Essure Ensures Sterilization

A Revolutionary Concept

"This procedure will revolutionize permanent birth control because it is less invasive than tubal ligation or vasectomy"... "What's so exciting about this procedure is that you don't need to make any incision. After the procedure, patients can go home or even go back to work."

These statements were made nearly a decade ago by Richard Marvel, M.D., a gynecologist at the University of Maryland Medical Center and an assistant professor of obstetrics, gynecology and reproductive sciences at the University of Maryland School of Medicine. The comments came in response to questions about a then-new non-surgical procedure to provide permanent birth control for women. The method is called "Essure" and it involves placing small coils directly into the fallopian tubes. Over the course of time, scar tissue builds up around the coils and permanently blocks the fallopian tubes thus preventing conception.

How Is the Procedure Performed?

Unlike a tubal ligation which requires general anesthetic, Essure is performed using a local anesthetic. To perform this procedure, the doctor uses a thin, telescope-type instrument called a hysteroscope which is inserted into the vagina, through the cervix and far into the uterus until it reaches the fallopian tubes. There is a camera on the end of the scope that produces a picture on a screen so the doctor is able to see into the uterus. A small, soft coil is placed into one of the fallopian tubes where it will expand and fill the tube. The doctor then moves to the other tube and repeats the process with a second coil. It takes about 30 minutes to perform and, after a short rest on the table after the procedure, the woman can get up and go about her day.

Quick and Thorough with Close to 100% Success

Even though the procedure itself is quick, it does take some time for scar tissue to grow and eventually block off the fallopian tubes entirely. During this time period, women continue to use another form of birth control for at least three months. A special x-ray taken 12 weeks after the procedure is done will show whether the tubes are sufficiently blocked to allow the woman to stop using alternative contraception.

In clinical trials of more than 600 women who had this procedure, there were no pregnancies following the installation of the coils. The studies showed that after three months tube closure was 96% and after six months tube closure stood at close to 100%. No procedure is guaranteed 100% effective all of the time; however, the manufacturer of Essure cites a 99.8% effectiveness rate in two years.

Tubal Ligation - A Thing of the Past?

Until Essure came along, the most frequently used method of permanent birth control has been tubal ligation, with about 700,000 performed every year. It is an invasive procedure and involves cutting, sealing, or placing bands or clips around the fallopian tubes. It is a surgical procedure that requires a small cut into the abdomen with a recovery time of four to six days. If done laparscopically the recovery time is a little faster, but there is still risk of damage to the bowel, bladder, blood vessels and nerves. Many women express concern over the potential damage, the anesthesia, and the length of time it takes to recover.

No Changing of the Mind 

The Essure method is less invasive, does not require a general anesthetic, incision, or long recovery time, and it can be done in the doctor's office. All of these factors make it very attractive. However, Essure is also permanent whereas a tubal ligation can be reversed should a woman decide she wants more children.

Women who opt for Essure must understand that it is irreversible and once it is done there is no longer any chance for natural conception.


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