HYSTEROSCOPIC STERILIZATION WITH ESSURE® - 8 YEARS OF OUR EXPERIENCE
ESC Congress Library. Correia A. May 28, 2014; 50654; A-239
Dr. Ana Isabel Correia
Dr. Ana Isabel Correia
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Abstract
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Objectives: The authors' objective consists in evaluating retrospectively the results and complications of hysteroscopic tubal with the Essure® devices.
Method: Retrospective analysis of medical records of women who underwent hysteroscopic sterilization using Essure® between February 2006 and December 2013. The authors analyzed some data including age, parity, reason of choice of this method, anesthesia, successful bilateral device placement, associated complications and results after confirmatory exam.
Results: This device was applied in 518 patients. The mean age of the patients undergoing the procedure was 38.7 years old (range 26-48). Analyzing the parity, 23.5% of women had only one or any children and only 12.9% had more than 3 children. Permanent contraception was the reason of choice this method in 73.9%.Successful bilateral device was achieved in 475 women (91.7%), 1.9% during the second attempt. During the first 2 years, 96.6% of procedures were performed under general anesthesia in an operating room. Since 2009 most of the women underwent placement of Essure® in an outpatient setting and without sedation, using only oral ibuprofen. At last 2 years only 3 procedures were done at operating room with general anesthesia. In the first years of this procedure, the follow up was made, 3 months later, with pelvic radiography and when inconclusive, the women were submitted to histerosalpingopraphy. Since 2011, we add the pelvic ultrasound to the follow up. The results obtained in the last 2 years with the pelvic ultrasound have been similar to those with the pelvic radiography. Successful bilateral device placement was obtained at majority of women, with no mortality and no major complications. The most detected complication was mild to moderate pain, reported by 27% of women. Two cases of pregnancy were detected, one secondary of misinterpreted histerosalpingopraphy and one after missed follow up.
Conclusions: In our series, the hysteroscopic tubal sterilization with Essure®, showed to be an effective procedure with low morbidity. This procedure can be safe and effectively performed in an outpatient basis with a low rate of complications. Pelvic ultrasound has been a reliable confirmatory test in cases of satisfactory placement and appears to have similar results to previously used methods.
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