COMPLICATIONS AND RISK-FACTORS ASSOCIATED WITH THE REMOVAL OF NORPLANT IMPLANTS

Objective: To describe the complications reported at the removal of No rplant implants, and to suggest potential risk factors for these compl ications. Methods: Complications at the removal of Norplant implants f rom 3416 users from 11 countries who participated in preintroductory c linical trials of the method were tabulated. A logistic regression mod el was used to identify the significant risk factors associated with r emoval complications. Results: Complications were reported in 4.5% of removals; most often, they were related to broken or deeply placed imp lants. The most important risk factors were complications at insertion and having an infection at the implant site (at or before removal). C onclusion: Proper insertion technique under aseptic conditions is very important in predicting whether Norplant implant removal will be diff icult. Although relatively infrequent even now, more vigilant training and the evaluation of some of the newer removal techniques could furt her reduce the incidence of difficult removals.