IS Case 403: Essure placement

Neal Young, MD

University of Rochester


Imaging Sciences URMC 2010
Publication Date: 2010-08-27

History

Patient is a 35-year-old female, presenting 3 months status post Essure placement to confirm fallopian tube occlusion.

Findings

See images

Diagnosis

Essure placement

Discussion

Essure is a form of permanent contraception that can be performed without surgery or general anesthesia. It is a microinsert device placed in the bilateral fallopian tubes from a transcervical approach with a hysteroscopic guidance. The device itself is made from concentric dual coils that expand into the tubal lumen when deployed. Polyethylene terephthalate fibers stimulate occlusive tissue growth over a 3 month period. Successful placement and tubal occlusion is confirmed by hysterosalpingography.

Satisfactory placement requires that the distal end of the inner coil is completely in the tube, with less than 50% of the length of the inner coil trailing into the uterine cavity, and that the proximal end of the inner coil is less than 30 mm into the tube from where contrast material fills the uterine cornu.

As this novel device may become more widely used, radiologists should be aware of the device's appearance and be able to assess device position and presence of tubal occlusion on HSG.

References

  1. Wittmer MH, Famuyide AO, Creedon DJ, Hartman RP. Hysterosalpingography for assessing efficacy of Essure microinsert permanent birth control device. AJR Am J Roentgenol. 2006 Oct;187(4):955-8. PMID: 16985142

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