Bipolar hysteroscopic procedures and placement of Essure microinserts for tubal sterilization: a case control study

Objective: To assess the effectiveness and complication rate with Essure microinsert placements for tubal sterilization and the concomitant bipolar intrauterine surgical procedure. Design: Case control study. Setting: Department of gynecology and obstetrics of a general hospital in France. Patient(s): 382 women, including 41 undergoing one or several concomitant uterine procedures with Essure placement, and 341 undergoing Essure placement only (controls). Intervention(s): Essure placement with or without bipolar hysteroscopic procedure for polyp, myoma, or endometrial ablation. Main Outcome Measure(s): Success rate for microinsert placement and complications at 3 months. Result(s): Forty-one patients had Essure microinserts placed in combination with a bipolar hysteroscopic procedure: endometrial resection (n = 32), fibroma resection (n = 4), or polyp ablation (n = 5). They were compared with 341 patients who underwent Essure placement only. The success rate for Essure placement was 97.6% in the combination group versus 97.6% in the control group. The complication rate was 4.9% (n = 2) in the combination group versus 2.6% (n = 9) in the control group. The difference in the success and complication rates was not statistically significant. Conclusion(s): Performing intrauterine bipolar resection during hysteroscopy for sterilization is possible without reducing the Essure placement success rate and without increasing morbidity. (Fertil Steril (R) 2011; 95: 2422-5. (C) 2011 by American Society for Reproductive Medicine.)