What Is the Economic Cost of Unplanned Pregnancy Following Hysteroscopic Sterilization in the US? A New National Estimate Based on Essure&lt;sup&gt;®&lt;/sup&gt; Procedure Prevalence, Failure Rates and Workforce Productivity

Sills, Eric Scott; Fernandez, Luca; Jones, Christopher A.

doi:10.12927/whp.2016.24899

Cited by 3 publications

(2 citation statements)

References 19 publications

(23 reference statements)

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“…Controversy also exists concerning the effectiveness of HS as a method of reliable birth control [2324]. This raises the question of device failure with profound economic and social implications of its own [25]. While none of this information was available for consideration when Essure was initially approved by the US Food and Drug Administration in 2002, awareness of such factors now could explain the level of patient interest in surgical device removal.…”

Section: Discussionmentioning

confidence: 99%

Analysis of surgeries performed after hysteroscopic sterilization as tabulated from 3,803 Essure patient experiences

Sills

Wood

et al. 2017

Obstet Gynecol Sci

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ObjectiveAlthough previous research has suggested that risk for reoperation among hysteroscopic sterilization (HS) patients is more than ten times higher than for patients undergoing standard laparoscopic tubal ligation, little has been reported about these subsequent procedures.MethodsThis descriptive cohort study used a confidential online questionnaire to gather data from women (n=3,803) who volunteered information on HS followed by device removal surgery performed due to new symptoms developing after Essure placement.ResultsIn this sample, mean age was 35.6 years and women undergoing hysterectomy after HS comprised 64.9% (n=2,468). Median interval between HS and hysterectomy was 3.7 (interquartile range, 3.9) years and mean age at hysterectomy was 36.3 years. Some patients (n=1,035) sought removal of HS devices and fallopian tubes only, while other miscellaneous gynecological procedures were also occasionally performed for Essure-associated symptoms. When data from all patients who had any post-Essure surgery besides hysterectomy were aggregated (e.g., device removal + “other” cases, n=1,335) and compared to those cases undergoing hysterectomy, mean age was significantly lower than for the hysterectomy group (34.4 vs. 36.3 years, respectively; P<0.01); uterus-conserving surgeries were also typically performed significantly earlier than hysterectomy (P<0.01).ConclusionThis investigation is the first to characterize specific gynecological operations after Essure, and suggests that the predominant surgical answer to HS complaints is hysterectomy for many women. Dissatisfaction with HS may represent an important indication for hysterectomy and additional study is needed to quantify this phenomenon.

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Section: Discussionmentioning

confidence: 99%

Analysis of surgeries performed after hysteroscopic sterilization as tabulated from 3,803 Essure patient experiences

Sills

Wood

et al. 2017

Obstet Gynecol Sci

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“…Following the discussion on international family planning, we direct your attention to a research paper from Sills et al (2016), who describe their investigations into the economic impact of unplanned pregnancy following hysteroscopic sterilization, with a specific focus T…”

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confidence: 99%

From the Editors

2016

whp

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Interval Female Sterilization

Stuart

Ramesh

2018

Obstetrics &Amp; Gynecology

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Female sterilization is relied on by nearly one in three women aged 35-44 years in the United States. Sterilization procedures are among the most common procedures that obstetrician-gynecologists perform. The most frequent sterilization procedures include postpartum tubal ligation, laparoscopic tubal disruption or salpingectomy, and hysteroscopic tubal occlusion. The informed consent process for sterilization is crucial and requires shared decision-making between the patient and the health care provider. Counseling should include the specific risks and benefits of the specific surgical approaches. Additionally, women should be counseled on the alternatives to sterilization, including intrauterine contraceptives and subdermal contraceptive implants. Complications, including unplanned pregnancy after successful female sterilization, are rare. The objectives of this Clinical Expert Series are to describe the epidemiology of female sterilization, access to postpartum sterilization, advances in interval sterilization techniques, and clinical considerations in caring for women requesting sterilization.

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What Is the Economic Cost of Unplanned Pregnancy Following Hysteroscopic Sterilization in the US? A New National Estimate Based on Essure<sup>®</sup> Procedure Prevalence, Failure Rates and Workforce Productivity

Cited by 3 publications

References 19 publications

Analysis of surgeries performed after hysteroscopic sterilization as tabulated from 3,803 Essure patient experiences

Analysis of surgeries performed after hysteroscopic sterilization as tabulated from 3,803 Essure patient experiences

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Interval Female Sterilization

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