Objectives - Hysteroscopic flexible micro- insert (Essure- R is an ambulatory improvement of fallopian tube sterilization, which is a deliberated suppression of fertility. The aim of this study was an evaluation of feasibility (learning curve) and the first year outcome of this method. Patients and methods. - This prospective study, carried out between February 2002 and March 2003, included patients who were matching with manufacturer recommendations. One surgeon only realized all the device placements. Results. - Fifty patients were included (one year follow- up). Mean age was 41 (± 3.3), mean parity was 2.7 (± 0.8). Mean time needed for device placement was 26 minutes (± 6.5) and was reduced with increased experience. Six failures of placement (12% ) were related, because of submucus leiomyomas, proximal tubal stenotic disease or too retroverted uterus. Only 5 patients (11.4% ) described intensive pelvic pain during the placement. The only case of device expulsion benefited from a successful second placement. The one- year follow- up showed no significant difference of body weight increasing, duration or quantity of menstruation, neither significant pelvic pain nor vaginal bleeding. Tolerance was rated at least at “ somewhat satisfied". There have been no pregnancies reported in 670 woman- months of effectiveness. Discussion and conclusion. - Our results agree in any point with those of larger studies. We think that hysteroscopy micro- insert placement is not only reserved to specialized centers but also to any gynecologist who is used to performing hysteroscopy because of its feasibility.
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