Abstract：
UNASSIGNED: Management and localisation strategies to remove nonpalpable contraceptive implants may be difficult. We aimed to evaluate our imaging modalities to identify deep implant and patient outcomes related to removal.
UNASSIGNED: In this retrospective study, we reviewed all cases referred to our specialised centre for nonpalpable contraceptive implants from January 2018 to August 2022.
UNASSIGNED: Out of the cohort studied, 47 female subjects exhibited nonpalpable implants. The implant was nonpalpable for thirty-six patients (76,6%) immediately after the insertion whereas it was not palpable several months after the insertion for eleven patients (23.4%). Twelve patients (25.5%) had one or more failed removal attempts before referral.All 47 implants were successfully visualised via ultrasound in the upper arm: 40 implants (85.1%) were located in the subdermal tissue, 4 (8.5%) were intrafascial and 3 (6.4%) were intramuscular. Depth of the implant was 4.0 mm [1.7 - 12.0]. No clinical factors were statistically associated with differences in depth or location (subdermal vs subfascial). Removal procedures were mainly under local anaesthesia in 74.5% of cases in an outpatient setting. There were two Clavien-Dindo grade 1 complications (one case of cutaneous scar dehiscence and one transient postoperative neuropathic complaint in the upper arm resolved within 3 months under analgetics).
UNASSIGNED: Identification of deep implants requires following the ultrasound modality protocol. Ultrasound detection makes easy and safe implant removal. Training programs for the insertion as well as for the removal of correct and incorrect inserted implants should be continued and developed all around the world.
UNASSIGNED: In this retrospective study, we reviewed all cases referred to our specialised centre for nonpalpable contraceptive implants from January 2018 to August 2022.
UNASSIGNED: Out of the cohort studied, 47 female subjects exhibited nonpalpable implants. The implant was nonpalpable for thirty-six patients (76,6%) immediately after the insertion whereas it was not palpable several months after the insertion for eleven patients (23.4%). Twelve patients (25.5%) had one or more failed removal attempts before referral.All 47 implants were successfully visualised via ultrasound in the upper arm: 40 implants (85.1%) were located in the subdermal tissue, 4 (8.5%) were intrafascial and 3 (6.4%) were intramuscular. Depth of the implant was 4.0 mm [1.7 - 12.0]. No clinical factors were statistically associated with differences in depth or location (subdermal vs subfascial). Removal procedures were mainly under local anaesthesia in 74.5% of cases in an outpatient setting. There were two Clavien-Dindo grade 1 complications (one case of cutaneous scar dehiscence and one transient postoperative neuropathic complaint in the upper arm resolved within 3 months under analgetics).
UNASSIGNED: Identification of deep implants requires following the ultrasound modality protocol. Ultrasound detection makes easy and safe implant removal. Training programs for the insertion as well as for the removal of correct and incorrect inserted implants should be continued and developed all around the world.
摘要：
■在这项回顾性研究中，我们审查了2018年1月至2022年8月期间转诊至我们的无法触及的避孕植入物专业中心的所有病例.
■在研究的队列中，47名女性受试者表现出无法触及的植入物。插入后立即无法触及36名患者（76,6％），而插入后几个月则无法触及11名患者（23.4％）。12名患者（25.5%）在转诊前有一次或多次失败的切除尝试。所有47个植入物均通过上臂超声成功可视化：40个植入物（85.1％）位于皮下组织中，筋膜内4例（8.5％），肌内3例（6.4％）。植入物的深度为4.0mm[1.7-12.0]。没有临床因素与深度或位置（真皮下vs筋膜下）的差异有统计学意义。在门诊中，有74.5％的病例主要在局部麻醉下进行摘除程序。有2例Clavien-Dindo1级并发症（1例皮肤瘢痕裂开，1例上臂术后短暂性神经病变在3个月内缓解）。
■深层植入物的鉴定需要遵循超声模式协议。超声检测可以轻松安全地移除植入物。应继续并在世界各地开发用于插入以及移除正确和不正确插入的植入物的培训计划。
■在研究的队列中，47名女性受试者表现出无法触及的植入物。插入后立即无法触及36名患者（76,6％），而插入后几个月则无法触及11名患者（23.4％）。12名患者（25.5%）在转诊前有一次或多次失败的切除尝试。所有47个植入物均通过上臂超声成功可视化：40个植入物（85.1％）位于皮下组织中，筋膜内4例（8.5％），肌内3例（6.4％）。植入物的深度为4.0mm[1.7-12.0]。没有临床因素与深度或位置（真皮下vs筋膜下）的差异有统计学意义。在门诊中，有74.5％的病例主要在局部麻醉下进行摘除程序。有2例Clavien-Dindo1级并发症（1例皮肤瘢痕裂开，1例上臂术后短暂性神经病变在3个月内缓解）。
■深层植入物的鉴定需要遵循超声模式协议。超声检测可以轻松安全地移除植入物。应继续并在世界各地开发用于插入以及移除正确和不正确插入的植入物的培训计划。
