Uncommon adverse local reactions associated with subdermal etonogestrel implants.

Subdermal etonogestrel implants (SEI) are an effective and safe contraceptive method. Insertion and removal are minimally invasive procedures, but several different local adverse reactions may occur.
Objective: To describe the clinical characteristics, monitoring and treatment of a series of cases of uncommon local adverse reactions associated with SEI insertion and extraction procedures (including its iconography), registered between 2011 and 2017 at the Center for Sexual and Reproductive Health Fuente de San Luis (Valencia, Spain).
Materials and methods: Between 2012 and 2017, ten cases of uncommon adverse local reactions with SEI insertion or extraction procedure were reported and registered in the Centre for Sexual and Reproductive Health Fuente de San Luis (Valencia, Spain). Cases were tagged according to the type of procedure that originated them: insertion or removal. Insertion cases were described as skin abscess, allergic reaction, painful scar, painful implant due to shallow insertion, partial self-expulsion and foreign body reaction. Removal cases were described as bent or deformed implant due to difficult extraction, and broken implant.
Results: Most local adverse reactions occur at the insertion and in these cases removal is often mandatory. Among all the complications observed, the abscess and allergy to the implant stand out. Most of them were related with Implanon NXT®.
Conclusions: The adverse local reactions secondary to insertion and removal of SEI are rare, but easy to handle. The role of barium in adverse reactions remains unclear.