Essure Sterilization in Patients with History of Pelvic Inflammatory Disease and Hydrosalpinges: An Analysis on Feasibility and Clinical Outcomes
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Objective: The purpose of this study was to evaluate the efficiency of Essure hysteroscopic sterilization in patients with a past history of pelvic inflammatory disease/hydrosaplinges. Setting: The study took place in an inner city, obstetrics and gynecology clinic. Study Design: The study was a retrospective case review via the electronic medical record system database of Women's Specialty Center in Dallas. The database search was from October 2007 to October 2010. The primary endpoint was rate comparison of successful bilateral microinsert placement (first attempt) between cohorts (hydrosalpinges versus nonhydrosalpinges). Secondary analysis was procedure time ("scope in" to "scope out") between the two. Demographic differences between groups were calculated using the rank-sum test for continuous variables and 2 for binary data. Statistical analysis for successful first attempt, bilateral placement was done by unpaired t test. Procedure time differences were analyzed by McNemar testing. Significance was set at p<0.05. Results: Sixteen patients met criteria for evaluation. Five had tubular disease on ultrasound; 4 of these were found to have bilateral distal tubal disease, and 1 had isolated left hydrosalpinx. No statistically significant differences in initial bilateral placement rates were noted between cohorts (p=0.09). All but 1 patient in the nonhydrosalpinx group had successful bilateral cannulation at first attempt. No patencies were noted in either cohort at the respective 3 month confirmation tests. No significant difference was noted in procedure time between cohorts (p=0.89). No postprocedural infectious morbidities were encountered in either cohort. Conclusions: Within the limits of this preliminary study, it is concluded that hysteroscopic sterilization with the Essure system is not hindered by the presence of hydrosalpinges in patients with a past history of treated pelvic inflammatory disease. (J GYNECOL SURG 28:343) Mary Ann Liebert, Inc.
