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Žegura Andrić B, Rosič M, Serdinšek T, Šumak R. Long-term patient satisfaction and removal rate after essure sterilization: a follow-up study. BMC Womens Health 2022; 22:250. [PMID: 35739506 PMCID: PMC9229077 DOI: 10.1186/s12905-022-01838-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 06/15/2022] [Indexed: 05/31/2023] Open
Abstract
Background The objective of our study was to assess the rate and causes for Essure® micro-insert system removal and patients’ long term satisfaction rate with the procedure.
Methods All patients who underwent Essure® hysteroscopic sterilization at our tertiary centre between years 2007 and 2018 were included in this follow-up study. A questionnaire was sent to all patients per standard mail. Patients who did not respond to questionnaires per mail, were called by phone. The satisfaction with the Essure® sterilization, as well as any additional procedures after the insertion or insertion-related complications were analysed. Results From the year 2007 to 2018, we performed 427 Essure® hysteroscopic sterilizations and of these, 329 patients responded to the questionnaire (response rate 77%). Ten patients (3%) had Essure® removal, two of them due to pain (0.6%). Patients were very satisfied with the procedure (9.5 on scale 0–10). Most patients (95.3%) would recommend the procedure to their friend. Conclusions Essure® hysteroscopic sterilization is a procedure with a very high satisfaction rate and a very low removal rate due to sterilization-related complications. Trial registration Institutional review board of University medical centre Maribor approved the study, approval number UKC-MB-KME-73/19.
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Affiliation(s)
- Branka Žegura Andrić
- Department of General Gynaecology and Urogynaecology, Clinic for Gynaecology and Perinatology, University Medical Centre Maribor, Ljubljanska 5, 2000, Maribor, Slovenia
| | - Maja Rosič
- Health Institution Rosič, Ptuj, Slovenia
| | - Tamara Serdinšek
- Department of General Gynaecology and Urogynaecology, Clinic for Gynaecology and Perinatology, University Medical Centre Maribor, Ljubljanska 5, 2000, Maribor, Slovenia
| | - Rok Šumak
- Department of General Gynaecology and Urogynaecology, Clinic for Gynaecology and Perinatology, University Medical Centre Maribor, Ljubljanska 5, 2000, Maribor, Slovenia.
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Amer MIM, Ahmed ME, Hassan DA. Hysteroscopic tubal occlusion using iso-amyl-2-cyanoacrylate in patients with hydrosalpinx. J Obstet Gynaecol Res 2018; 44:2174-2180. [PMID: 30058273 DOI: 10.1111/jog.13769] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 07/04/2018] [Indexed: 11/29/2022]
Abstract
AIM The aim of this work is to assess the effectiveness of hysteroscopic tubal occlusion using iso-amyl-2-cyanoacrylate, among infertile women with hydrosalpinx prior to in vitro fertilization (IVF). METHODS Hysteroscopic injection of fallopian tubes with hydrosalpinx by 0.5 mL iso-amyl-2-cyanoacrylate was done in 40 infertile women planning for IVF. The patients were then followed-up after 1 and 3 months, with hysterosalpingography (HSG) to confirm complete tubal occlusion. Reinjection with iso-amyl-2-cyanoacrylate was done in these patients with incomplete tubal occlusion after 1 month of the first injection, followed by HSG 2 months later to confirm complete tubal occlusion. Data were prescribed as range, mean and standard deviation (for parametric variables) and range, number and percentage (for categorical variables). RESULTS The total number of tubes injected in this study was 54, 42 (77.8%) of which were completely occluded after one injection while 12 (22.2%) were partially occluded. Reinjection of the partially occluded tubes was done, and (HSG) of all patients after 3 months of the primary injection confirmed 48 (88.9%) of the tubes completely occluded while 6 (11.1%) remained partially occluded. Thirty-two (80%) patients underwent one cycle of IVF/ET (embryo transfer), while 8 (20%) patients did not appear for follow-up. Among the patients who underwent IVF/ET, 24 (75%) got pregnant, while 8 (25%) failed to conceive. Among the pregnant patients, 8 (33.3%) delivered at term, 3 (12.5%) had first trimester abortion, while the remaining 13 (54.2%) did not deliver yet. CONCLUSION Iso-amyl-2-cyanoacrylate used for hysteroscopic tubal occlusion in patients with hydrosalpinx prior to IVF is safe and effective.
