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Essure Removal for the Treatment of Device-Attributed Symptoms: An Expanded Case Series and Follow-up Survey
Nisse V Clark1, Doortje Rademaker1, Avery A Mushinski1
1Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Massachusetts.
Study Objective:
To evaluate perioperative outcomes and symptom resolution in women undergoing removal of the Essure device for device-attributed symptoms.
Design:
Retrospective case series and follow-up patient survey (Canadian Task Force classification III).
Setting:
Large academic medical center.
Patients:
Fifty-two women who underwent laparoscopic or hysteroscopic Essure removal between 2012 and 2016.
Interventions:
Women underwent one of four procedures: laparoscopic hysterectomy (LH) and bilateral salpingectomy (BS), laparoscopic BS and cornuectomy, laparoscopic Essure removal and BS, or hysteroscopic Essure removal and laparoscopic BS.
Measurements And Main Results:
Fifty-two women who underwent Essure removal were asked to complete a survey regarding symptom resolution and quality of life following the procedure. Thirty-two women (61.5%) responded to the survey. Seventy-five percent (24/32) reported almost total or total improvement in quality of life, 56.3% (18/32) for sex life, 53.1% (17/32) for pelvic pain, and 65.6% (21/32) for daily activities. The majority of women reported some degree of improvement in all four domains queried (87.5%, 28/32). When asked about their symptoms in general, 31.3% (10/32) of women reported ongoing or worse symptoms after Essure removal. All procedures took approximately one hour (mean 65 min, SD 33 min), were associated with minimal blood loss (mean 31 mL, SD 17), and had no perioperative complications.
Conclusion:
Essure removal is a procedure that may be effective for treating most women with symptoms attributed to the device. Patients should be counseled that some symptoms may persist or even worsen following surgery.
