Clinical Outcomes and Patient-Reported Symptoms After Essure Removal Surgery: A Systematic Review.

Area of Science:

• Reproductive Medicine
• Minimally Invasive Surgery
• Patient Outcomes

Background:

• Essure, a permanent female sterilization device, has been associated with various adverse events.
• Surgical removal is an option for patients experiencing complications or desiring reversal.

Purpose of the Study:

• To evaluate clinical outcomes of Essure removal surgery.
• Focus on symptom reduction, quality of life, surgical techniques, and complications.

Main Methods:

• Systematic literature search of PubMed, Embase, and Cochrane Library.
• Included 18 studies (2014-2024) involving 2034 women; excluded case reports and non-English/Dutch articles.
• Assessed methodological quality, noting a high risk of bias in most included studies.

Main Results:

• Significant symptom improvement (pain, bleeding, asthenia) reported in 7 studies; some persistent/worse symptoms noted.
• Quality of life (QoL) improvements observed in 5 studies.
• Laparoscopic bilateral salpingectomy with device was the most frequent procedure (52.3%); overall complication rate was 6.5%.

Conclusions:

• Essure removal surgery is generally safe, leading to symptom reduction and improved QoL for most patients.
• Persistent or worsening symptoms can occur post-surgery.
• Limited evidence quality due to retrospective designs and non-standardized outcome measures necessitates further research.