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

IF 1.8 Q3 OBSTETRICS & GYNECOLOGY Open access journal of contraception Pub Date : 2022-01-01 DOI:10.2147/OAJC.S368250
Leila Katabi, Erica Stevens, Mona Ascha, Kavita Arora
{"title":"Characteristics of Patients Requiring Surgical Removal of Subdermal Contraceptive Implants: A Case-Control Study.","authors":"Leila Katabi,&nbsp;Erica Stevens,&nbsp;Mona Ascha,&nbsp;Kavita Arora","doi":"10.2147/OAJC.S368250","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Etonogestrel subdermal implants are a commonly used contraceptive device placed in the medial upper arm. Plastic and orthopedic surgeons may be consulted for difficult implant removals. We performed a case-control study comparing patients undergoing surgical and uncomplicated in-office removal at our institution.</p><p><strong>Patients and methods: </strong>We identified patients who underwent operative removal of implantable contraceptive devices by plastic or orthopedic surgeons at our institution from January 2014 to October 2019. Patients who underwent uncomplicated office removal during the same time were compared. Demographic and surgical variables were collected, and descriptive statistics were calculated. Univariate and multivariate logistic regression was performed with surgical versus outpatient removal as the outcome of interest.</p><p><strong>Results: </strong>A total of 669 patients undergoing etonogestrel subdermal implant removals were identified during the five-year study period, of which thirteen patients required surgical removal (1.9%) and 326 were selected as uncomplicated removal comparisons. There were no significant differences in median (IQR) body mass index (BMI) (31.1 [28.2, 35.2] versus 29.3 [24.0, 35.1], p = 0.19), median (IQR) weight gain since device placement (5 [-0.6, 14.7] kilograms versus 1.6 [-1.2, 5.8] kilograms, p = 0.15), or length of time since device insertion (2.3 [0.8, 2.8] years versus 1.0 [0.4, 2.2] years, p = 0.17). Of those who needed surgical removal, the most common indication for implant removal was device expiration (n = 5, 38.5%). Devices placed by OBGYN attendings were less likely to require surgical removal (p = 0.02). Family medicine attendings were more likely to refer patients for surgical removal (p = 0.02). No significant findings were detected on univariate or multivariate regression. Among surgical removals, radiography was the most frequently used imaging modality. Implants were most frequently subdermal (n = 11, 84.6%) though intramuscular placement was also identified (n = 2, 15.4%). Only one patient had residual paresthesia along the length of the incision. No other complications were identified.</p><p><strong>Conclusion: </strong>We did not identify risk factors associated with the difficult removal of etonogestrel subdermal implants. Practitioners should consult upper extremity surgeons if they encounter difficult removals.</p>","PeriodicalId":74348,"journal":{"name":"Open access journal of contraception","volume":null,"pages":null},"PeriodicalIF":1.8000,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bc/39/oajc-13-111.PMC9373992.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Open access journal of contraception","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2147/OAJC.S368250","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Purpose: Etonogestrel subdermal implants are a commonly used contraceptive device placed in the medial upper arm. Plastic and orthopedic surgeons may be consulted for difficult implant removals. We performed a case-control study comparing patients undergoing surgical and uncomplicated in-office removal at our institution.

Patients and methods: We identified patients who underwent operative removal of implantable contraceptive devices by plastic or orthopedic surgeons at our institution from January 2014 to October 2019. Patients who underwent uncomplicated office removal during the same time were compared. Demographic and surgical variables were collected, and descriptive statistics were calculated. Univariate and multivariate logistic regression was performed with surgical versus outpatient removal as the outcome of interest.

Results: A total of 669 patients undergoing etonogestrel subdermal implant removals were identified during the five-year study period, of which thirteen patients required surgical removal (1.9%) and 326 were selected as uncomplicated removal comparisons. There were no significant differences in median (IQR) body mass index (BMI) (31.1 [28.2, 35.2] versus 29.3 [24.0, 35.1], p = 0.19), median (IQR) weight gain since device placement (5 [-0.6, 14.7] kilograms versus 1.6 [-1.2, 5.8] kilograms, p = 0.15), or length of time since device insertion (2.3 [0.8, 2.8] years versus 1.0 [0.4, 2.2] years, p = 0.17). Of those who needed surgical removal, the most common indication for implant removal was device expiration (n = 5, 38.5%). Devices placed by OBGYN attendings were less likely to require surgical removal (p = 0.02). Family medicine attendings were more likely to refer patients for surgical removal (p = 0.02). No significant findings were detected on univariate or multivariate regression. Among surgical removals, radiography was the most frequently used imaging modality. Implants were most frequently subdermal (n = 11, 84.6%) though intramuscular placement was also identified (n = 2, 15.4%). Only one patient had residual paresthesia along the length of the incision. No other complications were identified.

Conclusion: We did not identify risk factors associated with the difficult removal of etonogestrel subdermal implants. Practitioners should consult upper extremity surgeons if they encounter difficult removals.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
需要手术切除皮下避孕植入物的患者特征:一项病例对照研究。
目的:依替诺孕酮皮下植入物是一种常用的放置在上臂内侧的避孕装置。对于难以移除的植入物,可以咨询整形外科医生。我们进行了一项病例对照研究,比较了在我们机构接受手术切除和不复杂的办公室内切除的患者。患者和方法:我们确定了2014年1月至2019年10月在我们机构由整形或骨科医生手术取出植入式避孕装置的患者。在同一时间内进行无并发症切除手术的患者进行比较。收集人口学和外科变量,并进行描述性统计。单因素和多因素logistic回归以外科手术和门诊手术作为关注的结果。结果:在5年的研究期间,共有669例患者接受了依替诺孕酮皮下植入物移除术,其中13例患者需要手术移除(1.9%),326例患者作为无并发症的移除对照。中位(IQR)体重指数(BMI)(31.1[28.2, 35.2]对29.3 [24.0,35.1],p = 0.19)、植入器械后中位(IQR)体重增加(5 [-0.6,14.7]kg对1.6 [-1.2,5.8]kg, p = 0.15)、植入器械后时间长度(2.3[0.8,2.8]年对1.0[0.4,2.2]年,p = 0.17)均无显著差异。在需要手术移除的患者中,最常见的指征是器械过期(n = 5, 38.5%)。OBGYN主治医师放置的器械不太可能需要手术移除(p = 0.02)。家庭医学主治医师更倾向于推荐患者进行手术切除(p = 0.02)。单因素或多因素回归均未发现显著结果。在手术切除中,x线摄影是最常用的成像方式。植入物最常见的是皮下植入(n = 11,84.6%),尽管也发现了肌肉内植入(n = 2,15.4%)。只有1例患者沿切口长度有残余感觉异常。未发现其他并发症。结论:我们没有发现与依替诺孕酮皮下植入物难以取出相关的危险因素。如果遇到困难,从业者应咨询上肢外科医生。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
自引率
0.00%
发文量
0
审稿时长
16 weeks
期刊最新文献
Patient Perceived Quality of Virtual Group Contraception Counseling. Prevalence of Depression Among Women Using Hormonal Contraceptives in Mogadishu, Somalia: A Cross-Sectional Study. Is There Still a Role for Sterilization by Tubal Ligation as a Contraceptive Method? Contraception in Medically Complex Adolescents and Young Adults Contraceptive Utilization and Its Associated Factors Among Married Women in West African Countries: A Population-Based Survey Using Multinomial Logistic Regression
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1