Hysterosalpingogram: an essential examination following Essure hysteroscopic sterilisation.
OBJECTIVE
The aim of this study was to describe our experience of imaging following hysteroscopic sterilisation with the Essure (Conceptus Inc., Mountain View, San Carlos, CA) microinsert, and to underline the importance of a carefully performed follow-up hysterosalpingogram (HSG) in the management of these patients.


METHODS
18 women underwent the procedure and all returned for follow-up HSG. A standard HSG technique was used and views were acquired to establish microinsert position and tubal occlusion.


RESULTS
In 16 of the 18 women, adequate microinsert positioning and bilateral tubal occlusion was present. In one woman, a unilateral microinsert occluded the fallopian tube, whereas the other fallopian tube was ligated with a clip. The final patient underwent two studies; both showed well-positioned microinserts but unilateral free spill from the right fallopian tube. There are no reported pregnancies thus far.


CONCLUSIONS
Essure sterilisation coils have a unique appearance when radiographed and are an effective means of permanently occluding the fallopian tubes. HSG is a rapid and safe method of confirming satisfactory placement and tubal occlusion. Non-HSG imaging techniques are suboptimal at detecting patent fallopian tubes and expose patients to the risk of an unwanted and potentially complicated pregnancy.
Department of Imaging, Hammersmith and Queen Charlotte Hospitals, Imperial College Healthcare NHS Trust, London, UK. vikasshah@yahoo.com
V
V
Shah
N
N
Panay
R
R
Williamson
A
A
Hemingway
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007047:Hysterosalpingography / Q000379:methods; D008875:Middle Aged; D013245:Sterilization, Reproductive / Q000379:methods*; D013246:Sterilization, Tubal / Q000009:adverse effects / Q000379:methods*