Outcomes in the Ultrasound Follow-up of the Essure Micro-Insert: Complications and Proper Placement

Ultrasound Assessment of the Essure Contraceptive Devices: Is Three-Dimensional Ultrasound Really Needed?

“…Considering the results of the present study, it is likely that in the study by Thiel et al [20] 3DUS was nondiagnostic or unsatisfactory because of differential positioning of the devices, which impaired proper 3DUS visualization on retrospective review of the cases.…”

“…The objective of this small prospective ultrasound study was not to confirm that ultrasound could replace HSG to confirm tubal occlusion in patients undergoing hysteroscopic Essure device placement; larger studies have already addressed this issue [11][12][13][14][15]20,21]. Our only objective was to describe the difficulties that we have encountered in relying on 3DUS only as the technique of choice to identify and classify the position of the inserts after hysteroscopy.…”

“…The use of 3DUS follow-up of Essure microinserts has been recently evaluated by Thiel et al [20], who retrospectively evaluated a large cohort of patients undergoing hysteroscopic placement of Essure microinserts and 3DUS evaluation at 3 months after the procedure. In their experience, 3DUS was ''nondiagnostic'' or ''unsatisfactory'' (i.e., suspicious of misplacement of the device) in 86 of 610 cases (15%).…”

Correct placement of the Essure device detected by transvaginal ultrasound at one month predicts correct placement at three months

“…It has been demonstrated that micro-insert presence inside the interstitial portion of the Fallopian tube can be used as a proxy for tubal occlusion. [4][5][6][7][8] The ability to perform the test sooner than the currently recommended three months post procedure has the potential to increase patient compliance and reassure patients earlier of correct micro-insert placement.…”

“…Several studies have demonstrated that the presence of the device in the interstitial portion of the Fallopian tubes amounts to tubal occlusion with no increase in failure rates and ultrasound is associated with much lower reported discomfort and pain than the HSG. [4][5][6][7][8] The current recommendation for performing the confirmation test three months post-procedure is derived from a peri-hysterectomy study. Women undergoing elective hysterectomy agreed to have the Essure procedure prior to their surgery.…”