[Ultrasonography as a method to determine the correct implantation of intratubaric devices]

Ginecol Obstet Mex. 2014 Aug;82(8):523-9.
[Article in Spanish]

Abstract

Background: Essure procedure consists in the placement of two coils in the intramural segment of Fallopian tubes by hysteroscopic causing a fibrosis reaction that unleashes a physiological obstruction. Hysterosalpingography, until today, is the gold standard checking the success of this method of sterilization.

Objective: Determining if a scan at three months postimplantation is sufficient to confirm the correct positioning of the device.

Material and methods: Descriptive study with 61 patients undergoing definitive hysteroscopic sterilization to validate transvaginal ultrasound as a technique to determine the effectiveness of the method.

Results: There were placed 120 devices, of which 117 (97'5%) were visible by ultrasound. Comparing ultrasound findings with gold standard, we obtain that in cases of proper bilateral implantation by hysterosalpingography, with ultrasound we diagnosed the 81 '13%; in cases of correct unilateral implantation we detected 75% with ultrasound, except one patient who was considered proper placement of the coil by ultrasound but hysterosalpingography reported that it was misplaced and the Fallopian tube was permeable.

Discussion: Transvaginal ultrasound is an appropriate method to confirm the correct position of intratubaric Essure devices, its safety, low cost and reproducibility. However, our study cannot replace the hysterosalpingography as gold standard.

MeSH terms

  • Adult
  • Contraceptive Devices, Female*
  • Fallopian Tubes / diagnostic imaging*
  • Female
  • Humans
  • Hysterosalpingography
  • Hysteroscopy*
  • Time Factors
  • Ultrasonography