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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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Analysis of surgeries performed after hysteroscopic sterilization as tabulated from 3,803 Essure patient experiences. Obstet Gynecol Sci 2017; 60:296-302. [PMID: 28534016 PMCID: PMC5439279 DOI: 10.5468/ogs.2017.60.3.296] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 12/15/2016] [Accepted: 01/02/2017] [Indexed: 11/08/2022] Open
Abstract
Objective Although previous research has suggested that risk for reoperation among hysteroscopic sterilization (HS) patients is more than ten times higher than for patients undergoing standard laparoscopic tubal ligation, little has been reported about these subsequent procedures. Methods This descriptive cohort study used a confidential online questionnaire to gather data from women (n=3,803) who volunteered information on HS followed by device removal surgery performed due to new symptoms developing after Essure placement. Results In this sample, mean age was 35.6 years and women undergoing hysterectomy after HS comprised 64.9% (n=2,468). Median interval between HS and hysterectomy was 3.7 (interquartile range, 3.9) years and mean age at hysterectomy was 36.3 years. Some patients (n=1,035) sought removal of HS devices and fallopian tubes only, while other miscellaneous gynecological procedures were also occasionally performed for Essure-associated symptoms. When data from all patients who had any post-Essure surgery besides hysterectomy were aggregated (e.g., device removal + “other” cases, n=1,335) and compared to those cases undergoing hysterectomy, mean age was significantly lower than for the hysterectomy group (34.4 vs. 36.3 years, respectively; P<0.01); uterus-conserving surgeries were also typically performed significantly earlier than hysterectomy (P<0.01). Conclusion This investigation is the first to characterize specific gynecological operations after Essure, and suggests that the predominant surgical answer to HS complaints is hysterectomy for many women. Dissatisfaction with HS may represent an important indication for hysterectomy and additional study is needed to quantify this phenomenon.
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Essure Surgical Removal and Subsequent Resolution of Chronic Pelvic Pain: A Case Report and Review of the Literature. Case Rep Obstet Gynecol 2016; 2016:6961202. [PMID: 26904330 PMCID: PMC4745314 DOI: 10.1155/2016/6961202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Revised: 12/31/2015] [Accepted: 01/03/2016] [Indexed: 11/18/2022] Open
Abstract
Background. Hysteroscopic tubal sterilization (Essure) is a minimally invasive option for permanent contraception with high reported rates of patient satisfaction. A small percentage of these women subsequently choose to have the tubal inserts removed due to regret or perceived side effects such as late-onset pelvic pain secondary to placement of the Essure device. Case. A twenty-nine-year-old woman G4P4014 presented with a two-year complaint of chronic pelvic pain and dyspareunia after the hysteroscopic placement of an Essure device for sterilization. On reviewing the images of the HSG, it was noted that although tubal occlusion was confirmed, the left Essure coil appeared curved on itself in an elliptical fashion and did not seem to follow the expected anatomic trajectory of the fallopian tube. The patient reported resolution of chronic pelvic pain following laparoscopic removal of Essure device. Conclusion. A misplaced Essure device should be considered in the differential diagnosis of chronic pelvic pain in women who had difficult placement of the device. In addition to demonstrating tubal occlusion, careful examination of the configuration of the Essure microinserts on HSG examination provides valuable information in patients with pelvic pain after Essure placement.
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Brito LGO, Cohen SL, Goggins ER, Wang KC, Einarsson JI. Essure Surgical Removal and Subsequent Symptom Resolution: Case Series and Follow-Up Survey. J Minim Invasive Gynecol 2015; 22:910-3. [DOI: 10.1016/j.jmig.2015.03.018] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 03/27/2015] [Accepted: 03/31/2015] [Indexed: 10/23/2022]
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Rufenacht E, Roesch M, Courjon M, Maillet R, Ramanah R, Riethmuller D. [Evaluation of satisfaction after hysteroscopic tubal ligation. About a study from the CHU of Besançon]. ACTA ACUST UNITED AC 2015; 43:176-80. [PMID: 25605508 DOI: 10.1016/j.gyobfe.2014.12.013] [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: 11/13/2014] [Accepted: 12/17/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The Essure(®) system is a hysteroscopic sterilization method. The purpose of our study was to retrospectively evaluate the sterilization procedure with Essure(®) devices without anesthesia. PATIENTS AND METHODS The descriptive study included all tubal sterilizations with Essure(®) devices performed without anesthesia, with MEOPA, from January 1st, 2013 till February 28th, 2014 in the CHU of Besançon. The evaluation of the global satisfaction of the patients was collected by telephone survey. RESULTS A hundred and forty-three patients benefited from Essure(®) without anesthesia during the period of study in the CHU of Besançon and among them, 120 patients answered the telephone survey questionnaire. The average age was of 41.3 years. As regards the satisfaction and the tolerance, 89.2% of the patients declared to be globally satisfied by this procedure and 95.8% would recommend it to a friend. Indeed, 66.6% of the patients declared to have felt no pain or moderate pain. Furthermore, the MEOPA was well tolerated at 79.9% of the patients. As regards the procedure of Essure(®) inserts without anesthesia the rate of failure was 9.2% and at 3 months the radiological control was satisfactory in 94.5% of the patients. DISCUSSION AND CONCLUSION The tubaire sterilization by implants Essure(®) is a fast and effective procedure. Our study shows, that at present, this technique can be realized without anesthesia, during a dedicated consultation, with an important rate of global satisfaction of the patients. It thus allows to decrease the number of hospitalization in ambulatory surgery and to decrease the cost of this intervention.
