Evaluation of the benefits of a new hysteroscopic sterilisation (Essure®) on the OPD

Evaluation of the benefits of a new hysteroscopic

sterilisation (Essure®) on the OPD

MPH Vleugels1 and

S Veersema2  

1Rivierenland hospital, Tiel, Netherlands, 2Antonius hospital,

Nieuwegein, Netherlands 

Objective (1) To develop a simple method to introduce a

new hysteroscopic sterilisation (Essure®) on the OPD department without any

anaesthesia. Criteria for success are, procedure time, pain experience,

placement failure rate , patient satisfaction . (2) To simplify the control of a

correct placement after three months by transvaginal ultrasound. 

Methods Introduction in the Netherlands is done according one identical protocol

regarding patient management, premedication, procedure of placement, Visual

Analogue Score for pain registration, quality of life interviews and control

after three months. Continuously ongoing registration and collection of data

resulted in an analysis which has met our objectives 

Results Overall 95%

placement rate has been achieved independently of the surgeon’s experience . The

transvaginal approach according Bettocchi with only premedication by supp. NSAID

resulted in a averaged pain score 2.5 (S.D. 2.5; median 2.0, range 0-8).The

procedure time was 8.1 minutes (median 10). Patient satisfaction was very high:

99% quoted to advocate this method to any other woman irrespectively whether

placement of the device succeeded. The control after three months was

prospectively studied with a plain Xray, Hysterosalpingogram and ultrasound. The

outcome proved that the vaginal ultrasound has the highest positive predicting

value (99%) after a non complicated procedure. 

Conclusion this new

hysteroscopic sterilisation with the Essure® device can be offered to women as

a fully out patient department procedure with a high success rate and high

patient satisfaction.

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