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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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Whittum M, Schickler R, Fanarjian N, Rapkin R, Nguyen BT. The History of Female Surgical Sterilization. J Gynecol Surg 2021. [DOI: 10.1089/gyn.2021.0101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Michelle Whittum
- Department of Obstetrics and Gynecology, University of South Florida Morsani College of Medicine, Tampa, Florida, USA
| | - Robyn Schickler
- Department of Obstetrics and Gynecology, University of South Florida Morsani College of Medicine, Tampa, Florida, USA
- Planned Parenthood of Southwest and Central Florida, Sarasota, Florida, USA
| | - Nicole Fanarjian
- Department of Obstetrics and Gynecology, University of South Florida Morsani College of Medicine, Tampa, Florida, USA
| | - Rachel Rapkin
- Department of Obstetrics and Gynecology, University of South Florida Morsani College of Medicine, Tampa, Florida, USA
| | - Brian T. Nguyen
- Section of Family Planning, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California, USA
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3
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Abbott J, Deans R. Accelerating the Science After 125 Years of Treating Intrauterine Adhesions. J Minim Invasive Gynecol 2020; 28:151-152. [PMID: 33373727 DOI: 10.1016/j.jmig.2020.12.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 12/23/2020] [Indexed: 01/23/2023]
Affiliation(s)
- Jason Abbott
- School of Women's and Children's Health, University of New South Wales, Randwick, NSW, Australia (Dr. Abbott); School of Women's and Children's Health, University of New South Wales, Sydney (Dr. Deans).
| | - Rebecca Deans
- School of Women's and Children's Health, University of New South Wales, Randwick, NSW, Australia (Dr. Abbott); School of Women's and Children's Health, University of New South Wales, Sydney (Dr. Deans)
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4
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Moureau D, Laurent N, Rubod C, Lucot JP, Salleron J, Faye N. Evaluation of tubal microinserts position using 3D ultrasound and pelvic X-ray. Diagn Interv Imaging 2015; 96:1133-40. [PMID: 26163222 DOI: 10.1016/j.diii.2014.12.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 04/30/2014] [Accepted: 12/03/2014] [Indexed: 11/17/2022]
Abstract
PURPOSE To retrospectively compare three-dimensional ultrasonography (3D-US) and pelvic X-rays to assess the position of tubal sterilization microinserts. MATERIAL AND METHODS Forty-four patients who underwent tubal sterilization with Essure(®) microinserts in our institution were included. The microinserts'position was evaluated three months after the procedure using 3D-US and pelvic X-rays. Placement on 3D-US was binary categorized as correct or incorrect and the distance between the two devices was reported. The orientation and symmetric deployment of the microinserts and the distance between the proximal parts of the two devices was assessed on pelvic X-rays. Performance of 3D-US and pelvic X-ray were compared using Mac Nemar test. Comparison of the distance between the two devices measured on pelvic X-rays and 3D-US was made with the paired Student t test. RESULTS 3D-US images showed microinserts in 93% (41/44). Eighty-six percent (38/44) were correctly positioned on 3D-US and 82% (36/44) on pelvic X-rays. No significant differences between the performances of the two imaging techniques were found. No significant differences for the distance between the two devices measured on pelvic X-ray and 3D-US was found. CONCLUSION 3D-US is a simple, non-ionizing technique, which appears as a promising alternate technique to pelvic X-rays to assess the correct position of Essure(®) microinserts.
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Affiliation(s)
- D Moureau
- Women Medical Imaging Department, Jeanne-de-Flandre Hospital, CHRU de Lille, avenue Eugène-Avinée, 59037 Lille, France.
| | - N Laurent
- Women Medical Imaging Department, Valenciennes Hospital, Lille Nord University, Valenciennes, France
| | - C Rubod
- Gynecology Department, Jeanne-de-Flandre Hospital, CHRU de Lille, avenue Eugène-Avinée, 59037 Lille, France
| | - J P Lucot
- Gynecology Department, Jeanne-de-Flandre Hospital, CHRU de Lille, avenue Eugène-Avinée, 59037 Lille, France
| | - J Salleron
- Department of Biostatistics, EA2694, UDSL, Lille University, Lille, France
| | - N Faye
- Women Medical Imaging Department, Jeanne-de-Flandre Hospital, CHRU de Lille, avenue Eugène-Avinée, 59037 Lille, France
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Abstract
More than 1 million abortions are performed annually in the United States. Women presenting for abortion care are often motivated by the pregnancy to use effective contraception; they are also at high risk for repeat unintended pregnancy. For these reasons, abortion represents an optimal time to initiate effective contraception. There is strong evidence that most methods of contraception, including intrauterine devices and the contraceptive implant, should be initiated at the time of the abortion procedure. Most women ovulate within the first month after an abortion. If provision of contraception is delayed, women are less likely to use effective contraception and more likely to have a repeat unintended pregnancy. Although some methods of permanent contraception can be safely performed at the time of abortion, federal and state laws often restrict these procedures being performed concurrently. Contraceptive counseling and provision at the time of abortion are important strategies to decrease rates of unintended pregnancy.
