OBJECTIVE: To describe incorrect positions of Essure microinserts detected at 3 months' follow-up. DESIGN: Case report. SETTING: Outpatient department of obstetrics and gynecology in a Dutch teaching hospital. PATIENT(S): Initial series of 100 patients who underwent hysteroscopic sterilization using Essure between December 2003 and June 2004. INTERVENTION(S): Hysteroscopic placement of the Essure System, follow-up at 3 months with transvaginal ultrasound (TVU), and hysterosalpingography. MAIN OUTCOME MEASURE(S): Bilateral placement rate, tubal obstruction, and detection of incorrect Essure microinsert localization at follow-up after apparent successful bilateral placement. RESULT(S): Bilateral placement of Essure microinserts in one session was successful in 93 women (93%). In 90 of these women (96.8%), tubal obstruction was proven at follow-up 3 months later. Three incorrect positions of an Essure insert were seen: two expulsions and one perforation into the abdominal cavity. CONCLUSION(S): Incorrect position of Essure microinserts was seen only when the initial placement procedure was difficult. When a placement procedure was difficult or other suboptimal conditions are present during the procedure, we advise performing a TVU or pelvic X-ray in these women 4 weeks after the procedure or after the first vaginal bleeding, instead of waiting for follow-up after 3 months.
OBJECTIVE: To describe incorrect positions of Essure microinserts detected at 3 months' follow-up. DESIGN: Case report. SETTING:Outpatient department of obstetrics and gynecology in a Dutch teaching hospital. PATIENT(S): Initial series of 100 patients who underwent hysteroscopic sterilization using Essure between December 2003 and June 2004. INTERVENTION(S): Hysteroscopic placement of the Essure System, follow-up at 3 months with transvaginal ultrasound (TVU), and hysterosalpingography. MAIN OUTCOME MEASURE(S): Bilateral placement rate, tubal obstruction, and detection of incorrect Essure microinsert localization at follow-up after apparent successful bilateral placement. RESULT(S): Bilateral placement of Essure microinserts in one session was successful in 93 women (93%). In 90 of these women (96.8%), tubal obstruction was proven at follow-up 3 months later. Three incorrect positions of an Essure insert were seen: two expulsions and one perforation into the abdominal cavity. CONCLUSION(S): Incorrect position of Essure microinserts was seen only when the initial placement procedure was difficult. When a placement procedure was difficult or other suboptimal conditions are present during the procedure, we advise performing a TVU or pelvic X-ray in these women 4 weeks after the procedure or after the first vaginal bleeding, instead of waiting for follow-up after 3 months.
Authors: Giuseppe Ricci; Stefano Restaino; Giovanni Di Lorenzo; Francesco Fanfani; Federica Scrimin; Francesco P Mangino Journal: Ther Clin Risk Manag Date: 2014-11-17 Impact factor: 2.423