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Contraceptive implant nerve damage

Ulnar nerve injury on removal of a contraceptive implan

  1. The close proximity of contraceptive implant placement to the course of the ulnar nerve can result in injury. Several factors have been implicated in this complication including: low BMI, erroneous placement of the implant, implantation over the brachial groove, and migration of the implant from its original insertion
  2. Ultrasonography found the implant to be lying in the subfascial plane of the inner arm. Results: The implant was found lying in the perineurium of the ulnar nerve, causing ulnar nerve neuropathy. A review 3 months after removal of the implant showed near-complete resolution of her symptoms
  3. ant upper arm and provides highly effective, well-tolerated contraception for up to 3 years. 1, 2, 3, 4, 5, 6 Complications with insertion and removal, such as nonpalpable, subcutaneously implanted contraceptives, are reported in literature,7 but there are no reports about nerve injuries

Contraceptive Implant-Related Acute Ulnar Neuropathy

subdermal contraceptive implants. J Fam Pract 40:184-186, 1995 3. Osman N, Dinh A, Dubert T, Goubier JN: [A new cause for iatrogenic lesion of the ulnar nerve at the arm: contraceptive hormonal implant. Report of two cases.] Chir Main 24:181-183, 2005 (Fr) 4. Smith JM, Conwit RA, Blumenthal PD: Ulnar nerve injury associated with removal of. 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 Our Hand Surgical Unit has treated two young women for serious injuries to the ulnar nervesustained during removal of contraceptive implants. To avoid permanent injuries, it isimportant that such implants are inserted correctly, and that patients are referred to a handsurgeon if it is suspected that an implant may prove difficult to remove

The surgeons behind the article do not believe that the use of birth control implants is a problem. They point out that cases of nerve damage associated with the implant are few, and that those that do occur happen when nerves are pulled during removal of the implant The implant may come out by itself. You may become pregnant if the implant comes out by itself. Use a back-up birth control method and call your healthcare provider right away if the implant comes out; The need for surgery in the hospital to remove the implant; Injury to nerves or blood vessels in your arm; The implant breaks making removal.

harm associated with contraceptive implants: non-insertion, deep insertion and nerve injury. Recommendations for safe clinical practice can be derived from analysis of legal cases and published case reports. Nerve injury has invariably been caused by clinicians without upper limb surgical skills attempting difficult removals The contraceptive implant, Nexplanon This leaflet is written for women who would like a subdermal contraceptive implant (Nexplanon) inserted just under the skin. Injury to nerve or blood vessel, including migration- very rare - less than 1 in 10,000 insertion Contraceptive implants are designed for easy subdermal insertion and removal under local anesthesia through a small incision over the medial aspect of the arm. 1 Rare cases of associated nerve injury, usually limited to cutaneous nerves, have been reported. 2-5 We present the first known case involving 2 major nerves

If the implant is non-palpable, it may have been inserted too deeply or it may have migrated within the upper arm or intravascularly (10, 11). Contraceptive implants that are difficult to palpate can be localised with X-rays (they contain barium sulphate) or ultrasound. Deeper positioning increases the risk of nerve damage 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

Nerve injury caused by removal of an implantable hormonal

Temporary pain, bruising, swelling, or irritation at the site where it was located. The formation of scar tissue, including keloid scars, at the insertion site. It is also possible that scarring already occurred when the Nexplanon implant was first inserted, making it harder to remove the device. Nerve damage at the insertion site The primary reasons for nerve injury were pulling or grasping of the nerve after mistaking it for the implant. Neurapraxia was the most common lesion and was treated primarily with implant removal and clinical surveillance Oct 11, 2017. Getty Images. When Tasha Hughes chose the implant as her method of contraception back in 2014, when she was 17-years-old, she had no idea it would have such drastic consequences. But. A doctor or nurse uses a special device to place the implant under the skin of your arm. Insertion is really fast and they'll numb your arm so it won't hurt. First, your doctor or nurse will ask you some questions about your health to see if the implant — also called Nexplanon — is a good.

