Portal de Periódicos da CAPES

Incorrect position of Essure microinserts 3 months after successful bilateral placement

2008; Elsevier BV; Volume: 91; Issue: 3 Linguagem: Inglês

10.1016/j.fertnstert.2008.08.013

1556-5653

Maria B.E. Gerritse, Sebastiaan Veersema, Anne Timmermans, Hans A.M. Brölmann,

Female Genital Mutilation/Cutting Issues

ObjectiveTo describe incorrect positions of Essure microinserts detected at 3 months' follow-up.DesignCase report.SettingOutpatient 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. To describe incorrect positions of Essure microinserts detected at 3 months' follow-up. Case report. Outpatient department of obstetrics and gynecology in a Dutch teaching hospital. Initial series of 100 patients who underwent hysteroscopic sterilization using Essure between December 2003 and June 2004. Hysteroscopic placement of the Essure System, follow-up at 3 months with transvaginal ultrasound (TVU), and hysterosalpingography. Bilateral placement rate, tubal obstruction, and detection of incorrect Essure microinsert localization at follow-up after apparent successful bilateral placement. 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. 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.