Placement of a permanent birth control device at a university medical center.
OBJECTIVE
To determine the Essure placement failure rate and analyze factors associated with failure in an urban, nonstudy population at a university medical center.


METHODS
A retrospective study was conducted of women who underwent attempted Essure hysteroscopic sterilization at the Detroit Medical Center (DMC) from January 1, 2003, to June 30, 2007.


RESULTS
There were 316 Essure procedures attempted at the DMC from January 2003 through June 2007. Of the 316 attempted procedures, there were 22 device placement failures and 3 documented post-Essure pregnancies. Of the 22 placement failures, 11 were attributed to difficulty visualizing the tubal ostia. Other causes of failure included device malfunction, uterine perforation, tubal perforation, expulsion of the device, tubal spasm, tubal ostia too large for the device and unspecified. Difficulty visualizing the ostia (p < 0.001) and a longer procedure time (p = 0.008) were significantly associated with failure.


CONCLUSIONS
The rate of successful placement of the Essure permanent birth control device at the DMC is 92.1%, with a post-Essure pregnancy rate of 0.95%. The majority of placement failures may be attributed to difficulty visualizing the tubal ostia.
Department of Obstetrics and Gynecology, Wayne State University School of Medicine and the Detroit Medical Center, Detroit, Michigan, USA.
Valerie I
VI
Shavell
Mazen E
ME
Abdallah
Michael P
MP
Diamond
Jay M
JM
Berman
D000046:Academic Medical Centers; D000328:Adult; D005187:Fallopian Tubes / Q000601:surgery; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D008824:Michigan; D011247:Pregnancy; D012189:Retrospective Studies; D013245:Sterilization, Reproductive / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D017211:Treatment Failure