AB158. SOH24AB_032. A systematic review of peripheral nerve injuries associated with the insertion or removal of subdermal contraceptive implants
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AB158. SOH24AB_032. A systematic review of peripheral nerve injuries associated with the insertion or removal of subdermal contraceptive implants

Aoife O’Brien1, Abidur Rahman2, Joshua Skeens-Birrane2, Roisin Dolan1

1Plastic Surgery, Royal College of Surgeons Ireland, Connolly Hospital, Blanchardstown, Co Dublin, Ireland; 2Plastic Surgery, Royal College of Surgeons Ireland, Dublin, Ireland

Background: Subdermal contraceptive implants (SCIs) are popular form of contraception due to their low maintenance while providing effective long-term contraception at least 3 years. The are regularly inserted and removed by doctors and other healthcare professionals. Significant nerve injuries however have been associated with the insertion and removal of these devices. The aim of the study is to examine the degree of nerve injuries that have been reported in the associated with SCIs in the literature, the long-term recovery and complications post treatment.

Methods: A comprehensive literature search was performed for the PubMed, Medline, and Google Scholar Databases to identify all articles from 1980 to 2022 related to upper limb neuropathy and usage of SCI as a cause of nerve damage. Studies for inclusion were identified by reviewing titles and abstracts followed by full text reviews of appropriate articles. A total of 17 papers were included in the final systematic review with a total 21 clinical cases in the analysis.

Results: The majority of the patients suffered from nerve injuries associated with SCI removal. 80% of the patients whose mode of injury were implant removal had undergone multiple attempts at removal prior to specialist referral. The terminal branches of the brachial plexus were most commonly injured, with injury to the Ulnar nerve being the most prevalent. Most common presenting symptoms for patients were paraesthesia and pain. Axonotmesis was the most common severity of injury for patients. More than two thirds of the patients who displayed complications post attempted or successful removal did not return to baseline functionality or sensation post treatment.

Conclusions: SCIs are an effective and easy to use device for effective contraception. However, significant complications have been associated with their insertion and removal. Alternate sites of implant placement should be considered to avoid damaging significant neurovascular structures.

Keywords: Subdermal contraceptive implants (SCIs); nerve injuries; systematic review; peripheral nerve; contraception

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-24-ab158
Cite this abstract as: O’Brien A, Rahman A, Skeens-Birrane J, Dolan R. AB158. SOH24AB_032. A systematic review of peripheral nerve injuries associated with the insertion or removal of subdermal contraceptive implants. Mesentery Peritoneum 2024;8:AB158.

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