title: Office ultrasound should be the first-line investigation for confirmation of correct ESSURE placement.
abstract: BACKGROUND
  Hysteroscopic options for permanent birth control (PBC), such as the ESSURE device, are becoming increasingly popular as an alternative to laparoscopic tubal ligation. The success of the technique hinges upon correct device placement within the intramural portion of the fallopian tube.
  
  
  OBJECTIVE
  To determine the utility of office ultrasound for confirming correct ESSURE PBC device placement at the 3-month check in a general gynaecology practice.
  
  
  METHODS
  The first 99 patients in a single centre following ESSURE PBC device placement.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Clinical data was reviewed from patient records, both from the time of the initial procedure and from the follow-up at 3 months. All women underwent an ultrasound at the 3-month check.
  
  
  RESULTS
  The ESSURE PBC devices were placed successfully in 84.8% of cases. Of those cases with apparently successful placement, office ultrasound alone confirmed correct device placement at the 3-month check in 94% of cases. Further imaging was needed in only 6% of cases.
  
  
  CONCLUSIONS
  Office ultrasound performed by the general gynaecologist at the 3-month check is more convenient for the patient, and is sufficient to confirm ESSURE PBC device placement in the vast majority of cases. We propose that the protocol for ESSURE PBC device follow-up should be altered to replace X-ray with ultrasound as the first-line investigation.
authors: Department of Obstetrics & Gynaecology, Monash University, Melbourne, Australia. gareth.weston@med.monash.edu.au
authors: Gareth
authors: G
authors: Weston
authors: John
authors: J
authors: Bowditch
mesh_terms: D000328:Adult; D000465:Algorithms; D003274:Contraceptive Devices, Female; D005187:Fallopian Tubes / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015907:Hysteroscopy; D008875:Middle Aged; D010824:Physicians' Offices; D011446:Prospective Studies; D015203:Reproducibility of Results; D013246:Sterilization, Tubal / Q000295:instrumentation*; D014463:Ultrasonography