[Essure--a novel method of sterilization]

Essure hysteroscopic sterilization is a minimally invasive, outpatient approach to female sterilization, which avoids the possible complications of laparoscopic sterilization. This procedure has been available since 2003 in both Europe and North America. We present our experience of the first 12 cases of the procedure performed in Israel.

Women who have completed their family planning were offered to consider Essure as their permanent contraception. The procedure was performed without anesthesia by the vaginoscopic technique at the hospital's outpatient clinic. Patients completed a questionnaire and were discharged immediately following the procedure. A follow-up checkup was completed after three months including three dimensional sonography, abdominal X-ray and occasional hysterosalpingogram.

Twelve patients participated in the pilot group at Hadassah. The average age was 40 years (34-45) and the average number of children was 5 (4-8). The average time for the procedure was under 8 minutes. Periostial adhesions required adhesiolysis prior to insertion of the device in one patient. All patients resumed their normal activity on the same day. Our patient satisfaction survey revealed that the procedure was associated with high satisfaction levels. Sonographic and radiographic studies confirmed the good placement of the device.

The Essure procedure was well tolerated by patients. The limitation is probably going to be the price of Essure, as this procedure is not covered by the 'health basket' in Israel.