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Non-surgical Sterilization For Women

One of the greatest advances in medical technology over the past ten years has been the increased development of minimally invasive surgical techniques for a host of conditions which previously required major surgery.  Female sterilization provides an excellent example.  Until the advent of laparoscopy, female sterilization could be done at the time of a caesarian section or otherwise required a full laparotomy.  Now, there is even a nonincisional alternative to laparoscopic tubal ligation: the Essure procedure.

The Essure procedure uses a hysteroscope which is inserted through the vagina to place micro-inserts into the fallopian tubes.  These inserts cause tissue ingrowth and tubal blockage.  This process takes about three months to complete, so women who have Essure insertion MUST use a back-up form of contraception for at least three months after the procedure.  To be sure that the procedure has worked, you must return to your physician for a confirmation procedure called a hysterosalpingogram (HSG).  This test involves injecting a contrast dye into your uterus to enhance an x-ray picture which will confirm that the implants have sufficiently blocked the Fallopian tubes.  Women who rely on Essure for contraception before completing this evaluation have a greater risk of getting pregnant, or having an ectopic (tubal) pregnancy which can be life-threatening.

The good news about this procedure is that it does not involve any incisions, it does not require general anesthesia, it takes an average of 35 minutes to perform, and it is performed as an outpatient procedure.  Women can generally leave within an hour of having the procedure and return to their full level of activity the next day.  Thus far, in 2 years of follow-up, this procedure has achieved a 99.8% efficacy rate, which is comparable to laparoscopic tubal ligation.  Like tubal ligation, the Essure procedure must be considered irreversible and is only recommended for women who are completely sure that they do not want to conceive any future children.

Created: 10/20/2003  -  Donnica Moore, M.D.

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