Essure microinsert imaging: does abnormal shape on ultrasound predict complications on HSG?

Area of Science:

• Radiology
• Gynecology
• Medical Imaging

Background:

• Essure microinsert placement is a method for permanent female sterilization.
• Hysterosalpingogram (HSG) is the gold standard for evaluating Essure placement complications.
• Ultrasound is a non-invasive imaging modality.

Purpose of the Study:

• To determine if the shape of the Essure microinsert on ultrasound can predict complications.
• To compare ultrasound findings with hysterosalpingogram (HSG) results.

Main Methods:

• Retrospective analysis of 122 Essure microinserts in 65 patients.
• Transvaginal ultrasounds (2D and 3D) performed three months post-placement.
• Ultrasound findings were graded and compared to HSG results by a blinded radiologist.

Main Results:

• Ultrasound identified 31 out of 37 complications, including uterine/tubal perforations and incorrect placement.
• Sensitivity of ultrasound for predicting complications was 94%, specificity 95%.
• Positive predictive value was 85%, negative predictive value 98% (Kappa = 0.85).

Conclusions:

• Ultrasound is a highly accurate imaging modality for assessing Essure microinsert placement.
• Ultrasound can effectively predict complications, potentially reducing the need for HSG.
• Ultrasound may serve as a frontline imaging tool for post-Essure placement evaluation.