Peripheral Nerve Injury with Nexplanon Removal: Case Report and Review of the Literature

Overview

Journal Contracept Reprod Med

Publisher Biomed Central

Specialty Reproductive Medicine

Date 2018 Nov 1

PMID 30377538

Citations 7

Authors

Rachel Lefebvre

Marianne Hom

Hyuma Leland

Milan Stevanovic

Affiliations

Soon will be listed here.

Abstract

Background: Implantable devices offer convenient, long-acting, and reversible contraception. Injury to the peripheral nerves and blood vessels have been reported as rare complications of implantation and extraction.

Case Presentation: We present a case of ulnar nerve injury in a 21-year-old woman from attempted in-office removal of a deeply implanted Nexplanon® device. The injury resulted in an ulnar nerve palsy requiring surgical exploration, neuroma excision, and sural nerve cable grafting.

Conclusions: In-office attempts to remove contraceptive implants that are deep or have migrated can cause iatrogenic nerve injury. Devices that are non-palpable, deep, or migrated should be imaged before formal surgical exploration and removal. Any patient with neurologic symptoms after placement or after attempted removal requires prompt diagnosis and referral to a peripheral nerve surgeon.

Citing Articles

Contraceptive implant migration to the ulnar nerve: A case report with literature review.

Asaad S, Salih N, Hassan M, Abid M, Hamid H, Ameen Ahmed N Clin Case Rep. 2024; 12(9):e9420.

PMID: 39234219 PMC: 11371881. DOI: 10.1002/ccr3.9420.

Reversible median nerve neuropathy and local muscle irritation resulting from blind removal attempts of etonogestrel contraceptive implant: a case report.

Fungtammasan S, Sinthuchai N, Pataradool K, Jaisamrarn U, Santibenchakul S Contracept Reprod Med. 2023; 8(1):57.

PMID: 38037175 PMC: 10691128. DOI: 10.1186/s40834-023-00257-5.

Characteristics of Patients Requiring Surgical Removal of Subdermal Contraceptive Implants: A Case-Control Study.

Katabi L, Stevens E, Ascha M, Arora K Open Access J Contracept. 2022; 13:111-119.

PMID: 35968271 PMC: 9373992. DOI: 10.2147/OAJC.S368250.

Minimally invasive removal of deep contraceptive implants under continuous ultrasound guidance is effective, quick, and safe.

Jacques T, Brienne C, Henry S, Baffet H, Giraudet G, Demondion X Eur Radiol. 2021; 32(3):1718-1725.

PMID: 34651210 PMC: 8831252. DOI: 10.1007/s00330-021-08263-4.

Safety, Quality, and Acceptability of Contraceptive Implant Provision by Community Health Extension Workers versus Nurses and Midwives in Two States in Nigeria.

Douthwaite M, Alabi O, Odogwu K, Reiss K, Taiwo A, Ubah E Stud Fam Plann. 2021; 52(3):259-280.

PMID: 34297857 PMC: 9292393. DOI: 10.1111/sifp.12168.

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