically.

Adult↗
PubMed2005

[Insertion problems, removal problems, and contraception failures with Implanon].

OBJECTIVE: Analysis of the results of a national pharmacovigilance study on Implanon, a contraceptive implant containing 68 mg of etonogestrel. PATIENTS AND METHODS: This survey concerns cases of pregnancies (contraception failures), of migrations and of insertion or removal problems with Implanon reported to French Regional Drug Pharmacovigilance Centres and to Organon SA between May 2001 and September 2002. RESULTS: In France, 39 unintended pregnancies were reported over 17 months. The pregnancies were in 77% of cases (N = 30) due to an insertion technique error (implant not found when pregnancy has been diagnosed). For 3 patients (7,6%), pregnancy was due to a failure of etonogestrel contraceptive effect, explained twice by its association with an enzymatic inductor drug. For 4 patients (10%), pregnancy was due to an untimely insertion (insertion after day 5 of menstrual cycle or woman already pregnant). For two patients, no information was available. The incidence of reported pregnancies in France is estimated at 0.359 / 10(3) implants [0.246-0.482], in accordance with a typical Pearl Index of 0.06 [0.04-0.08]. Twenty-eight suspected migrations (N = 11), problems or failures in removal of the implant (N = 11) and insertion difficulties (N = 6) were notified, corresponding to an incidence of 0.257/10(3) implants [0.162-0.363]. DISCUSSION AND CONCLUSION: Occurrence of pregnancy is possible with Implanon, due to errors in the insertion technique (device not really inserted) or to a non-respect of the SPC recommendations (drug-drug interaction or untimely insertion). Insertion problems can lead to localisation problems (implant not visible by X-ray) then needing further tests and even harmful practice (removal under general anaesthesia). That is why a real and strict training is highly recommended to physicians.

Adult↗
PubMed1988

A comparative study of the ease of removal of intrauterine contraceptive devices.

This study compares the rates of easy and difficult removals of various types of IUDs. Eight-hundred-sixteen IUDs were removed in Auckland Family Planning Clinics in an 8-month period. Nearly 80% were the standard Multiload Copper 250. Eight-eight percent of all IUDs were easy to remove with another 7% requiring a hard pull. Of the remaining 5%, 3.5% required simple intracervical exploration, 1% required intrauterine exploration and 0.5% were referred to hospital. When compared with the standard Multiload, no IUD was statistically easier and only the Mini-Copper 7 was harder to remove at the 5% level of significance.

Family Planning Services↗
PubMedDate not supplied

Insertion and removal of Norplant contraceptive implants by physicians and nonphysicians in an Indonesian clinic.

This paper reports on a study in which the performances of physicians were compared to those of nonphysician health personnel in inserting and removing NORPLANT subdermal contraceptive implants. The study was conducted in Raden Saleh Clinic at the University of Indonesia, Jakarta, from September 1982 to August 1984. In a group of 828 women who accepted NORPLANT 285 insertions were performed by physicians and 543 by nonphysician health personnel. During the study period, 122 removals were performed (43 by physicians and 79 by nonphysicians). This small proportion of removals reflects the high continuation rate for NORPLANT. There was no significant difference between the two groups of acceptors regarding age, parity, education, or side effects. The average insertion times were 7.6 minutes for the physician group and 7.4 minutes for the nonphysician group (p greater than 0.1). The average removal times were 21.7 minutes for physicians and 21.8 minutes for nonphysicians (p greater than 0.9). Complications during and following insertion and removal were minimal for both groups, and no significant differences were found. It was concluded that nonphysician health personnel are qualified to administer the NORPLANT contraceptive implants.

Adult↗
PubMed1982

Laparoscopic removal of translocated intrauterine contraceptives devices.

Over a 6 year period, 67 women had a translocated intrauterine contraceptive device (IUCD) removed from the peritoneal cavity or uterovesical fold under general anaesthesia. In 40 patients removal of the IUCD at laparoscopy succeeded, whereas in 24 laparotomy proved necessary and three IUCD were removed per vaginam. Compared with the inert plastic device a larger proportion of copper-containing IUCD in the peritoneal cavity required laparotomy for removal, however, 44% could be removed by laparoscopy, the less traumatic procedure.

Female↗