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Affiliation(s)
- Mohamed I M Amer
- Department of Obstetrics and Gynecology, Ain Shams University, Cairo, Egypt
| | - Mortada E Ahmed
- Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Dalal A Hassan
- Department of Obstetrics and Gynecology, El-Galaa Maternity Teaching Hospital, Cairo, Egypt
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Zizolfi B, Lazzeri L, Franchini M, Di Spiezio Sardo A, Nappi C, Piccione E, Exacoustos C. One-step transvaginal three-dimensional hysterosalpingo-foam sonography (3D-HyFoSy) confirmation test for Essure® follow-up: a multicenter study. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2018; 51:134-141. [PMID: 28067009 DOI: 10.1002/uog.17398] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 10/31/2016] [Accepted: 12/13/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To evaluate, in patients who underwent Fallopian-tube sterilization by hysteroscopic insertion of an Essure® device, the feasibility and accuracy of three-dimensional (3D) transvaginal sonography (TVS) to check the position of the device and 3D hysterosalpingo-foam sonography (3D-HyFoSy) using contrast-enhanced gel foam to assess consequent tubal occlusion. METHODS This was a prospective multicenter study conducted from June 2012 to July 2014 in four Italian centers, which included 50 women who underwent hysteroscopic Essure microinsert placement in a total of 95 Fallopian tubes. Placement of the microinserts was performed in an outpatient setting following standard procedure recommendations. All patients underwent transvaginal 3D-HyFoSy and hysterosalpingography (HSG) approximately 12-14 weeks after the procedure. The position of the devices was first checked on 3D-TVS and classified according to specific criteria (Positions A, B, C and D). Then, 3D-HyFoSy with ExEm® gel foam as the ultrasound contrast agent was performed to confirm tubal occlusion by the absence of contrast agent within the tubes and/or around the ovaries. To evaluate the feasibility of 3D-HyFoSy, consecutive volume acquisitions were performed while injecting the gel foam. After sonographic evaluation, women underwent HSG to assess the success of sterilization, as standard methodology. Side effects and pain evoked during and after 3D-HyFoSy and HSG were evaluated using a numeric pain rating scale. RESULTS On 3D-TVS, 10 devices (10.5%) were in Position A, two (2.1%) in Position B, 59 (62.1%) in Position C and 24 (25.3%) in Position D. During 3D-HyFoSy, tubal occlusion was observed in 89 of 95 tubes (93.7%). In the six cases in which the passage of the contrast was observed, one device (16.7%) was in Position B, one device (16.7%) in Position D and four devices (66.7%) were found to lie in Position C. Tubal patency was confirmed at HSG with a concordance rate of 100%. The mean pain score associated with 3D-HyFoSy was significantly lower than that on HSG. CONCLUSIONS 3D-TVS with HyFoSy allows accurate assessment of the position of Essure microinserts and tubal occlusion. It can be considered a safe, reliable, non-invasive alternative to HSG. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- B Zizolfi
- Obstetrics and Gynecology, University of Naples, Naples, Italy
| | - L Lazzeri
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - M Franchini
- Department of Obstetrics and Gynecology, Palagi Freestanding Unit, Florence, Italy
| | | | - C Nappi
- Obstetrics and Gynecology, University of Naples, Naples, Italy
| | - E Piccione
- Department of Biomedicine and Prevention, Obstetrics and Gynecology Clinic, University of Rome 'Tor Vergata', Rome, Italy
| | - C Exacoustos
- Department of Biomedicine and Prevention, Obstetrics and Gynecology Clinic, University of Rome 'Tor Vergata', Rome, Italy
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Marques CMV, Magalhães MMDVP, Carvalho MJLDS, Carvalho GMC, Fonseca FAFS, Torgal I. Definitive Contraception: Trends in a Ten-year Interval. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2017; 39:344-349. [PMID: 28472830 PMCID: PMC10416163 DOI: 10.1055/s-0037-1602706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 03/06/2017] [Indexed: 10/19/2022] Open
Abstract
Objective To evaluate the trends in definitive contraception in a ten-year interval comprising the years 2002 and 2012. Method Retrospective analysis of the tubal sterilization performed in our service in 2002 and 2012, analyzing the demographic characteristics, personal history, previous contraceptive method, definite contraception technique, effectiveness and complications. Results Definitive contraception was performed in 112 women in 2002 (group 1) and in 60 women in 2012 (group 2). The groups were homogeneous regarding age, parity, educational level and personal history. The number of women older than 40 years choosing a definitive method was more frequent in group 1, 49.1% (n = 55); for group 2, the rate was 34.8% (n = 23) (p = 0.04). The time between the last delivery and the procedure was 11.6 ± 6.2 and 7.9 ± 6.4 years (p = 0.014) in 2002 against 2012 respectively. In 2002, all patients performed tubal ligation by laparoscopic inpatient regime. In 2012, the bilateral placement of the Essure (Bayer Corporation, Whippany, NJ, US) device was suggested to 56.1% (n = 37) of the patients, while laparoscopy was suggested to 43.9% (n = 29) of them. All women who underwent laparoscopic sterilization had the procedure successfully completed using silastic rings. The overall bilateral device placement rate for the Essure was 91.6%, with only one complication reported. All Essure procedures were performed in an outpatient setting; for the laparoscopy, this rate was 79% (n = 15). No intentional pregnancies occurred until this date. Conclusions There is a trend in the decrease in definitive contraception over the years in our institution, maybe as a result of the development of long-acting reversible contraceptives. The hysteroscopic procedure has become a frequent option, as it is performed in an office setting without anesthesia, being a well-tolerated, minimal invasive method.
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Affiliation(s)
| | | | - Maria João Leal da Silva Carvalho
- Gynecology A Service, Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, Coimbra, Portugal
- Department of Medicine, Universidade de Coimbra, Coimbra, Portugal
| | | | | | - Isabel Torgal
- Gynecology A Service, Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, Coimbra, Portugal
- Department of Medicine, Universidade de Coimbra, Coimbra, Portugal
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Arthuis CJ, Simon EG, Hébert T, Marret H. Intraoperative Factors that Predict the Successful Placement of Essure Microinserts. J Minim Invasive Gynecol 2017; 24:803-810. [PMID: 28390945 DOI: 10.1016/j.jmig.2017.02.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 02/24/2017] [Accepted: 02/28/2017] [Indexed: 10/19/2022]
Abstract
STUDY OBJECTIVE To determine whether the number of coils visualized in the uterotubal junction at the end of hysteroscopic microinsert placement predicts successful tubal occlusion. DESIGN Cohort retrospective study (Canadian Task Force classification II-2). SETTING Department of obstetrics and gynecology in a teaching hospital. PATIENTS One hundred fifty-three women underwent tubal microinsert placement for permanent birth control from 2010 through 2014. The local institutional review board approved this study. INTERVENTION Three-dimensional transvaginal ultrasound (3D TVU) was routinely performed 3 months after hysteroscopic microinsert placement to check position in the fallopian tube. MEASUREMENTS AND MAIN RESULTS The correlation between the number of coils visible at the uterotubal junction at the end of the hysteroscopic microinsert placement procedure and the device position on the 3-month follow-up 3D TVU in 141 patients was evaluated. The analysis included 276 microinserts placed during hysteroscopy. The median number of coils visible after the hysteroscopic procedure was 4 (interquartile range, 3-5). Devices for 30 patients (21.3%) were incorrectly positioned according to the 3-month follow-up 3D TVU, and hysterosalpingography was recommended. In those patients the median number of coils was in both the right (interquartile range, 2-4) and left (interquartile range, 1-3) uterotubal junctions. The number of coils visible at the uterotubal junction at the end of the placement procedure was the only factor that predicted whether the microinsert was well positioned at the 3-month 3D TVU confirmation (odds ratio, .44; 95% confidence interval, .28-.63). When 5 or more coils were visible, no incorrectly placed microinsert could be seen on the follow-up 3D TVU; the negative predictive value was 100%. No pregnancies were reported. CONCLUSION The number of coils observed at the uterotubal junction at the time of microinsert placement should be considered a significant predictive factor of accurate and successful microinsert placement.
