What is Essure?
Essure is a permanent birth control option that is performed in the office. Two small specialized coils are placed in the opening of each fallopian tube and over 3 months, the body makes fibrinogen to essentially block each tube. You will need to use some back up birth control during this time. A hysterosalpingogram is performed 3 months after insertion to confirm the blockage.
When is it used?
Essure is used when a woman wants permanent birth control but does not want to go through a surgery involving general anesthesia. If you have your tubes tied in an outpatient surgery, then you will have to have general anesthesia and abdominal incisions that are like those of a laparoscopy. You will also require 2 weeks to recover. The Essure has a faster recovery with only a 1-2 day recovery.
How do I prepare for the insertion of Essure?
You may have this procedure performed in the office by Dr. Hardy. The day before the procedure, you will come to the office for a preoperative appointment in which we will describe everything that will happen during the procedure. We will also make sure you have all the medications required such as Valium to help you relax, Vicodin or something like this medication for pain relief and Misoprostol that will be inserted into the vagina by the Nurse Practitioner or Dr. Hardy to help the cervix soften before the procedure. You will also be given 1 Depo Provera injection approximately 1 month prior to the procedure to thin the lining of the uterus down so Dr. Hardy will be able to visualize the opening of both fallopian tubes.
What happens during the procedure?
Dr. Hardy will numb the cervix and uterus with a paracervical block. He will then proceed to dilate the cervix open just a little bit. He will insert the hysteroscope into the cervix to look inside the uterus. There will be a TV in the room to help Dr. Hardy locate each fallopian tube opening. Dr. Hardy will also use sterile solution to fill the uterus up that will also allow him to visualize the fallopian tubes. The micro-insert coil is inserted into each fallopian tube one at a time. All instruments are removed and the procedure is completed.
What happens after the procedure?
You may experience some light to moderate vaginal bleeding or watery discharge for a few days after the procedure. You may also experience some cramping for a few days after the procedure. The pain medicine should cover this discomfort. You should not place anything in the vagina such as tampons, douching or intercourse until your postoperative appointment in 2 weeks. You may resume normal activities in 1-2 days. You will need to have someone drive you from the appointment because you will have several medications in your system. In 3 months, we will schedule a hysterosalpingogram (HSG) to confirm that both tubes are completely blocked. This will be done at a hospital in the Radiology Department. You will need to continue with a back up birth control method during this time. Remember, you will have the Depo Provera injection in your system which will be out of range approximately 2 months after the procedure.
What are the benefits of this procedure?
You will have a permanent form of birth control without having to undergo an abdominal surgery, risk the complications of general anesthesia, and have to take up to 2 weeks off of work to recover. The Essure is quicker recovery, no general anesthesia or abdominal incisions.
What are the risks associated with this procedure?
Some of the risks associated with the Essure insertion are:
- Infection inside the uterus or fallopian tubes
- Allergic reaction to any medications used during and after the procedure
- Failure of complete blockage of one or both fallopian tubes that may result in an ectopic (tubal) pregnancy
- Inadvertent injury to the uterus, cervix, or fallopian tubes
There are people who have a higher risk of complications which are:
- Poor nutrition
- Recent or chronic illness
- Use of drugs such as antihypertensives, muscle relaxants, tranquilizers, sleeping pills, insulin, sedatives, beta-adrenergic blockers, or cortisone
- Use of mind-altering drugs including narcotics, psychedelics, hallucinogens, marijuana, sedatives, hypnotics or cocaine
When should I call the office?
Call the office right away if:
- You have heavy bleeding from your vagina (you need more than 1 pad or tampon per hour or the bleeding is heavier than your menstrual flow)
- You develop a fever over 100°F (37.8°C)
- You develop headache unrelieved with Tylenol, ibuprofen or narcotic pain medication, muscle aches, dizziness or a general ill feeling
- You have severe abdominal pain or abdominal pain that continues even after you take acetaminophen or aspirin
- Excessive vaginal discharge persists beyond 1 month after surgery