Referrals for Complications following hysteroscopic sterilization: Characteristics associated with symptomatic patients after the Essure procedure

July 25, 2016 5:08 pm Published by

 

The European Journal of Contraception & Reproductive Health Care, 2016

Scott Sills & Marie M Dalton

 

E Scott Sills, MD, PHD & Marie M Dalton (2016) Referrals for complications following hysteroscopic sterilization: characteristics associated with symptomatic patients after the Essure procedure, The European Journal of Contraception & Reproductive Health Care, 21 :3, 227-233,  DOI: 10.3109/3625187.2016.1151867
Medical Director
Reproductive Research Section
Center For Advanced Genetics
Carlsbad, California

Molecular and Applied
Biosciences Department
Doctoral Researcher
Faculty of Science and Technology
University of Westminster
London, UK

Marie M. Dalton, BSN
Graduate Assistant
Department of Political Science
Howard H. Baker, Jr. Center for Public Policy
University of Tennesee

 

 

Introduction

 

More than 300,000 women request permanent surgical sterilization in the U.S.A. each year.¹ While laparoscopic bilateral tubal ligation remains the most common technique to meet this contraceptive need, in 2002 a new non-incisional technique (Essure ®, Bayer Health Care AG; Whippany, NJ) became available.  This procedure entails bilateral tubal occlusion via hysteroscopic insertion of nickel-titanium inserts at the proximal fallopian tubes.  His hysteroscopic sterilization (HS) method offers several advantages over standard laparoscopy including lower cost,² as well as eliminating the need for abdominal access and general anaesthesia.³ˉ⁵  The only HS method currently available in the U.S.A. is Essure®.  While these contraceptive coils are latex free, the devices contain acrylonitrile butadiene styrene (ABS), polytetrafluoroethylene (PTFE) polyvinyl pyrrolidone, polyethylene terephthalate (PET), nickel, and other substances.⁶  Market data supplied by the manufacturer indicate that approximately 750,000 Essure® kits have been sold worldwide, and women in the U.S.A. account for approximately 600,000 of these sales.⁷ˉ⁹

This case series describes several previously unreported features of symptomatic Essure® patients, with a view to improve familiarity with these implants when the devices migrate, perforate, are spontaneously expelled, or are incorrectly positioned.  The important role of preoperative hysterosalpingography (and intraoperative photography) in evaluating these patients is also highlighted.

 

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