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Affiliation(s)
- Chloé J Arthuis
- Department of Obstetrics, Gynecology, Reproductive Medicine and Fetal Medicine, University Hospital Center of Tours, Tours, France; Inserm UMR930, François Rabelais University, Tours, France; Department of Obstetrics and Gynecology, Hôpital Mère-Enfant, Nantes, France.
| | - Emmanuel G Simon
- Department of Obstetrics, Gynecology, Reproductive Medicine and Fetal Medicine, University Hospital Center of Tours, Tours, France; Inserm UMR930, François Rabelais University, Tours, France
| | - Thomas Hébert
- Department of Obstetrics, Gynecology, Reproductive Medicine and Fetal Medicine, University Hospital Center of Tours, Tours, France
| | - Henri Marret
- Department of Obstetrics, Gynecology, Reproductive Medicine and Fetal Medicine, University Hospital Center of Tours, Tours, France; Inserm UMR930, François Rabelais University, Tours, France
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Twelve-year retrospective review of unintended pregnancies after Essure sterilization in the Netherlands. Fertil Steril 2016; 105:932-7. [DOI: 10.1016/j.fertnstert.2015.12.129] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 12/21/2015] [Accepted: 12/22/2015] [Indexed: 11/23/2022]
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Frietze G, Leyser-Whalen O, Rahman M, Rouhani M, Berenson AB. A Meta-Analysis of Bilateral Essure ® Procedural Placement Success Rates on First Attempt. J Gynecol Surg 2015; 31:308-317. [PMID: 26633935 DOI: 10.1089/gyn.2015.0054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: The Essure® (Bayer HealthCare Pharmaceuticals, Leverkusen, Germany) female sterilization procedure entails using a hysteroscope to guide a microinsert into the Fallopian tube openings. Failed placement can lead to patient dissatisfaction, repeat procedures, unintended or ectopic pregnancy, perforation of internal organs, or need for subsequent medical interventions. Additional interventions increase women's health risks, and costs for patients and the health care industry. Demonstrated successful placement rates are 63%-100%. To date, there have not been any systematic analyses of variables associated with placement rates. Objectives: The aims of this review were: (1) to estimate the average rate of successful bilateral Essure microinsert placement on first attempt; and (2) to identify variables associated with successful placement. Materials and Methods: A meta-analysis was conducted on 64 published studies and 19 variables. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, all published studies between November 2001 and February 2015 were reviewed. The studies were taken from from PubMed and Google Scholar, and by using the the "snowball" method that reported variables associated with successful bilateral Essure placement rates. Results: The weighted average rate of successful bilateral microinsert placement on first attempt was 92% (0.92 [95% confidence interval: 0.904-0.931]). Variables associated with successful placements were: (1) newer device models; (2) higher body mass index; and (3) a higher percent of patients who received local anesthesia. Conclusions: The data gathered for this review indicate that the highest bilateral success rates may be obtained by utilizing the newest Essure device model with local anesthesia in heavier patients. More standardized data reporting in published Essure studies is recommended. (J GYNECOL SURG 31:308).
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Affiliation(s)
- Gabriel Frietze
- Department of Psychology, The University of Texas at El Paso , El Paso, TX
| | - Ophra Leyser-Whalen
- Department of Sociology and Anthropology, The University of Texas at El Paso , El Paso, TX
| | - Mahbubur Rahman
- Center for Interdisciplinary Research in Women's Health, The University of Texas Medical Branch , Galveston, TX
| | - Mahta Rouhani
- Center for Interdisciplinary Research in Women's Health, The University of Texas Medical Branch , Galveston, TX
| | - Abbey B Berenson
- Center for Interdisciplinary Research in Women's Health, The University of Texas Medical Branch , Galveston, TX
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la Chapelle CF, Veersema S, Brölmann HA, Jansen FW. Effectiveness and feasibility of hysteroscopic sterilization techniques: a systematic review and meta-analysis. Fertil Steril 2015; 103:1516-25.e1-3. [DOI: 10.1016/j.fertnstert.2015.03.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 03/12/2015] [Accepted: 03/12/2015] [Indexed: 10/23/2022]
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Veersema S. Hysteroscopy and contraception. Best Pract Res Clin Obstet Gynaecol 2015; 29:940-50. [PMID: 26013880 DOI: 10.1016/j.bpobgyn.2015.03.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Accepted: 03/18/2015] [Indexed: 10/23/2022]
Abstract
The Essure method is the only available hysteroscopic sterilisation method. A 4-cm device is placed in the fallopian tubes, which then induces an inflammatory reaction that causes occlusion. The method has a high successful placement rate and high effectiveness, and it can be performed in an office setting without anaesthesia. Three months after the procedure, a confirmation test has to be conducted to assure a correct position of the micro-inserts and tubal occlusion. This test can be performed by hysterosalpingography (HSG), plain X-ray or ultrasound. Pregnancies reported after Essure sterilisation are, in a majority, related to non-adherence to the follow-up protocol or misreading of the confirmation test. A majority of the pregnancies occurred after HSGs that were determined to have been misinterpreted, including missed expulsion or perforation of the micro-insert. Other complications such as ectopic pregnancy and allergic reaction to the micro-inserts seem to have been described to be of low incidence.
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Affiliation(s)
- Sebastiaan Veersema
- Department of Obstetrics & Gynaecology, St Antonius Hospital, Nieuwegein, The Netherlands.
