Referrals for complications following hysteroscopic sterilisation: characteristics associated with symptomatic patients after the Essure procedure

Abstract

ABSTRACT Objective: This report summarises recent experience with a series of symptomatic Essure® patients with an emphasis on clinical presentation, preoperative imaging, surgical intervention, and outcome. Methods: This case series presents Essure® patients (n = 7) who sought medical consultation for various complications. This retrospective analysis is based on consultations during a six-month interval beginning in April 2015. Results: In this sample, mean (± SD) patient age was 35.9 ± 3.4 yrs. The gravida/parity status was 3.6 ± 1.1 and 2.4 ± 1.4, respectively. Average duration of exposure to Essure® coils among these patients was 25.6 ± 24.5 (range 5–67) months. Except for one woman, these patients had hysteroscopic sterilisation (HS) either with heavy sedation or under general anaesthesia. More than two Essure® devices were implanted in two women. Complications reported after HS included device migration, coil fragmentation, tissue perforation, and vaginal expulsion of Essure® fragment. Three of seven women have required hysterectomy. Conclusion: The current series offers evidence of migration of contraceptive coils as well as Essure® inserts perforating tissue and being spontaneously expelled. Evaluation of symptomatic HS patients should include determining how many devices have been implanted, as some women have more than two.