Name of the Procedure:

Levonorgestrel-releasing intrauterine contraceptive system (Skyla), 13.5 mg

• Common Names: Skyla, IUD, Birth Control Device
• Medical Terms: Levonorgestrel IUD, Intrauterine Contraceptive Device

Summary

Skyla is a small, T-shaped intrauterine device (IUD) that releases the hormone levonorgestrel. It's a long-acting, reversible contraceptive method designed to provide up to three years of birth control.

Purpose

Skyla is used to prevent pregnancy. It works by releasing levonorgestrel, which thickens cervical mucus to prevent sperm from reaching the egg, inhibits sperm movement, reduces sperm survival, and thins the uterine lining to prevent implantation.

Indications

Patients who seek a long-term contraceptive method with minimal maintenance.
Ideal for those who may not want to undergo daily, weekly, or monthly contraceptive routines.
Suitable for women who have not given birth.

Preparation

No specific fasting or medication adjustments are usually required.
A pelvic exam, STI screening, and overall health assessment may precede the insertion.

Procedure Description

1. Patient lies on an exam table.
2. A speculum is inserted to visualize the cervix.
3. The cervix and vagina are cleansed with an antiseptic solution.
4. A tenaculum might be used to stabilize the cervix.
5. A measuring instrument (sound) is used to determine the depth of the uterus.
6. Skyla is inserted through the cervical canal into the uterus using an applicator.
7. The applicator is withdrawn, leaving the device in place.
8. The strings of the IUD are trimmed to an appropriate length.

Duration

The procedure typically takes 10-20 minutes.

Setting

Usually performed in a healthcare provider's office or an outpatient clinic.

Personnel

• A healthcare provider (usually an obstetrician-gynecologist or a trained family physician)
• Possibly a nurse or a medical assistant

Risks and Complications

Common:

• Cramping or pain during and after insertion
• Light bleeding or spotting

Rare:

• Expulsion (the IUD falls out)
• Perforation (the IUD punctures the uterine wall)
• Infection

Benefits

• Highly effective (>99%) in preventing pregnancy.
• Long-term protection for up to three years.
• Minimal maintenance required after insertion.

Recovery

• Mild discomfort or cramping may last a few days.
• Regular activities can usually be resumed almost immediately.
• Follow-up appointment typically scheduled 4-6 weeks after insertion to ensure proper placement.

Alternatives

• Other IUDs (e.g., copper IUD)
• Hormonal methods (pills, patches, injections)
• Non-hormonal methods (condoms, diaphragms)

Pros and Cons of Alternatives:

• Other IUDs may last longer but might have different side effects.
• Hormonal pills require daily adherence.
• Non-hormonal methods offer less consistent pregnancy prevention.

Patient Experience

During the procedure, patients may feel discomfort, cramping, and pressure.
Post-procedure, some may experience light bleeding, cramping, and spotting for a few days.
Pain management includes over-the-counter painkillers like ibuprofen.

Comfort measures like heat pads can help alleviate cramping.
Patients are encouraged to contact their healthcare provider if they experience severe pain, heavy bleeding, or signs of infection.