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Ouzounelli M, Reaven NL. Essure Hysteroscopic Sterilization Versus Interval Laparoscopic Bilateral Tubal Ligation: A Comparative Effectiveness Review. J Minim Invasive Gynecol 2015; 22:342-52. [DOI: 10.1016/j.jmig.2014.12.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 11/18/2014] [Accepted: 12/02/2014] [Indexed: 12/01/2022]
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Adelman MR, Dassel MW, Sharp HT. Management of Complications Encountered With Essure Hysteroscopic Sterilization: A Systematic Review. J Minim Invasive Gynecol 2014; 21:733-43. [DOI: 10.1016/j.jmig.2014.03.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 03/20/2014] [Accepted: 03/21/2014] [Indexed: 10/25/2022]
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Xu B, Zhu KA, Xu D, Aili A. Management of long-term and reversible hysteroscopic sterilization: a novel device with nickel-titanium shape memory alloy. Reprod Biol Endocrinol 2014; 12:61. [PMID: 24999021 PMCID: PMC4105153 DOI: 10.1186/1477-7827-12-61] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2014] [Accepted: 07/01/2014] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Female sterilization is the second most commonly used method of contraception in the United States. Female sterilization can now be performed through laparoscopic, abdominal, or hysteroscopic approaches. The hysteroscopic sterilization may be a safer option than sterilization through laparoscopy or laparotomy because it avoids invading the abdominal cavity and undergoing general anaesthesia. Hysteroscopic sterilization mainly includes chemical agents and mechanical devices. Common issues related to the toxicity of the chemical agents used have raised concerns regarding this kind of contraception. The difficulty of the transcervical insertion of such mechanical devices into the fallopian tubes has increased the high incidence of device displacement or dislodgment. At present, Essure® is the only commercially available hysteroscopic sterilization device being used clinically. The system is irreversible and is not effective immediately. PRESENTATION OF THE HYPOTHESIS Our new hysteroscopic sterility system consists of nickel-titanium (NiTi) shape memory alloy and a waterproof membrane. The NiTi alloy is covered with two coatings to avoid toxic Ni release and to prevent stimulation of epithelial tissue growth around the oviducts. Because of the shape memory effect of the NiTi alloy, the device works like an umbrella: it stays collapsed at low temperature before placement and opens by the force of shape memory activated by the body temperature after it is inserted hysteroscopically into the interstitial tubal lumen. The rim of the open device will incise into interstitial myometrium during the process of unfolding. Once the device is fixed, it blocks the tube completely. When the patient no longer wishes for sterilization, the device can be closed by perfusing liquid with low temperature into the uterine cavity, followed by prospective hysteroscopic removal. After the device removal, the fallopian tube will revert to its physiological functions. TESTING THE HYPOTHESIS Currently, experimental and clinical studies are needed to attest the safety, efficiency and reversibility of the novel sterilization device. IMPLICATIONS OF THE HYPOTHESIS If our hypothesis is confirmed, appropriate and reversible contraceptive can be achieved with the device we have designed, which may have significant repercussions for numerous women worldwide.
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Affiliation(s)
- Bin Xu
- Department of Gynecology, Third Xiangya Hospital of Central South University, 138 Tongzipo Rd, Changsha City, Hunan Province 410013, China
| | - Ke-an Zhu
- Department of Gynecology, Third Xiangya Hospital of Central South University, 138 Tongzipo Rd, Changsha City, Hunan Province 410013, China
| | - Dabao Xu
- Department of Gynecology, Third Xiangya Hospital of Central South University, 138 Tongzipo Rd, Changsha City, Hunan Province 410013, China
| | - Aixingzi Aili
- Department of Gynecology, Shanghai East Hospital of Tongji University, 150 Jimo Rd, Shanghai 200120, China
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Ozgur K, Bulut H, Berkkanoglu M, Coetzee K, Kaya G. ICSI pregnancy outcomes following hysteroscopic placement of Essure devices for hydrosalpinx in laparoscopic contraindicated patients. Reprod Biomed Online 2014; 29:113-8. [DOI: 10.1016/j.rbmo.2014.03.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Revised: 02/27/2014] [Accepted: 03/06/2014] [Indexed: 10/25/2022]
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Probability of pregnancy after sterilization: a comparison of hysteroscopic versus laparoscopic sterilization. Contraception 2014; 90:174-81. [PMID: 24767963 DOI: 10.1016/j.contraception.2014.03.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Revised: 03/11/2014] [Accepted: 03/16/2014] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To compare the expected probability of pregnancy after hysteroscopic versus laparoscopic sterilization based on available data using decision analysis. STUDY DESIGN We developed an evidence-based Markov model to estimate the probability of pregnancy over 10 years after three different female sterilization procedures: hysteroscopic, laparoscopic silicone rubber band application and laparoscopic bipolar coagulation. Parameter estimates for procedure success, probability of completing follow-up testing and risk of pregnancy after different sterilization procedures were obtained from published sources. RESULTS In the base case analysis at all points in time after the sterilization procedure, the initial and cumulative risk of pregnancy after sterilization is higher in women opting for hysteroscopic than either laparoscopic band or bipolar sterilization. The expected pregnancy rates per 1000 women at 1 year are 57, 7 and 3 for hysteroscopic sterilization, laparoscopic silicone rubber band application and laparoscopic bipolar coagulation, respectively. At 10 years, the cumulative pregnancy rates per 1000 women are 96, 24 and 30, respectively. Sensitivity analyses suggest that the three procedures would have an equivalent pregnancy risk of approximately 80 per 1000 women at 10 years if the probability of successful laparoscopic (band or bipolar) sterilization drops below 90% and successful coil placement on first hysteroscopic attempt increases to 98% or if the probability of undergoing a hysterosalpingogram increases to 100%. CONCLUSION Based on available data, the expected population risk of pregnancy is higher after hysteroscopic than laparoscopic sterilization. Consistent with existing contraceptive classification, future characterization of hysteroscopic sterilization should distinguish "perfect" and "typical" use failure rates. IMPLICATIONS Pregnancy probability at 1 year and over 10 years is expected to be higher in women having hysteroscopic as compared to laparoscopic sterilization.
