Pain associated with hysteroscopic sterilization

The safety and efficacy of female hysteroscopic sterilization using the Essure system has been well documented. Given the marked differences in the execution of hysteroscopic and laparoscopic sterilization, the objective of this study was to assess the experience of pain postprocedure between the 2. Secondary end-points included postoperative pain medication, time to return to normal activities, postprocedure bleeding, and patient satisfaction.

Twenty cases each of laparoscopic sterilization (LS) and hysteroscopic sterilization (HS) were performed. Patients were surveyed regarding their experience of pain immediately postoperatively, 1 week, and 4 weeks postprocedure.

The average pain score immediately postprocedure was significantly lower among HS patients than among LS patients (t=-8.17, P<.0001). One-week postprocedure, none of the patients in the HS group reported any pain, while the average pain score among the LS patients was 2.65 (t=-9.67, P<.0001). Four weeks postprocedure, women in the HS group continued to report no pain, 35% of the LS group continued to report some pain (t=-3.04, P=.004).

Hysteroscopic sterilization offers a minimally invasive, less painful, equally efficacious modality for sterilization than laparoscopic sterilization and should be available to all women seeking permanent birth control.