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Letter to the editor
Essential anatomy: why anatomical words matter when it comes to subdermal implants
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  1. R Barlow - Evans1,
  2. K Jaffer2,
  3. J K Gupta3
    1. 1 Community Sexual and Reproductive Health, Umbrella Sexual Health Services, University Hospitals Birmingham, Birmingham, UK
    2. 2 Sexual and Reproductive Health, Umbrella Sexual Health Services, University Hospitals Birmingham, Birmingham, UK
    3. 3 Obstetrics and Gynaecology, Birmingham Women’s NHS Foundation Trust, Birmingham, UK
    1. Correspondence to Dr R Barlow - Evans, Community Sexual and Reproductive Health, Umbrella Sexual Health Services, University Hospitals Birmingham, Birmingham B15 2GW, UK; rachel.barlow-evans{at}nhs.net

    https://doi.org/10.1136/bmjsrh-2018-200217

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      The current clinical guideline on progestogen-only implants produced by the Faculty of Sexual and Reproductive Health (FSRH) Clinical Effectiveness Unit was written in February 2014 and is due to be updated within the next year.

      We are all familiar with the risks associated with an implant insertion which is too deep; these risks include neural or vascular damage, paraesthesia, migration, and rarely intravascular migration. Deep insertions also mean that the implant may be more difficult to remove, which may result in repeat patient appointments and additional scans or imaging, and it may be impossible to remove without an onward surgical referral.1 2

      Given this, healthcare professionals (HCPs) are understandably eager to minimise the risk of deep insertion for …

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