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Analysis of Adverse Events With Essure Hysteroscopic Sterilization Reported to the Manufacturer and User Facility Device Experience Database. J Minim Invasive Gynecol 2013; 20:825-9. [DOI: 10.1016/j.jmig.2013.05.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2013] [Revised: 05/07/2013] [Accepted: 05/08/2013] [Indexed: 11/17/2022]
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Janse JA, Pattij TOS, Eijkemans MJC, Broekmans FJ, Veersema S, Schreuder HWR. Learning curve of hysteroscopic placement of tubal sterilization microinserts in 15 gynecologists in the Netherlands. Fertil Steril 2013; 100:755-60. [PMID: 23768989 DOI: 10.1016/j.fertnstert.2013.05.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Revised: 05/15/2013] [Accepted: 05/15/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Juliënne A Janse
- Department of Gynecology and Obstetrics, St. Antonius Hospital, Nieuwegein, the Netherlands.
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Pregnancies after hysteroscopic sterilization: a systematic review. Contraception 2013; 87:539-48. [DOI: 10.1016/j.contraception.2012.08.006] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Revised: 07/26/2012] [Accepted: 08/07/2012] [Indexed: 11/17/2022]
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Simpson WL, Beitia L. Multimodality imaging of the Essure tubal occlusion device. Clin Radiol 2012; 67:e112-7. [PMID: 22985750 DOI: 10.1016/j.crad.2012.08.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Revised: 08/03/2012] [Accepted: 08/09/2012] [Indexed: 10/27/2022]
Abstract
The Essure device is a permanent birth-control device, which is gaining popularity. The micro-inserts are composed of metallic elements that can be seen on radiography, computed tomography, ultrasound, and magnetic resonance imaging. Knowledge of the normal location and appearance of the Essure device will ensure appropriate patient care. The purpose of this review is to describe the Essure tubal occlusion device and illustrate its normal and abnormal appearance using various imaging methods.
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Affiliation(s)
- W L Simpson
- Department of Radiology, Mount Sinai Medical Center, New York, NY, USA.
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Use of Intraoperative Fluoroscopy During Laparotomy to Identify Fragments of Retained Essure Microinserts: Case Report. J Minim Invasive Gynecol 2012; 19:667-70. [DOI: 10.1016/j.jmig.2012.04.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2012] [Revised: 04/24/2012] [Accepted: 04/28/2012] [Indexed: 12/25/2022]
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Abstract
BACKGROUND Tubal sterilization by hysteroscopy involves inserting a foreign body in both fallopian tubes. Over a three-month period, the tubal lumen is occluded by tissue growth stimulated by the insert. Tubal sterilization by hysteroscopy has advantages over laparoscopy or mini-laparotomy, including the avoidance of abdominal incisions and the convenience of performing the procedure in an office-based setting. Pain, an important determinant of procedure acceptability, can be a concern when tubal sterilization is performed in the office. OBJECTIVES To review all randomized controlled trials that evaluated interventions to decrease pain during tubal sterilization by hysteroscopy. SEARCH METHODS From January to March 2011, we searched the computerized databases of MEDLINE, POPLINE, CENTRAL, EMBASE, LILACS, and CINAHL for relevant trials. We searched for current trials via Clinicaltrials.gov. We also examined the reference lists of pertinent articles and wrote to known investigators for information about other published or unpublished trials. SELECTION CRITERIA We included all randomized controlled trials that evaluated pain management at the time of sterilization by hysteroscopy. The intervention could be compared to another intervention or placebo. DATA COLLECTION AND ANALYSIS Initial data were extracted by one review author. A second review author verified all extracted data. Whenever possible, the analysis was conducted with all women randomized and in the original assigned groups. Data were analyzed using RevMan software. Pain was measured using either a 10-cm or 100-point visual analog scale (VAS). When pain was measured at multiple points during the procedure, the overall pain score was considered the primary treatment effect. If this was not measured, a summation of all pain scores for the procedure was considered to be the primary treatment effect. For continuous variables, the mean difference with 95% confidence interval was computed. MAIN RESULTS Two trials met the inclusion criteria. The total number of participants was 167. Using a 10-cm VAS to measure pain, no significant difference emerged in overall pain for the entire procedure between women who received a paracervical block with lidocaine versus normal saline (mean difference -0.77; 95% CI -2.67 to 1.13). No significant difference in pain score was noted at the time of injection of study solution to the anterior lip of the cervix (mean difference -0.6; 95% CI -1.3 to 0.1), placement of the device in the tubal ostia (mean difference -0.60; 95% CI -1.8 to 0.7), and postprocedure pain (mean difference 0.2; 95% CI -0.8 to 1.2). Procedure time (mean difference -0.2 minutes; 95% CI -2.2 to 1.8 minutes) and successful bilateral placement (OR 1.0; 95% CI 0.19 to 5.28) was not significantly different between groups. During certain portions of the procedure, such as placement of the tenaculum (mean difference -2.03; 95% CI -2.88 to -1.18), administration of the paracervical block (mean difference -1.92; 95% CI -2.84 to -1.00), and passage of the hysteroscope through the external (mean difference -2.31; 95% CI -3.30 to -1.32) and internal os (mean difference -2.31; 95% CI -3.39 to -1.23), use of paracervical block with lidocaine resulted in lower pain scores.Using a 600-point scale calculated by adding 100-point VAS scores from six different portions of the procedure, no significant difference emerged in overall pain between women who received intravenous conscious sedation versus oral analgesia (mean difference -23.00; CI -62.02 to 16.02). Using a 100-point VAS, no significant difference emerged at the time of speculum insertion (mean difference 4.0; 95% CI -4.0 to 12.0), cervical injection of lidocaine (mean difference -1.8; 95% CI -10.0 to 6.4), insertion of the hysteroscope (mean difference -8.7; 95% CI -19.7 to 2.3), placement of the first device (mean difference -4.4; 95% CI -15.8 to 7.0), and removal of the hysteroscope (mean difference 0.9; 95% CI -3.9 to 5.7). Procedure time (mean difference -0.2 minutes; 95% CI -2.0 to 1.6 minutes) and time in the recovery area (mean difference 3.6 minutes; 95% CI -11.3 to 18.5 minutes) was not different between groups. However, women who received intravenous conscious sedation had lower pain scores at the time of insertion of the second tubal device compared to women who received oral analgesia (mean difference -12.60; CI -23.98 to -1.22). AUTHORS' CONCLUSIONS The available literature is insufficient to determine the appropriate analgesia or anesthesia for sterilization by hysteroscopy. Compared to paracervical block with normal saline, paracervical block with lidocaine reduced pain during some portions of the procedure. Intravenous sedation resulted in lower pain scores during insertion of the second tubal device. However, neither paracervical block with lidocaine nor conscious sedation significantly reduced overall pain scores for sterilization by hysteroscopy.