Risk of neurovascular injury and implant migration Nexplanon is a highly effective, long-acting contraceptive implant containing etonogestrel, a synthetic progestogen. Nexplanon acts by preventing.. Peripheral Nerve Injury Associated with a Subdermal Contraceptive Implant: Illustrative Cases and Systematic Review of Literature. Laumonerie P, Blasco L, Tibbo ME, Leclair O, Kerezoudis P, Chantalat E, Mansat P World Neurosurg 2018 Mar;111:317-325 BackgroundImplantable 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 presentationWe present a case of ulnar nerve injury in a 21-year-old woman from attempted in-office removal of a deeply implanted Nexplanon® device Nexplanon is a birth control implant that is designed to last up to four years and be 99% effective at preventing pregnancy. But the woman claimed the device was improperly placed, which caused her to make several visits to the Regional Medical Center where the implant was finally removed. The suit states she was left with nerve damage in. 4.1 Anatomy of the upper extremity. When evaluating a patient for etonogestrel contraceptive implant removal, we consider the proximity of the brachial artery, ulnar and median nerves, and superficial structures including the medial antebrachial cutaneous (MABC) nerve, other sensory nerve branches, and basilic vein

Peripheral nerve injury with Nexplanon removal: case

Cochlear Implant And Auditory Nerve Damage. Auditory nerve which is also known as cochlear nerve is a nerve in the ear that carries nerve impulses to the brain. It is a sensory nerve that carries acoustic energy to the brain. Auditory nerve starts from within the cochlea and goes up to the brainstem where the fibers of the auditory nerve make. Major nerve injury after contraceptive implant removal : Case illustration. / Restrepo, Carlos E.; Spinner, Robert J. In: Journal of neurosurgery, Vol. 124, No. 1, 01. The close proximity of contraceptive implant placement to the course of the ulnar nerve can result in injury. Several factors have been implicated in this complication including: low BMI, erroneous placement of the implant, implantation over the brachial groove, and migration of the implant from its original insertion. Clinicians should familiarise themselves with the vulnerable neurovascular.

Patients suffered severe nerve injury after removal of

  1. In the video below, one woman documents her horror story with getting the Nexplanon contraceptive implant in her arm, which actually ended up migrating and causing nerve damage. She says in the video that she will never get an implant again, and instead intends to use natural family planning
  2. The birth control implants release hormones that prevent the body from ovulating. Some women report weight gain when using this birth control method. In most users, however, the gain is only a few pounds and can be offset by simple lifestyle changes. Irregular Menstrual bleeding
  3. Lawsuit Claims & Settlements. Women who used the birth control implant Nexplanon are filing lawsuits against its manufacturer over allegations the implant can cause serious side effects, including blood clots, heart attack and stroke. The lawyers and attorneys at National Injury Help are investigating these cases from those injured by Nexplanon
  4. My implant has moved about an inch and I would rather go under to have it removed asleep. The first one I had was fine (I got this one from planned parenthood) and then I went to a local women's center in truckee and this one had been hell

Risks and Side Effects of NEXPLANON® (etonogestrel implant

However, over the years the contraceptive implant has been used, some women have suffered major complications aside from the usual side effects contraceptive methods can cause. As the contraceptive implant is inserted under the skin, there is a small risk that it can move around the body. In most cases where this happens, it is not a major issue BACKGROUND : Despite demonstrable safety and efficacy of subdermal contraceptive implants (SCIs), both insertion and removal of SCIs in the arm have been associated with neurovascular complications. The aim of this study was to investigate type and prognosis of nerve injuries associated with SCIs. METHODS : We performed a comprehensive search of 4 electronic databases for studies pertaining to. uterine enlargement. Side effects of the removal of Norplant include: multiple incisions, capsule fragments remaining, pain, multiple visits, and. lengthy removal procedure. The Norplant System consists of six Silastic capsules, each containing 36 mg of the progestin, levonorgestrel

a stuffy and runny nose. inflammation of the tissue lining the sinuses. constipation. urinary tract infection. enlarged breasts. itching of the genital area. hair loss. hirsutism, a condition of. Nearly 4.5 million women in the U.S. use an intrauterine device (IUD) for birth control. They are very effective at preventing pregnancy -- only one out of every 100 women with an IUD will get. A TEENAGER was left fighting for her life after she suffered a horrendous reaction to a contraceptive implant - which left her needing emergency surgery. optic nerve was damaged and referred.

