title: Initial experience with hysteroscopic tubal occlusion (Essure®).
abstract: OBJECTIVE
  To evaluate results of early tubal occlusions performed by hysteroscopy (Essure®).
  
  
  METHODS
  This prospective study included 38 patients, 73.7% of them were white, mean age 34.5 years, they have had on average 3 pregnancies and 2.7 of deliveries. A total of 86.8% of patients previously prepared the endometrium. All procedures were carried out at outpatient unit without anesthesia.
  
  
  RESULTS
  Insertion rate of the device was 100% at a mean time of 4 minutes and 50 seconds. Based on the analogical visual scale, average pain reported was three, and 55.3% of women did not report pain after the procedure. After 3 months, 89.5% of patients were very satisfied with the method. Simple radiographs of the pelvis showed 92.1% of topical devices, and one case of unilateral expulsion had occurred. A four years follow-up did not show failure in the method.
  
  
  CONCLUSIONS
  Tubal occlusion through hysteroscopy at outpatient unit and without anesthesia was a quickly and well-tolerated procedure. No serious complications were seen, the success rate was high, and patients were satisfied.
  
  
  OBJECTIVE
  Avaliar os resultados das primeiras oclusões tubárias realizadas pela via histeroscópica (Essure®).
  Estudo prospectivo com 38 pacientes, sendo 73,7% caucasianas, com média de idade de 34,5 anos, e com 3 gestações e 2,7 partos em média. Do total, 86,8% das pacientes fizeram preparo prévio do endométrio. Todos os procedimentos foram ambulatoriais e sem anestesia.
  
  
  RESULTS
  A taxa de inserção do dispositivo foi de 100%, com tempo médio de 4 minutos e 50 segundos. Segundo a Escala Visual Analógica, a dor média obtida foi de três, e 55,3% das mulheres não referiram qualquer dor após o método. Ocorreu um caso de reflexo vagal e 89,5% das pacientes retornaram às atividades normais no mesmo dia. Após 3 meses, 89,5% das pacientes encontravam-se muito satisfeitas com o método. A radiografia simples da pelve evidenciou 92,1% de dispositivos tópicos, ocorrendo um caso de expulsão unilateral. Após 4 anos de seguimento, não houve falha do método.
  A oclusão tubária por via histeroscópica em regime ambulatorial e sem anestesia foi um procedimento rápido, bem tolerado, isento de complicações graves e com alta taxa de sucesso e satisfação das pacientes.
authors.affiliation: Hospital do Servidor Público Estadual "Francisco Morato de Oliveira", São Paulo, SP, Brazil.
authors.forename: Daniella De Batista
authors.initials: Dde B
authors.lastname: Depes
authors.affiliation: Hospital do Servidor Público Estadual "Francisco Morato de Oliveira", São Paulo, SP, Brazil.
authors.forename: Ana Maria Gomes
authors.initials: AM
authors.lastname: Pereira
authors.affiliation: Hospital do Servidor Público Estadual "Francisco Morato de Oliveira", São Paulo, SP, Brazil.
authors.forename: Umberto Gazi
authors.initials: UG
authors.lastname: Lippi
authors.affiliation: Hospital do Servidor Público Estadual "Francisco Morato de Oliveira", São Paulo, SP, Brazil.
authors.forename: João Alfredo
authors.initials: JA
authors.lastname: Martins
authors.affiliation: Hospital do Servidor Público Estadual "Francisco Morato de Oliveira", São Paulo, SP, Brazil.
authors.forename: Reginaldo Guedes Coelho
authors.initials: RG
authors.lastname: Lopes
mesh_terms: D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015907:Hysteroscopy / Q000295:instrumentation / Q000379:methods*; D010147:Pain Measurement; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011446:Prospective Studies; D013246:Sterilization, Tubal / Q000295:instrumentation / Q000379:methods*