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Affiliation(s)
- E Rufenacht
- Pôle mère-femme, CHRU de Besançon, 3, boulevard Fleming, 25000 Besançon, France
| | - M Roesch
- Pôle mère-femme, CHRU de Besançon, 3, boulevard Fleming, 25000 Besançon, France
| | - M Courjon
- Pôle mère-femme, CHRU de Besançon, 3, boulevard Fleming, 25000 Besançon, France
| | - R Maillet
- Pôle mère-femme, CHRU de Besançon, 3, boulevard Fleming, 25000 Besançon, France
| | - R Ramanah
- Pôle mère-femme, CHRU de Besançon, 3, boulevard Fleming, 25000 Besançon, France
| | - D Riethmuller
- Pôle mère-femme, CHRU de Besançon, 3, boulevard Fleming, 25000 Besançon, France.
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Abstract
Hysteroscopic sterilization is growing in popularity. Nearly 500,000 women have been sterilized using this method, and an increasing number of physicians are now performing this procedure in the office setting. The office setting can provide a cost-effective, convenient, and safe environment for hysteroscopic sterilization. Patients may benefit from avoiding hospital preoperative visits, excessive laboratory evaluation, operating room wait times, and expense associated with hospital care. Physicians may improve productivity through remaining in their office or avoiding operating room delays. This article reviews office-hysteroscopic sterilization with the Essure microinsert system.
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Affiliation(s)
- Kelly R Hodges
- Division of Gynecologic and Obstetric Specialists, Department of Obstetrics and Gynecology, Baylor College of Medicine, 6651 Main Street, Set 1020 Houston, TX 77030, USA.
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Jerome D, Elizabeth B, Grace J, Charles K. Laparoscopic confirmation of hydrosalpinx is imperative prior to hysteroscopic occlusion for IVF to avoid permanent iatrogenic sterility. ASIAN PACIFIC JOURNAL OF REPRODUCTION 2012. [DOI: 10.1016/s2305-0500(13)60054-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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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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Stérilisation tubaire par voie hystéroscopique avec le système Essure® : étude descriptive et évaluation de l’efficacité de l’hypnose. ACTA ACUST UNITED AC 2011; 40:305-13. [DOI: 10.1016/j.jgyn.2011.02.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2010] [Revised: 02/15/2011] [Accepted: 02/22/2011] [Indexed: 11/22/2022]
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Thiel J, Suchet I, Tyson N, Price P. Outcomes in the Ultrasound Follow-up of the Essure Micro-Insert: Complications and Proper Placement. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2011; 33:134-138. [DOI: 10.1016/s1701-2163(16)34798-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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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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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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[Ambulatory Essure implant placement sterilization procedure for women: prospective study comparing general anesthesia versus hypnosis combined with sedation]. ACTA ACUST UNITED AC 2010; 29:889-96. [PMID: 21112724 DOI: 10.1016/j.annfar.2010.10.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2009] [Accepted: 10/15/2010] [Indexed: 11/23/2022]
Abstract
OBJECTIVE implant placement Essure, sterilization procedure for women, were performed under hypnosedation (HYP) and compared to the operative anxiety and analgesia of 12 patients operated-on under general anesthesia (GA). STUDY DESIGN prospective and comparative group study. PATIENTS AND METHODS two groups of twelve patients were matched and compared based on the choice of anesthetic technique: hypnotics (HYP) with possible additional sedation by propofol and remifentanil or GA involving propofol, sevoflurane and remifentanil. The assessment of anxiety and pain based on a visual analogy scale (0-10) and use of analgesics were studied in the recovery room and at discharge of hospital. The statistical analysis relies on nonparametric tests for paired data (Wilcoxon test). RESULTS all patients were operated. The two groups are statistically comparable. The preoperative anxiety before premedication is lower in the HYP group (p<0.05). No conversion to general anaesthesia is necessary in the HYP group, but five patients were using sedatives drugs but doses are very low compared to general anaesthesia. The analgesic consumption was equivalent in both groups. CONCLUSION we conclude that hypnosedation is a valuable alternative to traditional anesthetic techniques for ambulatory Essure implant. The use of hypnotic tool is an interesting alternative for the management of patients during invasive medical procedures or surgical, providing psychological benefits to the patient.
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Ploteau S, Haudebourg M, Philippe HJ, Lopes P. Stérilisation tubaire par voie hystéroscopique chez les femmes de plus de quarante ans : quelle motivation pour ces femmes ? ACTA ACUST UNITED AC 2009; 37:775-9. [DOI: 10.1016/j.gyobfe.2009.08.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2009] [Accepted: 08/12/2009] [Indexed: 12/01/2022]
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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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