Major nerve injury after contraceptive implant removal

insertion of the etonogestrel implant7 does not include nerve damage as a possible side effect of removal. While nerve damage is a rare side effect of removal (and in the cases described, lebugle K. Removal of etonogestrel contraceptive implants in the operating theatre: report on 28 cases. Contraception 2007;76:35-9. 6. soedler e. Nexplanon is a single-rod birth control implant that is placed in your upper arm to provide up to five years of protection against pregnancy. Measuring about the size of a matchstick at 1.6 inches long, Nexplanon is a progestin-only contraceptive that is discreet, effective, and long-lasting. 1 

The birth control implant is a slender rod of plastic that contains a form of the hormone progesterone. The implant is about the size of a matchstick. A doctor or nurse inserts it under the skin of your upper arm in an office procedure that only takes a few minutes. An implant can prevent pregnancy for 3 years Contraceptive implant or intrauterine system (IUS): Insert Nexplanon on the same day the previous contraceptive implant or IUS is removed. If inserted as recommended, back-up contraception is not necessary. If deviating from the recommended timing of insertion, the woman should be advised to use a barrier method until 7 days after insertion Key message points - There has been litigation in relation to the three types of harm associated with contraceptive implants: non-insertion, deep insertion and nerve injury. - Recommendations for safe clinical practice can be derived from analysis of legal cases and published case reports. - Nerve injury has invariably been caused by clinicians without upper limb surgical skills attempting.

Women who cannot use hormonal contraception containing estrogen have a variety of progestin-only contraceptive methods from which to choose. Implanon is a new single-rod progestin-only contraceptive implant that is easily inserted and can remain in place for up to 3 years. It is highly effective with a rapid onset of action and an equally rapid return of fertility once removed A Merck spokesman says the new version of the contraceptive implant is less likely than earlier versions to be inserted improperly or too deeply, which can lead to scarring and nerve damage. SLIDESHOW Sex-Drive Killers: The Causes of Low Libido See Slideshow. Health Solutions From Our Sponsors Peripheral nerve injury associated with a subdermal contraceptive implant: illustrative cases and systematic review of literature Laumonerie, Pierre and Blasco, Laurent and Tibbo, Meagan E. and Leclair, Olivier and Kerezoudis, Panagiotis and Chantalat, Elodie and Mansat, Pierre Peripheral nerve injury associated with a subdermal contraceptive.

Major nerve injury in association with use of

Contraceptive Implants (CIs) were introduced to the commercial market in the early 1980s. Frequency and severity of sharps injury, nerve damage, blood vessel damage, tissue damage, wound infection and cytotoxicity during and after the use of the device. Performed by investigation of site at the time of operation and one week later The etonogestrel contraceptive implant (Nexplanon®) remains the most effective hormonal contraceptive method available in the U.S. The contraceptive implant is routinely inserted just beneath the skin on the inner-side of the non-dominant arm, but insertion at this site has resulted in rare, yet potentially morbid complications Wechselberger G, Wolfram D, Pülzl P, et al. Nerve injury caused by removal of an implantable hormonal contraceptive. Am J Obstet Gynecol 2006; 195:323. O'Grady EE, Power DM. Ulnar nerve injury on removal of a contraceptive implant. Practitioner 2016; 260:21

Contraceptive implants: current perspectives Sam Rowlands,1,2 Stephen Searle3 1Centre of Postgraduate Medical Research and Education, School of Health and Social Care, Bournemouth University, Bournemouth, United Kingdom; 2Dorset HealthCare, Bournemouth, United Kingdom; 3Sexual Health Services, Chesterfield, United KingdomAbstract: Progestin-only contraceptive implants are a highly cost. OBJECTIVES We aim to describe our experiences and identify patients who may benefit from referral to a peripheral nerve surgeon for removal of contraceptive subdermal implants in which neurovascular injury may occur, and describe a treatment pathway for optimal care. STUDY DESIGN We reviewed the charts of 22 patients who were referred to the Division of Family Planning for difficult removal of. Charlene Clarke, 31, had a contraceptive implant incorrectly inserted in 2007; 'Surgeons hadn't probed deeper because there was a risk that would damage a nerve and my arm would be paralysed.

