| Essure | |
|---|---|
| Background | |
| Birth control type | Sterilization |
| First use | 2002 |
| Failure rates (first year, after occlusion) | |
| Perfect use | 0.2% |
| Typical use | 0.2% |
| Usage | |
| Duration effect | Permanent |
| Reversibility | Irreversible |
| User reminders | Additional methods until 3 month check by hysterosalpingogram |
| Clinic review | None |
| Advantages and disadvantages | |
| STD protection | No |
| Benefits | Permanent contraception |
Essure is a permanent transcervical sterilization procedure for women developed by Conceptus Inc. It was approved for use in the United States on November 4, 2002.[1]
Two economic studies, one of which implemented Essure as an in-office procedure, suggest that Essure could be more cost-effective than laparoscopic bilateral tubal ligation.[2]
Contents |
Inserts are placed into the fallopian tubes by a catheter passed from the vagina through the cervix and uterus. The insert contains inner polyethylene terephthalate fibers to induce benign fibrotic reaction and is held in place by flexible stainless steel inner coil and a dynamic outer nickel titanium alloy coil.[3] Once in place, the device is designed to elicit tissue growth in and around the insert to form over a period of three months an occlusion or blockage in the fallopian tubes; the tissue barrier formed prevents sperm from reaching an egg.
Unlike other forms of tubal ligation, no general anaesthetic nor incision through the abdomen is required.
Similar to some other methods of birth control, initially additional forms of birth control must be continued for 3 months[2] to prevent pregnancy until the method's effectiveness can be confirmed.
For the Essure method, three months after insertion a physician performs an x-ray test called a hysterosalpingogram[4] to confirm that the fallopian tubes are completely blocked and that the patient can rely on the Essure inserts for birth control.[1] A contrast agent (dye) is injected through the cervix, and an x-ray technologist takes photos of the Essure coils to ensure that they are in place.
Following successful insertion and occlusional response, the Essure procedure is 99.74% effective based on 5 years of follow-up, with zero pregnancies reported in clinical trials.[5][6]
The reported insertional failure rates are "failure to place 2 inserts in the first procedure (5%), initial tubal patency (3.5%), expulsion (2.2%), perforation (1.8%), or other unsatisfactory device location (0.6%)".[7] Upon follow-up, occlusion is observed to have occurred in 96.5% of patients at 3 months with the remainder occluded by 6 months.[1]
The inserts do not prevent the transmission of sexually transmitted diseases. The procedure takes about 10 minutes[8] for a trained physician to perform and can be performed in a physician's office. General anesthesia is not required. Unlike many temporary methods of birth control, the Essure inserts do not contain or release hormones.
The inserts are made from polyester fibers, nickel-titanium and stainless steel and are safe to use with MRI equipment. The Essure procedure is reported to be permanent and not reversible by the manufacturing company. Notwithstanding the manufacturer's position, several Essure reversals have been performed.[9]
Additional birth control must be used for three months after procedure.[7][10]
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