Radiofrequency global endometrial ablation followed by hysteroscopic sterilization.
OBJECTIVE
To describe the feasibility of performing Essure hysteroscopic sterilization immediately after NovaSure global endometrial ablation (GEA).


METHODS
Descriptive feasibility study (Canadian Task Force classification III).


METHODS
Midwestern United States academic medical center.


METHODS
Twenty-five women (aged 35-49 years) with menorrhagia who elected GEA treatment and requested concurrent permanent sterilization.


METHODS
NovaSure GEA followed immediately by Essure hysteroscopic sterilization. Patients returned 3 months after the procedure for hysterosalpingography (HSG) to document tubal occlusion.


RESULTS
The inserts were placed successfully in all 25 patients; 21 returned for 3-month follow-up HSG, as recommended. Bilateral tubal occlusion was documented at 3 months in 19 patients (90%) and unilateral occlusion in 2 patients. Six-month postprocedural HSG in these 2 patients documented bilateral tubal occlusion. Hysterosalpingography was not performed in 4 patients. In all 21 patients with appropriate follow-up, complete occlusion was documented, and the ability to perform or interpret HSG was not affected by endometrial ablation.


CONCLUSIONS
Essure hysteroscopic sterilization can be safely performed after NovaSure GEA. Intrauterine synechiae do not appear to adversely affect the ability to perform HSG at 3 months or to document tubal occlusion.
Hopkins
Matthew R
MR
Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota 55905, USA. hopkins.matthew@mayo.edu
Creedon
Douglas J
DJ
El-Nashar
Sherif A
SA
Brown
Douglas L
DL
Good
Andrew E
AE
Famuyide
Abimbola O
AO
D000328:Adult; D017115:Catheter Ablation; D004717:Endometrium / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D015907:Hysteroscopy; D008595:Menorrhagia / Q000601:surgery*; D008875:Middle Aged; D013246:Sterilization, Tubal / Q000379:methods*; D016896:Treatment Outcome