Management and localization strategies for the nonpalpable Implanon rod

PurposeThe goal of this paper is to review the imaging methods required for localizing nonpalpable Implanon™.MethodDifferent localization methods for nonpalpable Implanon rods are summarized, and clinical guidance is provided as to how best to localize such implants.ResultsIn the great majority of cases, optimal visualization of the single-rod Implanon rod is obtained with ultrasound using a high-resolution linear array transducer (10–15 MHz). An implant located just under the skin, under the fascia muscularis or one located deep in the muscle can most often be localized with ultrasound. In rare cases where ultrasound does not definitively locate the implant, magnetic resonance imaging is usually the next best choice. Measurements of serum etonogestrel levels may be necessary to confirm the presence or absence of the implant when it cannot be visualized by either of the two imaging methods.DiscussionClose clinical coordination between women's health care providers and radiologists is required to minimize or prevent removal complications and to facilitate subsequent contraceptive management of the patient.