Confirmation of Essure Placement Using Transvaginal Ultrasound

Study ObjectiveTo evaluate the protocol for confirmation of satisfactory Essure placement using transvaginal ultrasound.DesignProspective multicenter cohort study (Canadian Task Force classification II-2).SettingOutpatient departments of 4 teaching hospitals in the Netherlands.PatientsEleven hundred forty-five women who underwent hysteroscopic sterilization using the Essure device between March 2005 and December 2007.InterventionTransvaginal ultrasound examination 12 weeks after uncomplicated successful bilateral placement or as indicated according to the transvaginal ultrasound protocol after 4 weeks, and hysterosalpingography (HSG) at 12 weeks to confirm correct placement of the device after 3 months.Measurements and Main ResultsThe rate of successful placement was 88.4% initially. In 164 women (15%), successful placement was confirmed at HSG according the protocol. In 9 patients (0.84%), incorrect position of the device was observed at HSG. The cumulative pregnancy rate after 18 months was 3.85 per thousand women.ConclusionTransvaginal ultrasound should be the first diagnostic test used to confirm the adequacy of hysteroscopic Essure sterilization because it is minimally invasive, averts ionizing radiation, and does not decrease the effectiveness of the Essure procedure.