Complex Implant Removal Clinic
Who is this clinic for?
You have been referred to this clinic for removal of your contraceptive implant, either because it has been assessed as difficult to remove or because it is not possible to feel the implant in your arm.
This clinic is a part of county wide Sexual Health Service Nottingham and Nottinghamshire(SHSNN). The clinic for this procedure is based at Nottingham City Hospital.
Before your appointment:
Eating and drinking
You may eat and drink as normal. We advise a light meal or snack and non-alcoholic drink about an hour before your appointment.
Sex
If your implant is over three years old we suggest you have alternative contraception such as a pill or condoms.
Unprotected sex will not stop your implant being removed.
Contraception
As soon as your implant is removed it will stop working as contraception. If you do not want to become pregnant we recommend you start another method or use condoms.
We can provide all methods of contraception except for a coil at this appointment, as a coil fit needs a longer appointment.
If you would like a coil fit please let the Administration Team know so we can book you a longer appointment.
If you need help to decide on your next method of contraception you may find these websites
useful:
Other information
- Bring a list of any health conditions and medications to your appointment.
- Please attend without children if possible.
- Please allow up to an hour for your appointment – it is usually quicker but may take longer.
What will happen at your appointment?
You will be seen by a doctor trained to remove more difficult implants. They will talk with you about your health and contraception needs as well as any concerns or questions with you before any procedure.
A health care assistant or nurse will also be in the room to support you and to assist the doctor.
The doctor will discuss the risks and benefits of the procedure and check it is safe to go ahead – this is called gaining your consent.
Your procedure
An ultrasound scan of your arm may be needed to help find the implant, if this is not needed the doctor will not offer one.
The doctor will give you numbing injection (local anaesthetic) at your procedure to ensure you are comfortable.
A small cut will be made in the skin (usually less than 2cm length) and the implant will be carefully removed.
The cut will be covered with steristrips or traditional stitches and a plaster to help the cut heal.
A bandage is also put around your arm to reduce bleeding and bruising.
Risks
- The implant can be close to nerves and blood vessels in the arm, although great care is taken removing your implant, it is possible but very rare for these to be injured.
- There is a small risk of bleeding and infection.
- You may get some bruising and a small scar.
After your procedure
Follow up
Usually, no follow up is needed unless the clinician you see advises you otherwise, depending on your individual needs.
If we cannot find your implant at this appointment we will organise for x-rays of your arms and chest to look for it. We will talk about this in more detail with you if needed.
Wound care
Please keep your wound clean and dry for a week. You may shower and have a bath but avoid getting the wound very wet.
Bandage
Please remove your bandage after two days.
The bandage is designed to reduce bleeding and bruising but should not be tight enough to make your arm feel tingly, cold or numb. If it is cold, tingly or numb please loosen bandage.
If the symptoms persist then please contact Sexual Health or NHS 111 for advice.
Stitches
You can remove steri-strips yourself after seven days by peeling them off like a plaster.
If you have stitches they will need removing after seven days, this can be done in Sexual Health or with your GP and will be organised at your appointment.
Getting home/after care
Most people are fine and able to drive after the procedure, although some people prefer to have a friend/relative bring them to their appointment or take a taxi or bus.
Most people are able to go about their day as usual following the appointment; however, we advise against planning any major commitments in case you are uncomfortable or do not feel able to do them.
Pain relief
You may have some discomfort or an achy arm.
Unless you are unable to take pain killers, we advise you take paracetamol (1g by mouth) and ibuprofen (400mg by mouth, with some food to protect your stomach).
Sex
You can go back to having sex when you want to.
If you are starting another contraception method, your doctor will advise you how long it will take to work.
When to seek advice
If you notice your wound getting very hot, red, swollen or pus coming out of it this may be an infection. Please contact Sexual Health or your GP to get it checked and antibiotics if needed.
If your arm feels tingly, cold or numb and you have loosened your bandage please contact Sexual Health or out of hours NHS 111 for advice.
If you are worried for any reason related to you procedure, please contact Sexual Health for advice.
Contact numbers:
- Sexual Health Services Nottingham & Nottinghamshire: 0300 131 7010
- Out of hours; you can get urgent advice from NHS 111
- In the case of emergency out of normal hours please attend Urgent Care/Emergency Department at your local hospital, or call 999 for an ambulance.
If you change your mind or the appointment is not convenient, please telephone us to either cancel or rearrange on 0300 131 7010.
Further sources of information
Patient Experience Team (PET)
PET is available to help with any of your compliments, concerns or complaints, and will ensure a prompt and efficient service:
Nottingham University Hospitals: 0800 183 02 04
Email: nuhnt.PALS@nhs.net
King’s Mill Hospital: 01623 672222
Newark Hospital: 01636 685692
Email: sfh-tr.PET@nhs.net
If you would like this information in an alternative format, for example large print or easy or if you need help with communicating with us, for example because you use British Sign Language, please let us know. You can contact the Patient Experience Teams using the details above.