Effectiveness and feasibility of hysteroscopic sterilization techniques: a systematic review and meta-analysis

Chapelle, Claire F. la; Veersema, Sebastiaan; Brölmann, Hans A.M.; Jansen, Frank Willem

doi:10.1016/j.fertnstert.2015.03.009

Cited by 34 publications

(24 citation statements)

References 49 publications

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“…Quinacrine sterilization, typically performed in the follicular phase has a failure of about 27% with one application (3). Timing might also explain some cases of unilateral or bilateral failed microinsert placement during hysteroscopic permanent contraception (4). …”

Section: Introductionmentioning

confidence: 99%

Tubal patency during the menstrual cycle and during treatment with hormonal contraceptives: a pilot study in women

et al. 2016

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BackgroundHysterosalpingram (HSG) evaluation of tubal patency is typically performed in the follicular phase, but data to support this timing are lacking.PurposeTo determine whether menstrual cycle phase or hormonal treatments affect observation of tubal patency during HSG.Material and MethodsTen participants underwent repeated HSG examinations: during the follicular and luteal phase of a natural menstrual cycle; 30 days following continuous administration of a combined oral contraceptive (COC); and 30 days after an intramuscular injection of depo medroxyprogesterone (DMPA) acetate. Participants with tubal blockade following DMPA had a fifth HSG 30 days following a second course of COCs. The primary outcome was tubal patency.ResultsAll 10 participants demonstrated bilateral tubal patency (BTP) on at least one HSG examination during the study. One participant showed bilateral functional occlusion (FO) during the follicular phase examination, but BTP with the luteal phase, COC cycle, and DMPA exams. One participant with BTP discontinued participation and nine completed the COC HSG exam with BTP in seven, and one each with bilateral or unilateral FO. Seven participants completed the DMPA HSG with BTP in six and unilateral FO in one; BTP was seen in the final HSG after restarting the COC.ConclusionThis pilot study supports the luteal phase of natural cycles as the optimum time for evaluation of tubal patency. The occurrence of functional occlusion of the fallopian tube on HSG examination performed during the follicular phase and following contraceptive steroid treatment supports a role of hormonal action on the utero-tubal junction.

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Section: Introductionmentioning

confidence: 99%

Tubal patency during the menstrual cycle and during treatment with hormonal contraceptives: a pilot study in women

et al. 2016

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“…Although it is not surprising that such extra surgery brings additional expense, some research has shown that a priori costs for HS are already higher than for laparoscopic tubal ligation despite shorter operative time and less frequent use of general anesthesia [18]. Controversy also exists concerning the effectiveness of HS as a method of reliable birth control [2324]. This raises the question of device failure with profound economic and social implications of its own [25].…”

Section: Discussionmentioning

confidence: 99%

Analysis of surgeries performed after hysteroscopic sterilization as tabulated from 3,803 Essure patient experiences

Sills

Wood

et al. 2017

Obstet Gynecol Sci

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ObjectiveAlthough previous research has suggested that risk for reoperation among hysteroscopic sterilization (HS) patients is more than ten times higher than for patients undergoing standard laparoscopic tubal ligation, little has been reported about these subsequent procedures.MethodsThis descriptive cohort study used a confidential online questionnaire to gather data from women (n=3,803) who volunteered information on HS followed by device removal surgery performed due to new symptoms developing after Essure placement.ResultsIn this sample, mean age was 35.6 years and women undergoing hysterectomy after HS comprised 64.9% (n=2,468). Median interval between HS and hysterectomy was 3.7 (interquartile range, 3.9) years and mean age at hysterectomy was 36.3 years. Some patients (n=1,035) sought removal of HS devices and fallopian tubes only, while other miscellaneous gynecological procedures were also occasionally performed for Essure-associated symptoms. When data from all patients who had any post-Essure surgery besides hysterectomy were aggregated (e.g., device removal + “other” cases, n=1,335) and compared to those cases undergoing hysterectomy, mean age was significantly lower than for the hysterectomy group (34.4 vs. 36.3 years, respectively; P<0.01); uterus-conserving surgeries were also typically performed significantly earlier than hysterectomy (P<0.01).ConclusionThis investigation is the first to characterize specific gynecological operations after Essure, and suggests that the predominant surgical answer to HS complaints is hysterectomy for many women. Dissatisfaction with HS may represent an important indication for hysterectomy and additional study is needed to quantify this phenomenon.

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“…The success of the first attempt of bilateral placement has been quoted as between 78% and 84% . After successful placement, 91–100% of women were confirmed to have tubal blockade .…”

Section: Methods Of Hysteroscopic Sterilisationmentioning

confidence: 99%

“…The success of the first attempt of bilateral placement has been quoted as between 78% and 84% . After successful placement, 91–100% of women were confirmed to have tubal blockade . However, at 3 months confirmatory testing, up to 3.5% (46/1312 women) could not rely on the method for definitive contraception, but at 6 months the total complete tubal blockage was confirmed .…”

Section: Methods Of Hysteroscopic Sterilisationmentioning

confidence: 99%

“…After successful placement, 91–100% of women were confirmed to have tubal blockade . However, at 3 months confirmatory testing, up to 3.5% (46/1312 women) could not rely on the method for definitive contraception, but at 6 months the total complete tubal blockage was confirmed . Pregnancies were reported from as early as 3 months up to 24 months.…”

Section: Methods Of Hysteroscopic Sterilisationmentioning

confidence: 99%

See 1 more Smart Citation

Update on hysteroscopic sterilisation

Murthy

Edwards

Pathak

2017

The Obstetric & Gynaecologis

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Effectiveness and feasibility of hysteroscopic sterilization techniques: a systematic review and meta-analysis

Cited by 34 publications

References 49 publications

Tubal patency during the menstrual cycle and during treatment with hormonal contraceptives: a pilot study in women

Tubal patency during the menstrual cycle and during treatment with hormonal contraceptives: a pilot study in women

Analysis of surgeries performed after hysteroscopic sterilization as tabulated from 3,803 Essure patient experiences

Update on hysteroscopic sterilisation

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