title: Confirmation of Essure placement using transvaginal ultrasound.
abstract: OBJECTIVE
  To evaluate the protocol for confirmation of satisfactory Essure placement using transvaginal ultrasound.
  
  
  METHODS
  Prospective multicenter cohort study (Canadian Task Force classification II-2).
  
  
  METHODS
  Outpatient departments of 4 teaching hospitals in the Netherlands.
  
  
  METHODS
  Eleven hundred forty-five women who underwent hysteroscopic sterilization using the Essure device between March 2005 and December 2007.
  
  
  METHODS
  Transvaginal ultrasound examination 12 weeks after uncomplicated successful bilateral placement or as indicated according to the transvaginal ultrasound protocol after 4 weeks, and hysterosalpingography (HSG) at 12 weeks to confirm correct placement of the device after 3 months.
  
  
  RESULTS
  The rate of successful placement was 88.4% initially. In 164 women (15%), successful placement was confirmed at HSG according the protocol. In 9 patients (0.84%), incorrect position of the device was observed at HSG. The cumulative pregnancy rate after 18 months was 3.85 per thousand women.
  
  
  CONCLUSIONS
  Transvaginal ultrasound should be the first diagnostic test used to confirm the adequacy of hysteroscopic Essure sterilization because it is minimally invasive, averts ionizing radiation, and does not decrease the effectiveness of the Essure procedure.
authors.affiliation: Department of Obstetrics and Gynecology, St Antonius Hospital, Nieuwegein, the Netherlands. s.veersema@planet.nl
authors.forename: Sebastiaan
authors.initials: S
authors.lastname: Veersema
authors.forename: Michel
authors.initials: M
authors.lastname: Vleugels
authors.forename: Caroline
authors.initials: C
authors.lastname: Koks
authors.forename: Andreas
authors.initials: A
authors.lastname: Thurkow
authors.forename: Huub
authors.initials: H
authors.lastname: van der Vaart
authors.forename: Hans
authors.initials: H
authors.lastname: Brölmann
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005187:Fallopian Tubes / Q000601:surgery*; D005260:Female; D006801:Humans; D011247:Pregnancy; D018873:Pregnancy Rate; D013245:Sterilization, Reproductive / Q000295:instrumentation* / Q000379:methods; D016896:Treatment Outcome; D014463:Ultrasonography