Computed tomographic confirmation of distally placed Essure* microinsert

Objective: To highlight the use of CT scan to confirm proper placement of the Essure microinsert tubal occlusion device. Design: Case report. Setting: Community-based, outpatient setting. Patient(s): A 37-year-old woman (G2P2002) who desired permanent sterilization. Intervention(s): The patient underwent hysteroscopic placement of Essure microinserts, which was complicated by inability to confirm intraluminal placement of the left implant by hysteroscopic visualization. A CT scan performed that day confirmed intraluminal placement and ruled out intraperitoneal placement of the insert. Main Outcome Measure(s): Confirmation of correct insert placement. Result(s): A CT scan confirmed the placement of the Essure insert within the fallopian tube lumen and excluded perforation into the peritoneal cavity. Conclusion(s): Computed tomography is a reliable way to determine whether Essure microinserts are properly placed when this cannot be determined by hysteroscopic visualization. Follow-up hysterosalpingography continues to be required to confirm tissue ingrowth at 3 months' time. (Fertil Steril (R) 2009;91:1294.e5-e7. (C) 2009 by American Society for Reproductive Medicine.)