Evaluation of the benefits of a new hysteroscopic sterilisation (Essure®) on the OPD
MPH Vleugels1 and S Veersema2
1Rivierenland hospital, Tiel, Netherlands, 2Antonius hospital, Nieuwegein, Netherlands
Objective (1) To develop a simple method to introduce a new hysteroscopic sterilisation (Essure®) on the OPD department without any anaesthesia. Criteria for success are, procedure time, pain experience, placement failure rate , patient satisfaction . (2) To simplify the control of a correct placement after three months by transvaginal ultrasound.
Methods Introduction in the Netherlands is done according one identical protocol regarding patient management, premedication, procedure of placement, Visual Analogue Score for pain registration, quality of life interviews and control after three months. Continuously ongoing registration and collection of data resulted in an analysis which has met our objectives
Results Overall 95% placement rate has been achieved independently of the surgeon's experience . The transvaginal approach according Bettocchi with only premedication by supp. NSAID resulted in a averaged pain score 2.5 (S.D. 2.5; median 2.0, range 0-8).The procedure time was 8.1 minutes (median 10). Patient satisfaction was very high: 99% quoted to advocate this method to any other woman irrespectively whether placement of the device succeeded. The control after three months was prospectively studied with a plain Xray, Hysterosalpingogram and ultrasound. The outcome proved that the vaginal ultrasound has the highest positive predicting value (99%) after a non complicated procedure.
Conclusion this new hysteroscopic sterilisation with the Essure® device can be offered to women as a fully out patient department procedure with a high success rate and high patient satisfaction.