2014, Number 08
PDF size: 584.18 Kb.
ABSTRACTBackground: Essure® procedure consists in the placement of two coils in the intramural segment of Fallopian tubes by hysteroscopic causing a fibrosis reaction that unleashes a physiological obstruction. Hysterosalpingography, until today, is the gold standard checking the success of this method of sterilization.
Objective: Determining if a scan at three months postimplantation is sufficient to confirm the correct positioning of the device.
Material and methods: descriptive study with 61 patients undergoing definitive hysteroscopic sterilization to validate transvaginal ultrasound as a technique to determine the effectiveness of the method.
Results: there were placed 120 devices, of which 117 (97´5%) were visible by ultrasound. Comparing ultrasound findings with gold standard, we obtain that in cases of proper bilateral implantation by hysterosalpingography, with ultrasound we diagnosed the 81´13%; in cases of correct unilateral implantation we detected 75% with ultrasound, except one patient who was considered proper placement of the coil by ultrasound but hysterosalpingography reported that it was misplaced and the Fallopian tube was permeable.
Discussion: Transvaginal ultrasound is an appropriate method to confirm the correct position of intratubaric Essure® devices, its safety, low cost and reproducibility. However, our study cannot replace the hysterosalpingography as gold standard.
Solá D V, Pardo JS, Ricci AP, Guiloff FE. Nuevo método de esterilización ambulatoria y permanente con técnica histeroscópica Essure. Rev Chil Obstet Ginecol 2005;70:28-32.
Panel P, Grosdemouge I. Predictive factors of Essure implant placement failure: prospective, multicenter study of 495 patients. Fertility and Sterility 2010;93(1).
Úbeda A, Salas O, López-Menéndez M, Labastida R, Dexeus S. Método Essure: contracepción definitiva pos vía histeroscópica. Prog Obstet Ginecol 2006;49:192-5.
Thiel J, Suchet I, Tyson N, Price P. Outcomes in the ultrasound follow-up of the Essure micro-insert: complications and proper placement. J Obstet Gynaecol Can. 2011;33(2):134-138.
Veersema S, Vleugels MPH, Timmermans A, Brölmann HAM. Follow-up of successful bilateral placement of Essure microinserts with ultrasound. Fertility and Sterility® 2005; 84.
Weston G, Bowditch J. Office ultrasound should be the first-line investigation for confirmation of correct Essure placement. Aust NZJ Obstet Gynaecol 2005;45:312-5.
Ricci PA, Solá VD, Avilés GL, Pardo SJ. Control de dispositivos intratubáricos Essure mediante estudio de imágenes. Rev Chil Obstet Ginecol 2007;72:397-401.
Heredia F, Cos R, Moros S, Torrabadella L, Cayuela E. Radiological control of Essure placements. Gyneol Surg 2004;1:201-203.
Veersema S, Vleugels M, Koks C, Thurkow A, et al. Confirmation of Essure placement using transvaginal ultrasound. J Minimal Invas Gynecol 2011;18.
Wittmer MH, Brown Dl, Hartman RP, Famuyide AO, et al. Sonography, CT, and MRI appearance of the Essure microinsert permanent birth control device. AJR 2006;187.
Teoh M, Meagher S, Kovacs G. Ultrasound detection of Essure permanent birth control device: a case series. Aust NZJ Obstet Gynecol 2003;43:378-80.
Thiel JA, Suchet IB, Lortie K. Confirmation of Essure microinsert tubal coil placement with convencional and volume-contrast imaging three-dimensional ultrasound. Fertility and Sterility 2005;84.