For years when women requested permanent sterilization Obstetricians and Gynecologists performed a tubal ligation (“having your tubes tied”). That procedure involved either general or regional anesthesia in a hospital setting and anywhere from 1-3 incisions, with at least a 2-3 day downtime for recovery.
With the desire to decrease recovery time, avoid incisions and with the added benefit of significantly cutting patient expense and missed work, hysteroscopic sterilization was developed. A camera views the openings of your fallopian tubes through your cervix, the opening of your uterus, and then a device is used to block the tube causing your body to complete the process of complete obstruction over a 3-month period.
What is Essure? By stimulating your body’s own tissue to grow in and around, tiny, flexible inserts placed inside your fallopian tubes you will achieve permanent sterilization. The Essure inserts bend and conform to the shape of your fallopian tubes while remaining securely in place. The procedure itself takes about 10 minutes including the anesthesia given in the office. I prefer to have an anesthesiologist provide IV sedation in the office, as opposed to using local anesthesia, such as Lidocaine. Most patients go home within one hour of arriving for the procedure and return to work the next day with minimal if any pain medication required. It is possible the openings of both tubes cannot be visualized during the procedure in which case the procedure would be aborted. To minimize this scenario, I prefer to perform the procedure during the first part of your menstrual cycle; if you are breastfeeding, anytime will be okay.
The Essure insert is made of a polyester fiber, nickel-titanium, and stainless steel alloy, the same silicone-free material used in heart stents among other medical devices. Although the risk of allergic reaction is rare, for patients with an allergy to nickel, I recommend you select an alternative form of birth control.
To ensure your tubes are blocked, an X-ray confirmation test is performed after three months. An alternative form of birth control is required until tubal blockage is confirmed. In rare cases, tubal blockage may take more than 3 months. If this were to occur, a repeat Essure Confirmation Test (ECT) would be performed at 6 months following the procedure.
IMPORTANT: Although the company, Conceptus states, ‘Essure in no way affects your hormone levels, menstrual cycle and cannot be felt by the patient,’ every person is different, so this may not always be the case. Essure can only be removed safely through hysterectomy and In Vitro Fertilization (IVF) is NOT an option once Essure has been placed. Check out their website for more information (http://www.essure.com/what-is-essure). Please be 100% sure that you do not desire future children.
Although Essure is often more cost effective and a shorter procedure that is typically performed in the office. If female sterilization is what you are set on I recommend tubal ligation as no foreign objects are left inside the patient once it is completed.
As with any female permanent sterilization procedure, I always encourage vasectomy as the first option. Vasectomy is the easiest procedure to perform with the least risks.
Please feel free to schedule an appointment to discuss your options.
Jonathan Weinstein, MD, FACOG
Frisco Womens Health