Evaluation of the benefits of a new hysteroscopic
sterilisation (Essure®) on the OPD
MPH Vleugels1 and
S Veersema2
1Rivierenland hospital, Tiel, Netherlands, 2Antonius hospital,
Nieuwegein, Netherlands
Objective (1) To develop a simple method to introduce a
new hysteroscopic sterilisation (Essure®) on the OPD department without any
anaesthesia. Criteria for success are, procedure time, pain experience,
placement failure rate , patient satisfaction . (2) To simplify the control of a
correct placement after three months by transvaginal ultrasound.
Methods Introduction in the Netherlands is done according one identical protocol
regarding patient management, premedication, procedure of placement, Visual
Analogue Score for pain registration, quality of life interviews and control
after three months. Continuously ongoing registration and collection of data
resulted in an analysis which has met our objectives
Results Overall 95%
placement rate has been achieved independently of the surgeon’s experience . The
transvaginal approach according Bettocchi with only premedication by supp. NSAID
resulted in a averaged pain score 2.5 (S.D. 2.5; median 2.0, range 0-8).The
procedure time was 8.1 minutes (median 10). Patient satisfaction was very high:
99% quoted to advocate this method to any other woman irrespectively whether
placement of the device succeeded. The control after three months was
prospectively studied with a plain Xray, Hysterosalpingogram and ultrasound. The
outcome proved that the vaginal ultrasound has the highest positive predicting
value (99%) after a non complicated procedure.
Conclusion this new
hysteroscopic sterilisation with the Essure® device can be offered to women as
a fully out patient department procedure with a high success rate and high
patient satisfaction.