Repeat Tubal Procedures Up After Hysteroscopic Sterilization
TUESDAY, Jan. 22, 2019 -- Hysteroscopic sterilization is associated with an increased risk for additional tubal intervention within seven years compared with laparoscopic sterilization, according to a study published online Jan. 8 in Obstetrics...
Conclusion: Essure reversal is a feasible technique for removing the device and restoring tubal patency; however, more data are needed on pregnancy outcomes following this novel procedure. PMID: 30846897 [PubMed - in process]
CONCLUSION: Patients undergoing hysteroscopic sterilization have a higher risk of receiving an additional tubal resection or ligation than those undergoing laparoscopic sterilization, particularly within the first year of the index procedure. There is no difference in undergoing a subsequent hysterectomy between the two groups. With limited evidence of outcomes after hysteroscopic sterilization beyond 7 years and existing reports of removals years after initial implantations, continuous monitoring of long-term outcomes for women who received the device is warranted. PMID: 30633141 [PubMed - as supplied by publisher]
ConclusionTo conclude, preoperative embolization of the arteriovenous shunt improves surgery, avoiding excessive bleeding and permitting easier radical hysterectomy for deep pelvic endometriosis. Similar cases have been published , but to our knowledge, our video is the first regarding this subject. It appears that embolization can fail, but hysterectomy remains the gold standard treatment .
(Abstracted from Contraception 2018;97:428–433) The second most common form of contraception among reproductive-aged women in the United States is female sterilization, although trends suggest declining rates. Methods available for interval sterilization include laparoscopic tubal ligation (TL) and hysteroscopic sterilization (HS).
CONCLUSION: This case series suggests that laparoscopic salpingectomy for removal of Essure inserts is safe and feasible. We acknowledge that the numbers were small. However, consistent use of a laparoscopic approach in these eight patients indicates that this procedure is a feasible and suitable alternative to hysterectomy. PMID: 29842838 [PubMed - as supplied by publisher]
CONCLUSION: Patients with more than two Essure® devices comprise an unusual group with a complex pelvic foreign body presentation. This is the first report on surgical management for such patients, underscoring the importance of localizing these contraceptive devices with careful imaging before, during, and after surgery. Moreover, hysterectomy is not absolutely mandatory in this setting and intraoperative fluoroscopy/radiography can facilitate complete, safe removal of all implants on an out-patient basis. Creation of ICD-10 modifiers for various post-HS complaints would allow for improved surveillance of the Essure&r...
Discussion Checklist – Acceptance of Risk and Informed Decision Acknowledgement " with their patients before implantation. The checklist includes information about the device, its safety, and its effectiveness. Patients and physicians must sign the checklist before the device is implanted.From its approval in 2002 through 2017, the FDA received 26,773 medical device reports related toEssure. The most common adverse effects reported with its use were abdominal pain, heavier menses/menstrual irregularities, headache, fatigue, and weight fluctuations. Nickel allergy, migration of the device, dislodged or dislocated...
PMID: 29405606 [PubMed - as supplied by publisher]
BJOG: An International Journal of Obstetrics&Gynaecology,Volume 125, Issue 6, Page 764-765, May 2018.