title: Utility of Three-Dimensional Ultrasonography to Assess the Position of Essure Tubal Occlusion Device and Its Complications.
abstract: BACKGROUND
  To determine the utility of three-dimensional (3D) sonography to control the position of hysteroscopic sterilizing device compared to hysterosalpingography (HSG).
  
  
  METHODS
  A prospective observational study was carried out on 139 patients who underwent hysteroscopic tubal occlusion method between February 2012 and May 2013. Patients underwent 3D ultrasound scan to control device positioning, and they also underwent HSG as an additional control method. Comparison between both methods was carried out.
  
  
  RESULTS
  In all, 17 (12.2%) devices were inserted due to a hydrosalpinx and 122 (87.8%) due to sterilization purposes. In 124 (89.2%) cases, sonography correlated completely to HSG findings. Sonography-positive predictive value was 89.5% to detect correct device positioning. Just 4 (2.8%) patients did not present complete tubal occlusion 3 months after device insertion; one of them presented device expulsion, 2 of them presented previous hydrosalpinx (tubal occlusion was confirmed after 6 months), and the last case rejected to undergo further controls but device seem to be effective.
  
  
  CONCLUSIONS
  3D sonography seems to be effective for the control of sterilization device positioning, but it also detects insertion complications and device migration. Further studies would be required to assess our findings and the role of sonography in case of hydrosalpinx.
authors.affiliation: Department of Gynecology, La Paz University Hospital - IdiPAZ, Madrid, Spain.
authors.forename: Covadonga
authors.initials: C
authors.lastname: Alvarez-Lopez
authors.forename: Javier
authors.initials: J
authors.lastname: De Santiago
authors.forename: Antonio
authors.initials: A
authors.lastname: Piñera
authors.forename: Roberto
authors.initials: R
authors.lastname: Rodriguez
authors.forename: Beatriz
authors.initials: B
authors.lastname: Herrero
authors.forename: Maria
authors.initials: M
authors.lastname: Herrera
authors.forename: Jaime
authors.initials: J
authors.lastname: Pillado
authors.forename: Ignacio
authors.initials: I
authors.lastname: Zapardiel
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007047:Hysterosalpingography / Q000592:standards*; D015907:Hysteroscopy / Q000592:standards*; D021621:Imaging, Three-Dimensional; D010043:Outcome and Process Assessment, Health Care; D011446:Prospective Studies; D019736:Prostheses and Implants; D013246:Sterilization, Tubal / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D014463:Ultrasonography / Q000592:standards*