title: Essure Surgical Removal and Subsequent Symptom Resolution: Case Series and Follow-Up Survey.
abstract: Transcervical sterilization is a minimally invasive option for permanent contraception with high reported rates of patient satisfaction. A small percentage of women subsequently choose to have the tubal inserts removed due to regret or perceived side effects. There is limited information with regard to the improvement in the symptom profile following surgical removal of the tubal inserts. We present a retrospective case series of 11 women who underwent surgical removal of Essure by hysteroscopy, salpingectomy, and/or hysterectomy. The predominant symptom at presentation was pain (n = 10; 90.91%), as well as bleeding (n = 6; 54.54%) and/or dyspareunia (n = 5; 45.45%). After surgical removal, the majority of patients (n = 8; 72.72%) reported an improvement of their symptoms. However, 3 (27.27%) patients continued to have persistent symptoms after surgery. Before surgical removal of Essure, it is important to thoroughly discuss the risk of continuing symptoms with patients.
authors.affiliation: Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Luiz Gustavo O
authors.initials: LG
authors.lastname: Brito
authors.affiliation: Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Cohen
authors.affiliation: Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Emily R
authors.initials: ER
authors.lastname: Goggins
authors.affiliation: Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Karen C
authors.initials: KC
authors.lastname: Wang
authors.affiliation: Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: jeinarsson@partners.org.
authors.forename: Jon I
authors.initials: JI
authors.lastname: Einarsson
mesh_terms: D000328:Adult; D020878:Device Removal; D004414:Dyspareunia / Q000209:etiology; D055356:Endometrial Ablation Techniques / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D015907:Hysteroscopy / Q000009:adverse effects / Q000379:methods*; D017060:Patient Satisfaction; D017699:Pelvic Pain / Q000209:etiology; D011247:Pregnancy; D012107:Research Design; D012189:Retrospective Studies; D058994:Salpingectomy / Q000379:methods*; D013246:Sterilization, Tubal / Q000009:adverse effects* / Q000379:methods; D016896:Treatment Outcome; D014592:Uterine Hemorrhage / Q000209:etiology
keywords: Essure; Hysterectomy; Pelvic pain; Postoperative status; Salpingectomy; Survey