II. Definition
- Hysteroscopically-placed device in fallopian tube
III. Indication
- Permanent sterilization for women
IV. Contraindications
- Nickel allergy
- Chronic use of Corticosteroids
V. Background
- Small coil device (Essure) that expands after placement
- Lower adverse effects than Tubal Ligation
- Irreversible
VI. Technique
- Performed by gynecologist using hysteroscopy
- Procedure time <15 minutes
- Additional 20 minutes of set-up and completion
- Placed during Proliferative Phase of Menstrual Cycle
- Place at least 2 days prior to anticipated Ovulation
- Assists with identifying fallopian tube opening
- Lowers risk of pregnancy following insert
- May not be possible to place both sides at same time
- Return for second side placement in 10-20%
VII. Precautions
- Not effective until 12 weeks after placement
- Needs hysterosalpingogram at 3 months to confirm placed
- Ultrasound may be sufficient
VIII. Adverse Effects
- Expulsion of Essure device: 2.9%
- Perforation: 1.8%
- Mis-placed device: 0.6%
- Miscellaneous adverse effects post-procedure
- Pelvic Pain
- Altered menstrual flow (5%)
- Abdominal Pain
- Back or Leg Pain
IX. References
- Welsh (2006) New Contraceptives, Lecture, Wyoming, MN
- Cooper (2003) Obstet Gynaecol 102:59-67 [PubMed]