Hysteroscopic Sterilization

(Essure Sterilization)

Definition

Hysteroscopic sterilization provides a permanent form of birth control for women by blocking the fallopian tubes. The fallopian tubes allow eggs to pass from the ovaries to the uterus. During the procedure, a device is placed in the fallopian tubes that stimulates tissue to grow. The growth of tissue will eventually block the fallopian tubes and prevent the sperm from reaching and fertilizing eggs.

This procedure does not require incisions into the skin. It is done with a special scope that is passed through the vagina into the uterus toward the fallopian tubes. The sterilization is also called Essure sterilization after the brand name of a medical device used in this procedure.

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Reasons for Procedure    TOP

Hysteroscopic sterilization is done to prevent pregnancy. It does not stop ovulation or menstruation. It does not protect from sexually transmitted diseases.

This procedure is only recommended for people seeking a permanent method of birth control. Other birth control options are more appropriate for those seeking temporary birth control or if they are unsure of wanting a future pregnancy. The doctor will discuss all birth control options before a sterilization procedure.

Possible Complications     TOP

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

  • Improper placement or slipping of device
  • Tubes are not completely blocked
  • Injury to the uterus or fallopian tubes
  • Rupture of fallopian tube during the procedure
  • Chronic pain
  • Unintended or ectopic pregnancy

Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications, such as:

  • Smoking
  • Drinking
  • Chronic disease, such as diabetes or obesity

What to Expect    TOP

Prior to Procedure

A physical exam will be done. Since the device is permanent, your doctor may advise counseling. The best time for the procedure is after the end of your menstrual cycle.

Anesthesia

You may be given local anesthesia. It will block any pain. Sedation may be used to ease anxiety.

Description of the Procedure     TOP

Hysteroscopic sterilization can be done in a doctor’s office or operating room. A soft, flexible tube called a hysteroscope will be used. The sterilization devices are passed through the hysteroscope and placed into each of the fallopian tubes. Once the devices are in place the hysteroscope is removed.

The inserted devices are made with nickel, which stimulates the growth of tissue. After about 3 months, there is often enough scar tissue to completely block the fallopian tubes.

How Long Will It Take?    TOP

About 10 minutes

Will It Hurt?    TOP

There may be some discomfort and pressure during the procedure.

Post-procedure Care    TOP

At the Doctor’s Office

You will be monitored after the procedure is done. It may be up to 45 minutes before you can leave. If there are complications, this time may be longer.

At Home

The device takes about 3 months to be effective. During this time, other birth control methods will need to be used to prevent pregnancy. At a follow-up appointment, the doctor will perform an imaging test to confirm that the fallopian tubes are completely closed.

Hysteroscopic sterilization does not protect you against sexually transmitted diseases (STDs). Consistent and proper condom use is the best method to prevent an STD infection.

Normal activity is often resumed within 1-2 days. Common side effects include:

  • Mild cramping
  • Pelvic discomfort
  • Nausea and/or vomiting
  • Vaginal bleeding

Call Your Doctor     TOP

It is important to monitor your recovery. Alert your doctor to any problems. If any of the following occur, call your doctor:

  • The device falls out
  • Signs of infection, including fever or chills
  • Pain or bleeding that lasts longer than you or your doctor expect
  • Excessive vaginal bleeding
  • New or worsening symptoms

If you think you have an emergency, call for medical help right away.

RESOURCES:

The American Congress of Obstetricians and Gynecologists
http://www.acog.org
Women's Health—US Department of Health and Human Services
http://www.womenshealth.gov

CANADIAN RESOURCES:

The Society of Obstetricians and Gynaecologists of Canada
http://sogc.org
Women’s Health Matters
http://www.womenshealthmatters.ca

References:

Essure Permanent Birth Control. US department of Health and Human Services website. Available at:
...(Click grey area to select URL)
Updated August 23, 2017. Accessed December 13, 2017.
The Essure procedure. Essure website. Available at:
...(Click grey area to select URL)
Accessed December 13, 2017.
Hurskainen R, Hovi SL, et al. Hysteroscopic tubal sterilization: A systematic review of the Essure system. Fertil Steril. 2010;92(1):16-19.
Hysteroscopic sterilization. The American College of Obstetricians and Gynecologists. Available at:
...(Click grey area to select URL)
Updated April 2017. Accessed December 13, 2017.
Lessard CR, Hopkins MR. Efficacy, safety, and patient acceptability of the Essure procedure. Patient Prefer Adherence. 2011;5:207-212.
Morantz C, Torrey B. Clinical Briefs. Am Fam Physician. 2003;67(1):201-205.
Tubal sterilization. EBSCO DynaMed Plus website. Available at: https://www.dyname.... Updated January 24, 2017. Accessed December 13, 2017.
Last reviewed December 2017 by Beverly Siegal, MD, FACOG

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