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Affiliation(s)
- Bliss Kaneshiro
- Department of Obstetrics and Gynecology, University of Hawaii, Honolulu, USA.
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Contraception permanente par pose hystéroscopique d’implants tubaires. ACTA ACUST UNITED AC 2012; 40:434-44. [DOI: 10.1016/j.gyobfe.2012.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Accepted: 04/10/2012] [Indexed: 11/20/2022]
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Isley MM, Jensen JT, Nichols MD, Lehman A, Bednarek P, Edelman A. Intrauterine lidocaine infusion for pain management during outpatient transcervical tubal sterilization: a randomized controlled trial. Contraception 2012; 85:275-81. [DOI: 10.1016/j.contraception.2011.06.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2011] [Accepted: 06/30/2011] [Indexed: 10/17/2022]
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Panel P, Bajka M, Le Tohic A, Ghoneimi AE, Chis C, Cotin S. Hysteroscopic placement of tubal sterilization implants: virtual reality simulator training. Surg Endosc 2012; 26:1986-96. [PMID: 22234594 DOI: 10.1007/s00464-011-2139-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2011] [Accepted: 12/15/2011] [Indexed: 11/27/2022]
Abstract
STUDY OBJECTIVE To assess face and construct validity of a new virtual reality (VR) training simulator for hysteroscopic placement of tubal sterilization implants. DESIGN Nonrandomized, controlled trial comparing responses and performance of novices and experts on the simulator. DESIGN CLASSIFICATION Canadian task force II-1. SETTING Forty-six gynecologists were personally invited or recruited at the 33rd Conference of the French National College of Gynecologists and Obstetricians (CNGOF) from December 9 to 12, 2009, grouped as 20 experts and 26 novices. They all performed the defined sequence of virtual procedures on the simulator (case 1 for familiarization, case 4 for study assessment) and finally completed the study questionnaire. MEASUREMENTS AND MAIN RESULTS Responses to realism, educational potential, and general opinion were excellent, proving face validity. Significant differences between novices and experts were assessed for 7 of the 15 metrics analyzed, proving construct validity. CONCLUSIONS We established face and construct validity for EssureSim, an educational VR simulator for hysteroscopic tubal sterilization implant placement. The next steps are to investigate convergent and predictive validity to affirm the real capacity of transferring the skills learned on the training simulator to the patient in the operating room.
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Affiliation(s)
- Pierre Panel
- Service de Gynécologie-Obstétrique, Centre Hospitalier de Versailles, Hôpital André Mignot, 177 avenue de Versailles, 78157 Le Chesnay, France.
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Leyser-Whalen O, Rouhani M, Rahman M, Berenson AB. Tubal risk markers for failure to place transcervical sterilization coils. Contraception 2011; 85:384-8. [PMID: 22036044 DOI: 10.1016/j.contraception.2011.09.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2011] [Revised: 09/07/2011] [Accepted: 09/08/2011] [Indexed: 10/15/2022]
Abstract
BACKGROUND There is a growing body of literature on placement rates of the Essure® procedure, yet prior studies have not attempted to identify tubal-associated risk factors for placement failures. The current study examines risk markers associated with the inability to deploy the Essure® coils into the tubal lumen using the new ESS305 design. STUDY DESIGN We used electronic medical record data to assess risk markers associated with the inability to place the Essure coils in the tubal lumen using the new ESS305 design. A total of 310 attempted procedures between June 14, 2007, and April 29, 2011, were analyzed. RESULTS There were 18 tubal failures (5.8%) out of the 310 attempted procedures. A history of a prior sexually transmitted infection (STI) was associated with tubal failure (odds ratio 2.64, 95% confidence interval 1.01-6.90, p=.048). CONCLUSIONS We speculate that the observed association between a prior STI and an inability to place the coil was due to a past history of pelvic inflammatory disease.
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Affiliation(s)
- Ophra Leyser-Whalen
- Center for Interdisciplinary Research in Women's Health, Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX 77555, USA
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Reliability of laparoscopic compared with hysteroscopic sterilization at 1 year: a decision analysis. Obstet Gynecol 2011; 118:273-279. [PMID: 21775842 DOI: 10.1097/aog.0b013e318224d4d2] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To estimate the probability of successful sterilization after an hysteroscopic or laparoscopic sterilization procedure. METHODS An evidence-based clinical decision analysis using a Markov model was performed to estimate the probability of a successful sterilization procedure using laparoscopic sterilization, hysteroscopic sterilization in the operating room, and hysteroscopic sterilization in the office. Procedure and follow-up testing probabilities for the model were estimated from published sources. RESULTS In the base case analysis, the proportion of women having a successful sterilization procedure on the first attempt is 99% for laparoscopic sterilization, 88% for hysteroscopic sterilization in the operating room, and 87% for hysteroscopic sterilization in the office. The probability of having a successful sterilization procedure within 1 year is 99% with laparoscopic sterilization, 95% for hysteroscopic sterilization in the operating room, and 94% for hysteroscopic sterilization in the office. These estimates for hysteroscopic success include approximately 6% of women who attempt hysteroscopically but are ultimately sterilized laparoscopically. Approximately 5% of women who have a failed hysteroscopic attempt decline further sterilization attempts. CONCLUSION Women choosing laparoscopic sterilization are more likely than those choosing hysteroscopic sterilization to have a successful sterilization procedure within 1 year. However, the risk of failed sterilization and subsequent pregnancy must be considered when choosing a method of sterilization.