Neuropathy associated with etonogestrel implant insertion

  1. i-mised by moving the implant away from these structures using fluid under direct vision. This should carry much less risk of trauma than use of retractors and multiple instruments through an open incision. There is no risk of mistaking a 'white' nerve trunk for the white implant
  2. ant arm, about 8-10 cm (3-4 inch) above the elbow bone. The particular location of the implant is very important due to the following reasons
  3. Contraceptive implants are progestin-based, highly effective, and rapidly reversible methods of contraception that require little of the user and have few side effects. Nerve injury can result in impaired sensibility, severe localized pain, or the formation of painful neuroma
  4. repeat pregnancy test. The hormones from the implant will not harm the pregnancy. Consent form documentation for Implant • Patient must be able to provide consent • Indicate implant insertion and specify which arm • Risks: pain, bleeding, infection, scarring, nerve damage, need for another procedure, failure and deep insertio
  5. Etonogestrel is a medication which is used as a means of birth control for women. It is available as an implant placed under the skin of the upper arm under the brand names Nexplanon and Implanon, and in combination with ethinylestradiol, an estrogen, as a vaginal ring under the brand names NuvaRing and Circlet. Etonogestrel is effective as a means of birth control within 8 hours of insertion.
  6. Etonogestrel birth control implant, sold under the brand names Nexplanon among others, is a device made up of a single rod containing etonogestrel which is used for birth control. It is one of the most effective forms of birth control with a one year failure rate around 0.05%. The device is placed under the skin and lasts for up to three years
  7. Contraceptive implant. The contraceptive implant (Nexplanon) is a small flexible plastic rod that's placed under the skin in your upper arm by a doctor or nurse. It releases the hormone progestogen into your bloodstream to prevent pregnancy and lasts for 3 years. Credit

Ulnar nerve injury associated with removal of Norplant

18.3 Nerve damage 38 18.4 Intramuscular insertion 38 19 Impalpable and deeply sited etonogestrel implants 38 19.1 Initial management of impalpable implants 38 19.2 Etonogestrel implants that have been identified deeply sited in the arm 38 contraceptive subdermal implant available in the UK INDICATIONS. The NORPLANT (levonorgestrel implants (unavailable in us)) SYSTEM is indicated for the prevention of pregnancy and is a long-term (up to 5 years) reversible contraceptive system. The capsules should be removed by the end of the 5th year The birth control implant, available in over 100 countries, is a highly-effective form of hormonal birth control that many people find to be a convenient method of preventing pregnancy. The implant is inserted into the arm and can be kept for up to five years. 1 Using a synthetic version of the hormone progestin rather than estrogen, the implant stops ovulation and thickens the walls of the.

I have the contraceptive implant in my arm for 18 months now, and this weekend i was out with my boyfriend shopping and i get such painfull shoulders and i dont understand why i couldnt put them down straight or it hurt so badly then started to feel sick, get stabbing pains in my stomach and back sometimes it just feels like cramp other times ive stabbing pains, i feel this mostly sore on my. Contraception. As a woman with a disability, you have the right to decide whether to become pregnant and give birth, as well as the number, spacing, and timing of your children. You have a right to obtain accurate information and counseling regarding contraception (birth control). Remember, only you and your healthcare provider can determine. An implant is a medical device manufactured to replace a missing biological structure, support a damaged biological structure, or enhance an existing biological structure. Medical implants are man-made devices, in contrast to a transplant, which is a transplanted biomedical tissue.The surface of implants that contact the body might be made of a biomedical material such as titanium, silicone. Implanon Contraceptive Implant Average Failure Rate: less than 1%. Removals of deeply inserted implants can lead to serious scarring, nerve damage, or other complications. If the implant cannot be removed, this may result in infertility, pregnancy outside of the womb (ectopic pregnancy), or inability to stop a drug-related allergy.. Implant dissolves into the body after it speeds nerve healing. Scientists have developed the first ever bioresorbable electronic medicine: a biodegradable wireless implant that speeds nerve.

muscle anterolateral to the sulcus to avoid damage to the ulnar nerve which runs posteromedial to the sulcus insertion of the etonogestrel contraceptive implant J Iwangaa, M Foxb, H Rekersb, L Schwartzb, R. S. Tubbsa displaced the ulnar nerve anteriorly towards the sulcus Injury or damage to tissue or implant as a result of implant surgery Infection, including Toxic Shock Syndrome Occurs when wounds are contaminated with microorganisms, such as bacteria or fungi

