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[The ESTHYME study. Women's satisfaction after hysteroscopic sterilization (Essure micro-insert). A retrospective
1Service de Gynécologie-Obstétrique, Maternité Aline-de-Crépy, Hôpital Bichat-Claude-Bernard, Assistance Publique-Hôpitaux de Paris, 46, Rue Henri-Huchard, 75018, Paris, France. catherine.scarabin@bch.aphp.fr
Objective:
To assess the satisfaction and recovery of women undergoing sterilization with a permanent birth control device (Essure micro-insert).
Patients And Methods:
French multicenter survey carried out in 12 public and private hospitals. One thousand and thirty-two patients undergoing permanent hysteroscopic sterilization (Essure micro-insert) between 2002 and 2006 were enrolled. An anonymous satisfaction questionnaire was sent to all patients. Demographic data as well as the level of tolerance and acceptability of the procedure were analyzed. Seven hundred and two (68%) patients responded to the questionnaire.
Results:
Forty-five percent of all procedures were done without anaesthesia, and 55% under local or general anaesthesia or neuroleptanalgesia. Mean age was 42 years. Sterilization was a personal decision in 62% of cases. Only one out of three women (33%) was informed of the law of sterilization's legalization. Patients came to know about this procedure by their gynecologist (74%), or by media (14%). Eighty-four percent of patients considered the level of tolerance during the procedure from no pain to moderate pain. The method without anesthaesia is described painless in 24% of cases when the surgeon has done more than 50 procedures versus 11% when he has done less than 50 (P = 0.012). Seventy-seven percent of patients were appreciative of following the procedure on the monitor screen. Patients returned to everyday life within 24 h in 90% of cases, whereas 24 h return to work was attained in 75%. The procedure without general anesthesia offered a quicker return to work (80% within 24 h) than the procedure carried out with general anesthesia (59%, P < 0.05). The memory of the procedure was described as "very good" to "acceptable" in 96% of cases. Most of the patients (98%) would recommend this procedure to their friends.
Discussion And Conclusion:
The results of this national survey confirm that hysteroscopic sterilization is associated with good overall satisfaction, because it is a fast, easy and safe method of permanent sterilization with good levels of tolerance and immediate recovery. The technique without anaesthesia is now recommended. Its tolerance is improved with surgeon's experience.