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A comparison of novice and experienced physicians performing hysteroscopic sterilization: an analysis of an FDA-mandated trial. Fertil Steril 2011; 96:643-648.e1. [DOI: 10.1016/j.fertnstert.2011.06.047] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2011] [Revised: 06/15/2011] [Accepted: 06/16/2011] [Indexed: 11/22/2022]
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Brown WW. An unusual complication of hysteroscopic sterilization. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2011; 30:707-709. [PMID: 21527621 DOI: 10.7863/jum.2011.30.5.707] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Essure transcervical tubal sterilization: a 5-year x-ray follow up. Fertil Steril 2011; 95:2114-5. [DOI: 10.1016/j.fertnstert.2011.02.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2010] [Revised: 02/11/2011] [Accepted: 02/11/2011] [Indexed: 11/17/2022]
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Wang LG, Qiu Y, Fan YJ, Li XY, Han XJ. Reversible contraceptive effect of the oviduct plug with nickel–titanium shape memory alloy and silicone rubber in rabbits. Contraception 2011; 83:373-7. [DOI: 10.1016/j.contraception.2010.08.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2010] [Revised: 08/05/2010] [Accepted: 08/06/2010] [Indexed: 11/25/2022]
Affiliation(s)
- Lei-Guang Wang
- Key Laboratory for Improving Birth Outcome Technique, Shandong Provincial Family Planning Institute of Science and Technology, Shandong 250002, China
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Serfaty D. Stérilisation. Contraception 2011. [DOI: 10.1016/b978-2-294-70921-0.00016-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Thiel JA, Lukwinski A, Kamencic H, Lim H. Oral Analgesia vs Intravenous Conscious Sedation during Essure Micro-Insert Sterilization Procedure: Randomized, Double-Blind, Controlled Trial. J Minim Invasive Gynecol 2011; 18:108-11. [DOI: 10.1016/j.jmig.2010.10.006] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2010] [Revised: 10/12/2010] [Accepted: 10/14/2010] [Indexed: 11/24/2022]
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Hastings-Tolsma M, Nodine P, Teal SB. Essure: Hysteroscopic Sterilization. J Midwifery Womens Health 2010; 51:510-4. [DOI: 10.1016/j.jmwh.2006.04.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Shah V, Panay N, Williamson R, Hemingway A. Hysterosalpingogram: an essential examination following Essure hysteroscopic sterilisation. Br J Radiol 2010; 84:805-12. [PMID: 21123309 DOI: 10.1259/bjr/95330860] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The aim of this study was to describe our experience of imaging following hysteroscopic sterilisation with the Essure (Conceptus Inc., Mountain View, San Carlos, CA) microinsert, and to underline the importance of a carefully performed follow-up hysterosalpingogram (HSG) in the management of these patients. METHODS 18 women underwent the procedure and all returned for follow-up HSG. A standard HSG technique was used and views were acquired to establish microinsert position and tubal occlusion. RESULTS In 16 of the 18 women, adequate microinsert positioning and bilateral tubal occlusion was present. In one woman, a unilateral microinsert occluded the fallopian tube, whereas the other fallopian tube was ligated with a clip. The final patient underwent two studies; both showed well-positioned microinserts but unilateral free spill from the right fallopian tube. There are no reported pregnancies thus far. CONCLUSION Essure sterilisation coils have a unique appearance when radiographed and are an effective means of permanently occluding the fallopian tubes. HSG is a rapid and safe method of confirming satisfactory placement and tubal occlusion. Non-HSG imaging techniques are suboptimal at detecting patent fallopian tubes and expose patients to the risk of an unwanted and potentially complicated pregnancy.
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Affiliation(s)
- V Shah
- Department of Imaging, Hammersmith and Queen Charlotte Hospitals, Imperial College Healthcare NHS Trust, London, UK.
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El sistema Essure® como método de esterilización femenina permanente. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2010. [DOI: 10.1016/j.gine.2009.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Reproducibility of the interpretation of pelvic x-ray 3 months after hysteroscopic sterilization with Essure. Fertil Steril 2010; 94:1202-1207. [DOI: 10.1016/j.fertnstert.2009.05.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2008] [Revised: 05/10/2009] [Accepted: 05/11/2009] [Indexed: 11/19/2022]
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Novel implant for transcervical sterilization. J Biosci Bioeng 2010; 110:242-9. [DOI: 10.1016/j.jbiosc.2010.02.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2009] [Revised: 02/01/2010] [Accepted: 02/02/2010] [Indexed: 11/21/2022]
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Di Spiezio Sardo A, Bettocchi S, Spinelli M, Guida M, Nappi L, Angioni S, Sosa Fernandez LM, Nappi C. Review of new office-based hysteroscopic procedures 2003-2009. J Minim Invasive Gynecol 2010; 17:436-48. [PMID: 20621007 DOI: 10.1016/j.jmig.2010.03.014] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2009] [Revised: 03/09/2010] [Accepted: 03/12/2010] [Indexed: 11/30/2022]
Abstract
Office operative hysteroscopy is a recent technique that enables treatment of uterine pathologic disorders in the ambulatory setting using miniaturized hysteroscopes with mechanical or electric instruments. The available international literature from 1990 to 2002 has clearly demonstrated that such technique enables performance of hysteroscopically directed endometrial biopsy and treatment of uterine adhesions, anatomic disorders, polyps, and small myomas safely and successfully without cervical dilation and the need for anesthesia. This review provides a comprehensive survey of further advancements of office operative hysteroscopy in the treatment of other gynecologic pathologic conditions that have not been included in the schema of treatment indications for office procedures proposed in 2002. A search of MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews identified articles published from 2003 to 2009. Eighteen articles were identified: 9 on hysteroscopic sterilization; 1 on office-based metroplasty, 8 on office-based treatment of some uncommon gynecologic pathologic conditions (e.g., hematometra, diagnosis and treatment of vaginal lesions, treatment of uterine cystic neoformations, bleeding from the cervical stump, diagnosis and treatment of endocervical ossification, and removal of uterovaginal packing). All performed procedures were carried out safely and successfully in the office setting, with high patient tolerance and minimal discomfort. The success of the procedures has been confirmed by resolution of symptoms and at follow-up ultrasonographic and hysteroscopic examinations. Currently, as a result of technologic advancements and increased operator experience, an increasing number of gynecologic pathologic conditions traditionally treated in the operating room may be treated safely and effectively using office operative hysteroscopy.
