Name of the Procedure:

Levonorgestrel-releasing intrauterine contraceptive system (Kyleena), 19.5 mg (HCPCS Code: J7296)

Summary

The Levonorgestrel-releasing intrauterine system (Kyleena) is a small, T-shaped device inserted into the uterus to release a hormone called levonorgestrel. It provides long-term birth control by preventing pregnancy.

Purpose

The procedure aims to:

• Prevent pregnancy for up to five years.
• Offer a long-term, reversible contraceptive solution.
• Reduce menstrual bleeding and pain for some users.

Indications

The procedure is appropriate for females who:

• Desire long-term, reversible birth control.
• Prefer a hormone-based contraception method.
• Have had issues with other forms of birth control.

Preparation

• No specific fasting or dietary restrictions are required.
• The patient may be advised to take an over-the-counter pain reliever before the appointment.
• A pelvic exam may be performed to assess the uterus size and position.

Procedure Description

1. The patient lies down in a gynecological exam position.
2. A speculum is inserted to visualize the cervix.
3. The cervix and vagina are cleaned with an antiseptic solution.
4. A local anesthetic may be administered if needed.
5. The healthcare provider inserts a thin tube containing the Kyleena device through the cervix into the uterus.
6. The Kyleena device is released from the tube, and the tube is then removed.
7. The strings of the device are trimmed to the appropriate length.

Duration

The entire procedure typically takes about 10-15 minutes.

Setting

The procedure is usually performed in an outpatient clinic or a gynecologist’s office.

Personnel

• A gynecologist or qualified healthcare provider performs the procedure.
• Nursing staff may assist.

Risks and Complications

Common risks:

• Mild to moderate pain or cramping.
• Spotting or irregular bleeding.

Rare risks:

• Expulsion of the device.
• Perforation of the uterus.
• Infection.

Benefits

• Highly effective birth control lasting up to five years.
• Reduced menstrual pain and bleeding for some users.
• Reversible upon removal, with quick return to fertility.

Recovery

• Patients may experience cramps or spotting for a few days.
• Regular activities can usually be resumed immediately.
• Follow-up visits may be scheduled to check the device's position.

Alternatives

• Oral contraceptive pills.
• Hormonal patches or rings.
• Copper intrauterine devices (IUDs).
• Barrier methods like condoms.

Pros and cons of alternatives vary; some may require daily attention or less effective.

Patient Experience

• Patients may feel a pinch or cramp during insertion.
• Mild discomfort and spotting are common shortly after the procedure.
• Pain management might include over-the-counter pain relievers.