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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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Jensen JT, Hanna C, Yao S, Micks E, Edelman A, Holden L, Slayden OD. Blockade of tubal patency following transcervical administration of polidocanol foam: initial studies in rhesus macaques. Contraception 2014; 89:540-9. [PMID: 24560476 PMCID: PMC4033706 DOI: 10.1016/j.contraception.2013.11.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Revised: 11/18/2013] [Accepted: 11/19/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To demonstrate the feasibility of polidocanol foam (PF) as a nonsurgical method of female permanent contraception using a nonhuman primate model. STUDY DESIGN Four groups of adult female rhesus macaques underwent either transcervical treatment with 5% PF directly into the uterine cavity, treatment with inert (methylcellulose, MF) foam or no treatment followed by removal of the reproductive tract for histologic evaluation. Untreated animals were included in Group 1 (n=3). Group 2 animals (n=4) were treated once with MF. Group 3 (n=7) received a single, and Group 4 (n=5) received multiple monthly treatments with PF; in these 2 groups, baseline tubal patency was assessed either laparoscopically by chromopertubation (CP) or by hysterosalpingography. RESULTS Group 1 (untreated) and Group 2 (MF) animals had normal tubal histology. In contrast, Group 3 and 4 females treated with PF showed evidence of tubal damage. In Group 4, bilateral tubal blockade was noted on CP after two (n=2) or three (n=3) treatments. Histologic analysis confirmed complete tubal occlusion (loss of epithelium, fibrosis) in three of these animals, and one showed significant tubal damage localized to the intramural segment. Nontarget (cervix, vagina, endometrium, ovary) reproductive tissues were unaffected. While similar tubal changes were observed after a single treatment (Group 3), endometrial hemorrhage was also noted as an acute change. CONCLUSION PF is a promising candidate agent for nonsurgical permanent female contraception. The histologic features of PF occlusion are confined to the intramural portion of the tube. IMPLICATIONS This study in rhesus macaques supports further development of transcervical administration of PF as a nonsurgical approach to permanent contraception. A nonsurgical method could reduce risks and costs associated with surgical female sterilization and increase access to permanent contraception.
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MESH Headings
- Animals
- Catheterization, Peripheral
- Dose-Response Relationship, Drug
- Drug Administration Schedule
- Drug Evaluation, Preclinical
- Drugs, Investigational/administration & dosage
- Drugs, Investigational/adverse effects
- Drugs, Investigational/pharmacology
- Endometrium/blood supply
- Endometrium/drug effects
- Endometrium/pathology
- Epithelium/diagnostic imaging
- Epithelium/drug effects
- Epithelium/pathology
- Fallopian Tubes/diagnostic imaging
- Fallopian Tubes/drug effects
- Fallopian Tubes/pathology
- Feasibility Studies
- Female
- Fibrosis
- Hysterosalpingography
- Laparoscopy
- Macaca mulatta
- Polidocanol
- Polyethylene Glycols/administration & dosage
- Polyethylene Glycols/adverse effects
- Polyethylene Glycols/pharmacology
- Sclerosing Solutions/administration & dosage
- Sclerosing Solutions/adverse effects
- Sclerosing Solutions/pharmacology
- Sterilization, Tubal/adverse effects
- Ultrasonography
- Uterine Hemorrhage/chemically induced
- Uterine Hemorrhage/pathology
- Vaginal Creams, Foams, and Jellies/administration & dosage
- Vaginal Creams, Foams, and Jellies/adverse effects
- Vaginal Creams, Foams, and Jellies/pharmacology
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Affiliation(s)
- Jeffrey T Jensen
- Department of Obstetrics & Gynecology, Oregon Health & Science University (OHSU), Portland, OR, USA; Division of Reproductive and Developmental Sciences, Oregon National Primate Research Center, Beaverton, OR, USA.
| | - Carol Hanna
- Division of Reproductive and Developmental Sciences, Oregon National Primate Research Center, Beaverton, OR, USA
| | - Shan Yao
- Division of Reproductive and Developmental Sciences, Oregon National Primate Research Center, Beaverton, OR, USA
| | - Elizabeth Micks
- Department of Obstetrics & Gynecology, University of Washington, Seattle, WA, USA
| | - Alison Edelman
- Department of Obstetrics & Gynecology, Oregon Health & Science University (OHSU), Portland, OR, USA; Division of Reproductive and Developmental Sciences, Oregon National Primate Research Center, Beaverton, OR, USA
| | - Lindsay Holden
- Division of Reproductive and Developmental Sciences, Oregon National Primate Research Center, Beaverton, OR, USA
| | - Ov D Slayden
- Division of Reproductive and Developmental Sciences, Oregon National Primate Research Center, Beaverton, OR, USA
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Lopera J, Suri R, Kroma GM, Garza-Berlanga A, Thomas J. Role of Interventional Procedures in Obstetrics/Gynecology. Radiol Clin North Am 2013; 51:1049-66. [DOI: 10.1016/j.rcl.2013.07.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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9
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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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Wortman M. Instituting an Office-Based Surgery Program in the Gynecologist’s Office. J Minim Invasive Gynecol 2010; 17:673-83. [DOI: 10.1016/j.jmig.2010.07.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2010] [Revised: 06/14/2010] [Accepted: 07/02/2010] [Indexed: 11/27/2022]
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Abstract
Ever since ancient civilizations, the possibility of preventing unwanted pregnancies has always been the subject of interest. All available contraception methods have both advantages and disadvantages, and it is up to the doctor and the patient to make a rational choice in each individual case. Many methods for temporary prevention of unwanted pregnancy are used for the purpose of contraception, as well as sterilization, as a permanent method. A large variety of contraceptives offers opting for the most suitable method for each patient, with the highest level of efficiency and safety. With their adequate administration, the rate of unwanted pregnancies should be significantly minimized. Methods used for contraception are constantly improving and simultaneously, new and more efficient ones are being developed. The research in the field of contraceptives is not completed yet and hopefully, in the future, we shall be closer to finding available, efficient, user-friendly medicaments in the prevention of pregnancy and sexually transmitted diseases, with minimum side effects, which is on the verge of perfection. Novelties in the field of contraception must be the theme of continuous medical education of gynaecologists, so that they could provide the right information and give advice to their patients in choosing the most adequate contraceptive.