Video: possible ulnar nerve damage?? : Nexplano

The birth control pill is a popular, effective way to prevent unintended pregnancy and is generally accepted as a safe method of birth control. However, it can cause serious side effects in rare. The birth control implant is a hormonal contraceptive that is inserted subdermally into a woman's upper arm to slowly release a synthetic form of the sex hormone progesterone (progestin) over time. The implant does not contain estrogen. The release of the hormone progestin helps prevent ovulation, meaning a woman does not release an egg to be fertilized Birth control has a promising effect on the functioning of a balanced social life. With 99% effectiveness, contraceptive implants are a long term birth control option for women. Like other birth control methods, the implant releases a hormone called progestin. Hormones are chemicals made in our body and control how different body parts function

Essure birth control device concerns 05:28. Tens of thousands of women say they suffered painful and serious side-effects from Essure, a medical device meant as a permanent birth control option. The birth control implant, Nexplanon, is highly effective with just a 0.01% chance of pregnancy. The birth control implant requires a quick and painless procedure and lasts for up to three years. Common side effects of the birth control implant include irregular bleeding, headaches, and acne Peripheral nerve injury associated with a subdermal. Scarring where the implant was removed Injury to the nerve or blood vessels Breaking of the implant A second incision could be needed to remove the implant or a second visit could be needed to remove the implant Based on my knowledge of the above, I consent to the removal of the contraceptive implant

sertion), non-palpability of the implant at insertion and removal, local-ization of non-palpable implants, and dif!cult removals. Clinically signi!cant consequences included: pregnancy due to unrecognized non-insertion, nerve or vascular injury, and hospitalization and/or sur-gery for localization and/or removal sub dermal contraceptive implants is due to the are somewhat essential to avoid damage to the many structures in this region at the time of insertion as well as during the removal of implants. Figure 1. When the implant is adherent to a sensory nerve, patient reports pain. If the implant is within the biceps muscle If the implant is not removed, then the effects of NEXPLANON will continue for a longer period of time. Other problems related to insertion and removal include pain, irritation, swelling, bruising, numbness and tingling, scarring, infection, injury to the nerves or blood vessels, and breaking of the implant

Woman Awarded $2.78 Million in Malpractice Suit against ..

Wechselberger G, Wolfram D, Pulzl P, et al. Nerve injury caused by removal of an implantable hormonal contraceptive. Am J Obstet Gynecol. 2006;195:323-6. PubMed Article Google Scholar 3. Osman N, Dinh A, Durbert T, et al.. A new cause for iatrogenic lesion of the ulnar nerve at the arm: contraceptive hormonal implant The Contraception Guide. Dr. Jolene BrightenPublished: August 8, 2019 Last Reviewed: May 4, 2021 Birth Control Leave a Comment. Information about contraception can make your head spin. There are so many kinds of birth control available today (yay!), and what works for one woman may not work for another peroneal nerve injury ureter injury bladder injury bowel injury Background. Sterilization is the most common form of contraception used in the United States. Over 18% of women and 8% of men relied on sterilization in 1990. As age goes up, so do the surgical sterilization rates so that at age 40-44, over 50% of women using contraception utilized. Women need to be very careful about medical contraception if they have vascular disease, nephropathy/ retinopathy/ neuropathy (kidney disease or damage/eye damage/nerve damage), or diabetes that has lasted longer than 20 years. In general, the combined pill, patch, and ring should be avoided, because they pose unacceptable health risks

Median Nerve Injury After Removal of Subdermal Implantable

Amanda's arm after the Implanon device was removed.Source: Facebook. Amanda Nicole Vinson of Columbus in Ohio in the United States posted about her horrific experience of using the Nexplanon, or Implanon as it's known in South Africa, contraceptive implant two years ago. According to her post the implant 'got lost' and the doctors had to 'dig. Hip replacement complications include blood clots, change in leg length, dislocation, fractures, infection and loosening of the implant. People who have received metal-on-metal hips may also experience metallosis, a form of metal poisoning that causes tissue damage and other serious conditions. This is an active lawsuit

