Follow-up of successful bilateral placement of Essure microinserts with ultrasound.
OBJECTIVE
To evaluate the reliability of pelvic X-ray and transvaginal ultrasound to localize Essure microinserts (Conceptus, San Carlos, California) after successful placement in both fallopian tubes 3 months after placement.


METHODS
Prospective, observational study.


METHODS
Gynecology departments at two teaching hospitals.


METHODS
One hundred eighty-two patients who underwent hysteroscopic sterilization by placement of Essure microinserts between August 2002 and August 2004.


METHODS
Transvaginal ultrasound, pelvic X-ray, and hysterosalpingography (HSG) 3 months after sterilization with Essure.


METHODS
Transvaginal ultrasound confirmation of correct localization of microinserts after a 3-month follow-up.


RESULTS
In 150 of 182 patients, confirmation of successful bilateral placement of two microinserts (300 devices) was possible. In 9 patients it was not possible to identify both devices with ultrasound, or there was doubt about the extension of the device through the uterotubal junction. The other 291 devices were identified as being in a good position.


CONCLUSIONS
Hysterosalpingography at the 3-month follow-up after successful placement of Essure microinserts can be replaced by transvaginal ultrasonography. A 3-month follow-up with HSG after the Essure procedure is only required after unsatisfactory placements. In those patients in whom transvaginal ultrasonography cannot confirm satisfactory localization, a complementary pelvic X-ray should be performed.
Veersema
Sebastiaan
S
St. Antonius Hospital, Nieuwegein, The Netherlands. s.veersema@antonius.net
Vleugels
Michel P H
MP
Timmermans
Anne
A
Brölmann
Hans A M
HA
D003274:Contraceptive Devices, Female; D005187:Fallopian Tubes / Q000000981:diagnostic imaging*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007047:Hysterosalpingography / Q000592:standards*; D010388:Pelvis / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D013245:Sterilization, Reproductive / Q000295:instrumentation / Q000379:methods*; D014463:Ultrasonography / Q000592:standards*; D014621:Vagina / Q000000981:diagnostic imaging