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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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13
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Abstract
Women have many options regarding contraception. A patient's desire for a long- or short-term method, for one that is reversible or permanent, and her belief that she can be compliant with the method all factor into the choice of contraceptive method. Practitioners must discuss coexisting conditions, contraindications, and whether the patient desires scheduled monthly bleeding or if she will tolerate unscheduled bleeding. Finally, cost and coverage by insurance tends to be one of the most important factors in choosing the method of contraception.
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Affiliation(s)
- Kristen A Plastino
- Department of Obstetrics & Gynecology, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA.
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Aitken RJ, Baker MA, Doncel GF, Matzuk MM, Mauck CK, Harper MJK. As the world grows: contraception in the 21st century. J Clin Invest 2008; 118:1330-43. [PMID: 18382745 DOI: 10.1172/jci33873] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Contraceptives that are readily available and acceptable are required in many poorer countries to reduce population growth and in all countries to prevent maternal morbidity and mortality arising from unintended pregnancies. Most available methods use hormonal steroids or are variations of barrier methods. Reports from several fora over the last 12 years have emphasized the number of unwanted pregnancies and resultant abortions, which indicate an unmet need for safe, acceptable, and inexpensive contraceptive methods. This unmet need can be assuaged, in part, by development of new nonhormonal contraceptive methods. This Review addresses the contribution that the "omic" revolution can make to the identification of novel contraceptive targets, as well as the progress that has been made for different target molecules under development.
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Affiliation(s)
- R John Aitken
- Discipline of Biological Sciences and ARC Centre of Excellence in Biotechnology and Development, University of Newcastle, Callaghan, New South Wales, Australia
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Transcervical sterilization. Curr Opin Obstet Gynecol 2008; 20:182-3; author reply183-4. [PMID: 18388820 DOI: 10.1097/gco.0b013e3282fb2ea8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Famuyide AO, Hopkins MR, El-Nashar SA, Creedon DJ, Vasdev GM, Driscoll DJ, Connolly HM, Warnes CA. Hysteroscopic sterilization in women with severe cardiac disease: experience at a tertiary center. Mayo Clin Proc 2008; 83:431-8. [PMID: 18380988 DOI: 10.4065/83.4.431] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To determine the feasibility and effectiveness of hysteroscopic sterilization as a minimally invasive sterilization method for women with high-risk cardiac disease. PARTICIPANTS AND METHODS In a retrospective cohort study, 18 women with high-risk cardiac conditions that strictly contraindicated pregnancy were compared with a reference cohort of 157 women without cardiac disease. All underwent microinsert hysteroscopic sterilization at Mayo Clinic from January 2003 through February 2007. End points included successful placement, fallopian tube patency determined by hysterosalpingogram 3 months after the procedure, and pregnancy status. RESULTS Women in the cardiac cohort were younger than those in the reference cohort (median age, 25 vs 39 years; P<.001), had lower parity (median, 0 vs 2; P<.001), and had a higher proportion of patients categorized as American Society of Anesthesiologists' physical status 3 (severe systemic disease) and physical status 4 (systemic disease that is a constant threat to life) (83% vs 6%; P<.001). No significant differences were noted for use of general anesthesia (17% vs 27%; P=.41), successful bilateral device placement (100% vs 95%; P>.99), postoperative pain score (median, 0 for both groups; P=.87), or length of hospitalization (median, 6 vs 6 hours; P=.63). No intraoperative complications occurred. Follow-up hysterosalpingography showed high tubal occlusion rates in both cohorts (100% cardiac; 98% reference; P>.99). No pregnancies occurred during a median follow-up period of 20 months (interquartile range, 8-33 months). CONCLUSION For women with cardiac disease and strict contraindications for pregnancy, microinsert hysteroscopic sterilization provided minimally invasive, permanent, and reliable contraception.
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Affiliation(s)
- Abimbola O Famuyide
- Department of Obstetrics and Gynecology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
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