[What signs should you look for ultrasound (2D/3D) to affirm the good location of tubal implants? About a retrospective study of 92 cases].
OBJECTIVE
The aim of this study is to propose an analysis of the route and the curvature of the Essure®system in 3D ultrasound to determine their correct location so as not to miss a tubal perforation.


METHODS
This is a retrospective single center study during 2 years analyzing 92 3D ultrasound performed by a single sonographer. Implant placement was performed by different operators. One prescribed 3D ultrasound control in case of difficulties with the installation; other indications where systematics.


RESULTS
The Essure®'s position is right in 79% of cases. Twenty-eight implants appear incorrectly positioned on ultrasound 3D positioning. Abnormalities found are those described by the classification proposed in the literature. In one case, the curvature of the implant, not taking into account this classification, allowed to evoke a tubal perforation. Among the 28 cases of non-visualized implants in place, 3 cases of wrong position of the implant were confirmed by additional examinations (laparoscopy or HSG). For 14 cases, the ASP or HSG disproved the wrong position of the implants. In other cases, we did not have other complementary examinations.


CONCLUSIONS
Ultrasonography 3D seems to be the method of choice to control implants for simple implementation and good reproducibility. However, the interpretation of 3D ultrasound images is sometimes difficult. The study of the curvature of the implant should be systematically analyzed not to miss a tubal perforation.
Service de gynécologie-obstétrique, CHU de Nantes, quai 38, boulevard Jean-Monnet, 44093 Nantes cedex, France.
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Simorre
Service de gynécologie-obstétrique, CHU de Nantes, quai 38, boulevard Jean-Monnet, 44093 Nantes cedex, France.
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Lopes
Service de gynécologie-obstétrique, CHU de Nantes, quai 38, boulevard Jean-Monnet, 44093 Nantes cedex, France. Electronic address: claudine.levaillant@chu-nantes.fr.
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Le Vaillant
D000328:Adult; D005187:Fallopian Tubes / Q000000981:diagnostic imaging* / Q000293:injuries; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008875:Middle Aged; D011247:Pregnancy; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013246:Sterilization, Tubal / Q000295:instrumentation* / Q000379:methods*; D016896:Treatment Outcome; D014463:Ultrasonography / Q000379:methods*
Essure; Hysteroscopic sterilization; Stérilisation tubaire hystéroscopique; Three-dimensional sonography; Ultrasons; Ultrasound; Échographie tridimensionelle