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Affiliation(s)
- Attilio Di Spiezio Sardo
- Department of Gynaecology and Obstetrics, and Pathophysiology of Human Reproduction, University of Naples Federico II, Naples, Italy.
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Hysteroscopic tubal sterilization: a systematic review of the Essure system. Fertil Steril 2010; 94:16-9. [DOI: 10.1016/j.fertnstert.2009.02.080] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2008] [Revised: 02/16/2009] [Accepted: 02/25/2009] [Indexed: 11/19/2022]
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Predictive factors of Essure® implant placement failure: prospective, multicenter study of 495 patients. Fertil Steril 2010; 93:29-34. [DOI: 10.1016/j.fertnstert.2008.09.063] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2007] [Revised: 09/18/2008] [Accepted: 09/19/2008] [Indexed: 11/19/2022]
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Veersema S, Vleugels MP, Moolenaar LM, Janssen CA, Brölmann HA. Unintended pregnancies after Essure sterilization in the Netherlands. Fertil Steril 2010; 93:35-8. [DOI: 10.1016/j.fertnstert.2008.10.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2008] [Revised: 09/28/2008] [Accepted: 10/03/2008] [Indexed: 11/24/2022]
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Lousquy R, Friederich L, Le Tohic A, Grosdemouge I, Renouvel F, Gairin F, Panel P. État des lieux de la formation des chirurgiens gynécologues à l’hystéroscopie en France et en Europe. Enquête CONFORM sur la formation à la mise en place des implants de stérilisation tubaire par voie transcervicale. ACTA ACUST UNITED AC 2009; 37:691-6. [DOI: 10.1016/j.gyobfe.2009.07.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2009] [Accepted: 07/03/2009] [Indexed: 10/20/2022]
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Affiliation(s)
- C Stanley Chan
- Department of Dermatology, Baylor College of Medicine, Houston, Texas, USA.
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Grosdemouge I, Engrand JB, Dhainault C, Marchand F, Martigny H, Thevenot J, Villefranque V, Lopes P, Panel P. [Essure implants for tubal sterilisation in France]. ACTA ACUST UNITED AC 2009; 37:389-95. [PMID: 19410494 DOI: 10.1016/j.gyobfe.2009.03.024] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2008] [Accepted: 03/25/2009] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Law no. 2001-588 of 4 July 2001 liberalised the practice of tubal sterilisation in France, at the same time as a new hysteroscopic method of female sterilization appeared. The growth of this method has been spurred by the reduced need for analgesia, absence of incision and scar, reduced duration of hospitalization and diminution of costs. The aim of this study was to analyse the use of the Essure procedure in France. PATIENTS AND METHODS This multicentre study covered seven French facilities from January 2004 through June 2006. This study included 1061 attempted placements of the Essure micro-insert, marketed by Conceptus SAS (France). RESULTS The first placement attempt was successful in 992 cases (94.4%). The success rate for second attempts was 59% (n = 23). Mean VAS was 3,23 +/- 0.19. Ninety-three percent of patients undergoing Essure placement were satisfied or very satisfied. DISCUSSION AND CONCLUSION Tubal sterilisation with Essure micro-inserts is a reliable and reproducible method that requires a short period of training. In the future, the hysteroscopic pathway will replace the laparoscopic route.
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Affiliation(s)
- I Grosdemouge
- Service de gynécologie-obstétrique, centre hospitalier de Versailles, 177, rue de Versailles, 78150 Le Chesnay, France
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Franchini M, Cianferoni L, Lippi G, Calonaci F, Calzolari S, Mazzini M, Florio P. Tubal sterilization by laparoscopy or hysteroscopy: which is the most cost-effective procedure? Fertil Steril 2009; 91:1499-502. [DOI: 10.1016/j.fertnstert.2008.08.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2008] [Revised: 07/26/2008] [Accepted: 08/07/2008] [Indexed: 10/21/2022]
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48
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Incorrect position of Essure microinserts 3 months after successful bilateral placement. Fertil Steril 2009; 91:930.e1-5. [DOI: 10.1016/j.fertnstert.2008.08.013] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2008] [Revised: 07/22/2008] [Accepted: 08/07/2008] [Indexed: 11/23/2022]
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Arjona JE, Miño M, Cordón J, Povedano B, Pelegrin B, Castelo-Branco C. Satisfaction and tolerance with office hysteroscopic tubal sterilization. Fertil Steril 2008; 90:1182-6. [DOI: 10.1016/j.fertnstert.2007.08.007] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2007] [Revised: 08/02/2007] [Accepted: 08/03/2007] [Indexed: 10/22/2022]
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50
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Feasibility of Essure Placement in Intrauterine Device Users. J Minim Invasive Gynecol 2008; 15:485-90. [DOI: 10.1016/j.jmig.2008.04.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2007] [Revised: 04/14/2008] [Accepted: 04/19/2008] [Indexed: 11/23/2022]
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