Bipolar hysteroscopic procedures and placement of Essure microinserts for tubal sterilization: a case control study

ObjectiveTo assess the effectiveness and complication rate with Essure microinsert placements for tubal sterilization and the concomitant bipolar intrauterine surgical procedure.DesignCase control study.SettingDepartment of gynecology and obstetrics of a general hospital in France.Patient(s)382 women, including 41 undergoing one or several concomitant uterine procedures with Essure placement, and 341 undergoing Essure placement only (controls).Intervention(s)Essure placement with or without bipolar hysteroscopic procedure for polyp, myoma, or endometrial ablation.Main Outcome Measure(s)Success rate for microinsert placement and complications at 3 months.Result(s)Forty-one patients had Essure microinserts placed in combination with a bipolar hysteroscopic procedure: endometrial resection (n = 32), fibroma resection (n = 4), or polyp ablation (n = 5). They were compared with 341 patients who underwent Essure placement only. The success rate for Essure placement was 97.6% in the combination group versus 97.6% in the control group. The complication rate was 4.9% (n = 2) in the combination group versus 2.6% (n = 9) in the control group. The difference in the success and complication rates was not statistically significant.Conclusion(s)Performing intrauterine bipolar resection during hysteroscopy for sterilization is possible without reducing the Essure placement success rate and without increasing morbidity.