Ultrasound detection of the Essure permanent birth control device: a case series

The current recommendation to check the position of the Essure permanent birth control (PBC) micro-insert device after its insertion is by abdominal X-ray 3 months after insertion. We propose that ultrasound imaging is more suited for this purpose and gives reassurance much earlier. The sonographic appearance of the micro-inserts and the reliability of this modality in localising the devices is described in the present study.

To ascertain the appearance of the Essure PBC device at transvaginal and transabdominal ultrasound scanning and to determine the reliability of this approach in localising the contraceptive device.

All patients who had the Essure PBC procedure between June 2002 and January 2003 at our centre were offered an ultrasound scan to check device position.

The micro-inserts were easily distinguished by their echogenic coil-like appearance within each uterine cornua extending into the proximal fallopian tube. Of the 15 patients examined, 14 pairs of devices were seen: one device was malpositioned in the lower part of the uterus. In one patient, only one device was seen in the correct position but the other device was not identified and presumably expelled after a notably difficult insertion.

Ultrasound appears to be well suited for micro-insert localisation. An early post insertion ultrasound scan is recommended to reassure about correct positioning of device and may potentially alleviate patient anxiety, or diagnose malposition early.