Norplant removal procedures -- evidence of success of the insertion training programme.

1996 
There were 125 removals of Norplant contraceptive implants at St. James University Hospital (SJUH) between October 1995 and March 1996. Detailed records were kept on these cases in the attempt to identify factors possibly associated with difficulties in removing Norplant. Norplant capsules inserted at SJUH and elsewhere were overall readily palpable. 116 were primary removals with the remainder being secondary to removal attempts made elsewhere. All removals were of capsules inserted by trained or training professionals including 44 inserted at SJUH. Of the 116 primary procedures there were 32 instances of misalignment 62 cases in which no capsules were visible and 103 cases in which all six capsules were palpable throughout their length. The capsules in all of the cases in which previous attempts had been made were extricated within 15 minutes. Trainers removed the Norplant capsules significantly faster than did trainees under supervision. The authors believe that these results confirm the effectiveness of the UK Norplant training program in establishing appropriate levels of expertise among the majority of those doctors undertaking insertions.
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