Essure tubal sterilization: a tertiary level hospital experience in eleven years
ESC Congress Library. Nércio A. May 28, 2014; 50603; A-188
Dr. Ana Cristina Nércio
Dr. Ana Cristina Nércio
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Abstract
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Hysteroscopic flexible micro-insert (Essure) is a minimally invasive alternative for permanent female sterilization, approved for use by the European Health Office in November 2001, and performed in our department since July 2002.


The purpose of this study was to present our experience in the use of Essure permanent birth control micro-insert device in an outpatient setting and evaluate safety and tolerance of the placement procedure, incidence of complications, device placement success rate, post-operative adverse events and effectiveness at preventing pregnancy.


An eleven year retrospective study was done, carried out between July 2002 and August 2013 in a tertiary level hospital. The data were collected from hospital records and patient files, descriptively.


It includes 136 women in reproductive age and proven fertility that requested for permanent contraception and accepted hysteroscopic sterilization with the Essure micro-insert.  In 8%(11 cases/136) the insertion was not performed because of technical difficulties (8 cases) or intracavitary pathology (3 cases). The mean duration time of the device placement was 13minutes with a good tolerability (mean pain intensity score of 4), the great majority (14/125) without local anesthesia. The device placement success rate at three months was 81,6%. There was only one case reported of pregnancy, in a woman who missed the control.


Essure is a minimally invasive option for proximal tubal occlusion. The transcervical route avoids the need for general anesthesia and incisions, with short operative time. It is associated with minimal postoperative pain, allows faster recovery and resumption of normal activities. Even though and due to the absence of a surgery waiting list in our hospital, this procedure carries out a higher cost and is only performed in women with co-morbidities and anesthetic risks. This is a safe and well tolerated procedure, with a high success rate.

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