title: Ultrasound: an effective method for localization of the echogenic Essure sterilization micro-insert: correlation with radiologic evaluations.
abstract: OBJECTIVE
  To examine the reliability and practicality of performing office-based transvaginal ultrasound for determining the ease of locating the Essure hysteroscopic sterilization micro-insert and compare its usefulness against established radiologic evaluations.
  
  
  METHODS
  Prospective single-center, single-arm, clinical study (Canadian Task Force classification xx).
  
  
  METHODS
  Hospital-based clinical research center.
  
  
  METHODS
  One hundred forty-five women of reproductive age and proven fertility.
  
  
  METHODS
  Thirty-seven women who underwent the Essure hysteroscopic method of sterilization had routine radiologic and transvaginal ultrasound assessments for determining the retention of these micro-inserts from 3 months to 2 years after placement. An additional 108 women had ultrasound assessment as the only means of micro-insert localization 3 months after placement.
  
  
  RESULTS
  The 145 women (100%) who underwent an ultrasound assessment at a 3-month, posthysteroscopic-sterilization office visit had their micro-inserts readily identified and localized to the uterotubal area due to the micro-inserts' dense echogenic properties. For the 37 women who had both assessments, the ultrasound findings correlated with pelvic radiograph and hysterosalpingogram assessments of micro-insert location in all instances. In addition, the ultrasound evaluations provided additional information about the micro-inserts relative position to the surrounding, less-echogenic soft tissue structures of the upper uterotubal area. In the 37 women who had serial ultrasound and radiologic evaluations performed for up to 2 years after micro-insert placement, ultrasound was found to be equally effective in identifying the location of the micro-inserts and indicted that their position remained identifiable and stable over time.
  
  
  CONCLUSIONS
  A single transvaginal ultrasound in-office examination, performed 3 months after hysteroscopic micro-insert placement, was found to be a simple, reliable, and convenient method of assessing micro-insert location, when compared with radiologic assessments.
authors.affiliation: Flinders Reproductive Medicine, Flinders University, Adelaide, South Australia, Australia.
authors.forename: John F
authors.initials: JF
authors.lastname: Kerin
authors.forename: Barbara S
authors.initials: BS
authors.lastname: Levy
mesh_terms: D000556:Ambulatory Surgical Procedures; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000379:methods*; D007434:Intrauterine Devices; D011446:Prospective Studies; D013246:Sterilization, Tubal / Q000295:instrumentation* / Q000379:methods; D013997:Time Factors; D014463:Ultrasonography / Q000379:methods*; D014621:Vagina