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A prospective randomized comparison of transvaginal and transabdominal placement of Essure coils in the prevention of fallopian tube damage.
The Essure system is an FDA-approved hysteroscopic sterilization device. The coils remain in place at the level of the utero-tubal junction and are released and extruded through the fallopian tubes. At the time of placement, the device is seen transcervically; however, the recommended procedure involves intrauterine placement. We sought to compare the efficacy of two different methods of Essure placement. We performed a randomized prospective trial of 52 patients undergoing tubal sterilization with Essure implants. Group A (26 patients) underwent laparoscopic insertion of the Essure device, with intrauterine placement of the device. Group B (26 patients) underwent transvaginal insertion of the Essure device, with transcervical placement of the device. At 6 months and 1 year after placement, the percentage of patients with an open fallopian tube on hysterosalpingography was 38.46% (10 of 26 patients) in Group A and 8.3% (2 of 26 patients) in Group B. The difference between ac619d1d87
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