Ultrasound - Assisted Removal of Impalpable Contraceptive Implants at The Korle Bu Teaching Hospital

Removal of Impalpable Contraceptive Implants

Authors

  • Swarray-Deen A University of Ghana Medical School, College of Health Sciences, Korle Bu, Accra
  • Sefogah PE University of Ghana Medical School https://orcid.org/0000-0003-3575-2838
  • Ibine BR Obstetrics and Gynaecology Department, University of Health and Allied Sciences, School oof Medicine, Ho
  • Asah-Opoku K University of Ghana Medical School, College of Health Sciences, Korle Bu
  • Mumuni K University of Ghana Medical School, College of Health Sciences, Korle Bu, Accra
  • Oppong SA University of Ghana Medical School, College of Health Sciences, Korle Bu, Accra

DOI:

https://doi.org/10.60014/pmjg.v14i1.373

Keywords:

contraceptive, implant, low-resource, non-palpable, successful ultrasound scans

Abstract

Objective: To describe our experience of using ultrasonography to locate and remove impalpable implants in a low-resource environment.

Methodology: We report a series of non-palpable subdermal contraceptive implants with unsuccessful removal attempts at other facilities, who were referred to the Reproductive Health Unit, KorleBu Teaching Hospital, between 2015-2018. A high-resolution linear-array probe ultrasound was done to localize the implants. Removal was performed under local anaesthesia, involving a longitudinal incision within the ultrasound-guided skin markings and blunt dissection to locate and retrieve the implant.

Results: Fifteen patients with non-palpable subdermal contraceptive implants were referred after failed attempts by midwives or gynaecologists over the period. Implants included Implanon (9) and Jadelle (6), with durations of use ranging from 8 months to 5 years. Most implants were successfully located using high-resolution linear-array ultrasound probe, and removed under local anaesthesia. Implants were abnormally positioned in 5 cases, with depths ranging between 5 mm and 7 mm. In 14 cases, removal was successful through skin marker guidance or direct ultrasound guidance. One case required general anaesthesia and plastic surgeon’s assistance. No significant complications were reported.

Conclusion: In Ghana, the increasing incidence of impalpable contraceptive implants necessitates the use of interventional radiological methods for removal. Our case series demonstrates that ultrasound-guided removal of non-palpable implants is effective and can be performed with minimal complications in low-resource settings. We recommend training providers, including midwives, in ultrasound-guided implant removal techniques and advocating for early referral to specialized centers.

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Published

2025-03-28

How to Cite

Swarray-Deen, A., Sefogah, P. E., Ibine, B. R., Asah-Opoku, K., Mumuni, K., & Antwi Oppong, S. (2025). Ultrasound - Assisted Removal of Impalpable Contraceptive Implants at The Korle Bu Teaching Hospital: Removal of Impalpable Contraceptive Implants. Postgraduate Medical Journal of Ghana, 14(1), 11–15. https://doi.org/10.60014/pmjg.v14i1.373