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Hysteroscopic sterilization provides a permanent form of birth control for women. The procedure places a device in the fallopian tubes that stimulates a growth of tissue. The fallopian tubes allow eggs to pass from the ovaries to the uterus. The tissue growth eventually blocks the fallopian tubes and prevents 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
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.
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
- Rupture of fallopian tube during the procedure
- Device is pushed out of fallopian tubes before being effective
- Injury to local tissue
- Chronic pain
- Adverse reaction to nickel—the implanted device is made of nickel
- 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:
- Chronic disease, such as diabetes or obesity
What to Expect
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.
You may be given local anesthesia. It will block any pain. Sedation may be used to ease anxiety.
Hysteroscopic sterilization can be done in a doctor’s office or operating room. A soft, flexible tube called a hysteroscope will be used. The tube is inserted into the vagina and passed through to the uterus and the fallopian tubes. 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 three months, there is often enough tissue growth to completely block the fallopian tubes.
There may be some discomfort and pressure during the procedure.
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.
The device takes about three 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
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.
Essure Permanent Birth Control. US department of Health and Human Services website. Available at: http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/ucm371014.htm. Accessed February 23, 2015.
The Essure procedure. Essure website. Available at: http://www.essure.com/getting-essure/what-to-expect. Accessed February 20, 2015.
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: http://www.acog.org/Patients/FAQs/Hysteroscopic-Sterilization. Accessed February 24, 2015.
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 website. Available at: http://www.ebscohost.com/dynamed. Updated January 26, 2015. Accessed February 20, 2015.
Last reviewed February 2015 by Andrea Chisholm, MD
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