Symptoms After Nexplanon Removal: What Can You Expect

Birth Control Nexplanon Implant The Nexplanon ® contraceptive implant (Picture 1) is a thin, matchstick-sized, flexible rod inserted under the skin of your upper arm by your healthcare provider. The implant has a small amount of progestin similar to the hormones that are naturally made in a woman's body out, I can have a new contraceptive implant put in or choose a different method of birth control today. I understand that it could take up to 30 minutes to take out the contraceptive implant. • Scarring where the implant was removed • Injury to the nerve or blood vessels • Breaking of the implant Pseudotumor Cerebri Linked to Birth Control. In 1995, the New England Journal of Medicine published a study linking 56 cases of intracranial hypertension (also known as pseudotumor cerebri) and optic disc edema with birth control pills and contraceptive implants containing the hormone levonorgestrel, such as Mirena. Other studies and case. The contraceptive implant (Implanon NXT®) is a soft plastic stick about 4 centimetres long. The implant slowly releases a hormone, progestogen, into your body over time. Progestogen is like the hormone produced by the ovaries. Other types of hormonal contraception include oral tablets (the combined pill and the mini pill), the hormonal IUD and. • Contraceptive implant or intrauterine system (IUS): Insert NEXPLANON on the same day the previous contraceptive implant or IUS is removed. If inserted as recommended, back-up contraception is not necessary. If deviating from the recommended timing of insertion, the woman should be advised to use a barrier method until 7 days after insertion

The implant (WAS/WAS NOT) placed at (CLINIC NAME). An informed consent was signed prior to removal and will be scanned into the Electronic Health Record. Risks of the procedure include: bleeding, infection, scarring, and nerve damage What should I know about birth control and epilepsy? There are many choices available to women with epilepsy for effective birth control (also called contraceptives). Hormone-based oral contraceptives (called OCs or the pill) are used most often to prevent pregnancy. These usually contain forms of both estrogen and progesterone, so are called combination pills Injury of ulnar nerve at upper arm level, left arm, init; Injury of left ulnar nerve at upper arm level; Ulnar nerve injury, left upper arm level. ICD-10-CM Diagnosis Code S44.02XA. Injury of ulnar nerve at upper arm level, left arm, initial encounter Z95.81 Presence of other cardiac implants and grafts... Z95.810 Presence of automatic. Teva Pharmaceuticals manufactures the Paragard IUD. The device is designed to provide long-term birth control (contraception), and was FDA-approved in 1984. Women who prefer not to take birth control pills often turn to IUDs as an alternative option. The device is made of a plastic, T-shaped base with copper wire coiled around it

Nerve or tissue damage may occur when a surgeon places an implant too close to a nerve. Signs of damage include numbness or tingling in the tongue, lips, gums, or face. Foreign body rejection. Nexplanon is a nonbiodegradable, single-rod, long-acting, hormonal contraceptive implant, inserted subdermally. If the implant is inserted deeper than subdermally (deep insertion), neural or vascular injury may occur. Deep or incorrect insertion has been associated with paraesthesia (due to neura

Contraceptive subcutaneous device migration: what does an

The Mirena IUD is just the latest birth control device linked to Pseudotumor cerebri (PTC), the most common medical name for this potentially fatal brain disorder. Nexplanon and Xulane exhibit side effects that resemble PTC. The disorder is also known as idiopathic intracranial hypertension. While PTC is a rare side effect, it is one of the. Contraceptive Implant Counselling Interactive OSCE Checklist. Opening the consultation. Wash your hands and don PPE if appropriate. Introduce yourself to the patient including your name and role. Confirm the patient's name and date of birth. Check the patient's understanding of the types of contraception available Depression & Implanon the contraceptive implant. Sexual health and contraception. Contraceptive implant but feel pregnant. Rac63hji. 18/11/2010 at 11:31 am

The Pill is a prescription tablet containing estrogen, progestin, or both. When taking the pill, women with disabilities may have an increased risk of blood clots. 10 They may also experience weight gain that could complicate transfers. 5 Some other medications may make the pill less effective. 3,11 Some women with disabilities take the pill to reduce blood flow and make it easier. If rods have been correctly inserted, migration to other tissues is not thought to occur, however, there have been rare cases reported of insertion into deep tissue, nerve and vascular injury. 3 There is no delay in return to fertility after removal of a levonorgestrel implant so a contraceptive should be initiated immediately if the patient is. The etonogestrel implant has been available in Australia since 2001. General practitioners routinely insert and remove these implants in their rooms under local anaesthetic. We report two cases of significant median nerve injury following inappropriate dissection of the arm to remove this device when impalpable The contraceptive implant consists of a flexible plastic rod about 40 mm long, which contains progestin. This is released at a constant low rate into the body. It should be inserted only by a.