Women reaching a time in their lives when they know they don’t want any more (or any) children have many options — some extreme and some, like Essure, less shocking to the body.
Essure, a permanent sterilization procedure performed in doctors’ offices and operating rooms, requires little anesthesia, is 99.8 percent effective and is a non-invasive procedure, according to Marshall Medical Center OB/GYN Michele Cherry.
“A small camera, known as a hysteroscope, is placed through the cervix and into the uterus. The uterus is distended with fluid so that both ostia (the site where the tube enters the uterus) can be visualized,” Dr. Cherry explained. “An Essure micro-insert (a spring shaped device with an inner core made up of polyester fibers) is then placed in both tubes under direct visualization. With placement of the miro-insert the procedure is complete.”
Over the next three months scar tissue forms around the inserts, effectively blocking the fallopian tubes. During this time, Cherry said, patients must continue to use some sort of birth control to prevent a tubal pregnancy, “which can be life threatening.”
“After 12 weeks the patient is scheduled for a hysterosalpingogram. This is a procedure that is performed in the radiology department at Marshall,” Cherry said. “A small amount of contrast dye is injected through the cervix and through several X-rays the dye is followed in to the uterus. The dye should not pass through the tubes. If the dye passes through the tubes the patient is continued on a temporary birth control for another 12 weeks and the test is repeated. When the tubes are occluded (completely blocked) the patient is permanently sterile.
“Patients need to follow their doctors’ instructions,” she continued. “They need to continue on a temporary form of birth control following the procedure and make sure they have the hysterosalpingogram 12 weeks following the procedure. Not doing so puts them at risk for pregnancy. Patients should also remember that this procedure protects one from pregnancy but not from sexually transmitted diseases or HIV.”
Essure has its side effects — cramping, pain, nausea/vomiting, bleeding/spotting, dizziness/light-headedness and, rarely, improper placement and insert slippage — a Conceptus clinical trial discovered. Conceptus markets the procedure. But for many women the benefits outweigh the risks.
Cherry points out that Essure requires no incisions and no hormones. Patients can go home within 45 minutes of the procedure and they’re back to work within 24 hours, she said, adding that the procedure is highly effective and the confirmation test gives the patient peace of mind.
Essure is ideal for women who might not be eligible for invasive sterilization, according to Cherry, but not women who “are uncertain about ending their fertility, have uterine abnormalities, an allergy to nickel, are pregnant or think they are pregnant, have been pregnant during the past six weeks, have or have had a recent pelvic infection or have an allergy to contrast dye.”
“Each patient is an individual and before deciding on a form of birth control a doctor should have a consultation/conversation with that patient,” Cherry concluded. “They can decide together what form of birth control would be best based on age, number of children they have, relationship status and health status.”