title: Trends in sterilization since the introduction of Essure hysteroscopic sterilization.
abstract: OBJECTIVE
  To investigate trends in sterilization in women at the Detroit Medical Center, Michigan (DMC), since the introduction of Essure hysteroscopic sterilization.
  
  
  METHODS
  Retrospective study (Canadian Task Force classification II-2).
  
  
  METHODS
  Outpatient surgery center and university teaching hospitals.
  
  
  METHODS
  Women who underwent interval sterilization procedures at the DMC (Hutzel Women's Hospital, Sinai-Grace Hospital, and the Berry Center) and postpartum sterilization procedures at Hutzel Women's Hospital between January 1, 2002, and December 31, 2007.
  
  
  METHODS
  Permanent sterilization procedures including minilaparotomy tubal ligation, laparoscopic sterilization, Essure hysteroscopic sterilization, and postpartum tubal ligation performed at the time of cesarean section or after vaginal delivery.
  
  
  RESULTS
  In all, 5509 permanent sterilization procedures were performed in the 6 years between January 1, 2002, and December 31, 2007, at the DMC facilities analyzed: 2484 interval sterilization procedures at Hutzel Women's Hospital, Sinai-Grace Hospital, and the Berry Center, and 3025 postpartum tubal ligations at Hutzel Women's Hospital. From 2002 through 2007, the decrease in laparoscopic sterilizations from 97.9% to 48.5% of all interval sterilization procedures corresponded significantly with the increase in Essure hysteroscopic sterilizations from 0.0% to 51.3% (p <.001). Postpartum tubal ligations performed after vaginal delivery also decreased significantly during the study period from 7.9% to 3.3% of all vaginal deliveries (p <.001) while the percentage of tubal ligations performed at the time of cesarean section remained constant (p =.051).
  
  
  CONCLUSIONS
  At the DMC facilities analyzed from January 1, 2002, through December 31, 2007, a significant decrease occurred in the percentage of laparoscopic sterilizations and postpartum tubal ligations performed after vaginal delivery. Of the interval sterilizations performed, the percentage of Essure hysteroscopic sterilizations increased significantly from 0.0% to 51.3% of all procedures. Since the approval of Essure hysteroscopic sterilization in November 2002, this minimally invasive method of hysteroscopic sterilization has increased in popularity at the DMC.
authors.affiliation: Department of Obstetrics and Gynecology, Wayne State University School of Medicine and the Detroit Medical Center, Detroit, Michigan, USA.
authors.forename: Valerie I
authors.initials: VI
authors.lastname: Shavell
authors.forename: Mazen E
authors.initials: ME
authors.lastname: Abdallah
authors.forename: George H
authors.initials: GH
authors.lastname: Shade
authors.forename: Michael P
authors.initials: MP
authors.lastname: Diamond
authors.forename: Jay M
authors.initials: JM
authors.lastname: Berman
mesh_terms: D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000379:methods / Q000639:trends*; D008824:Michigan; D019060:Minimally Invasive Surgical Procedures / Q000379:methods / Q000639:trends; D009096:Multi-Institutional Systems; D010044:Outpatient Clinics, Hospital; D049590:Postpartum Period; D012189:Retrospective Studies; D013246:Sterilization, Tubal / Q000295:instrumentation* / Q000379:methods / Q000639:trends*