Teoh Mark, Meagher Simon, Kovacs Gabor
Box Hill Medical School, Monash University, Box Hill Hospital, Box Hill, Victoria, Australia.
Aust N Z J Obstet Gynaecol. 2003 Oct;43(5):378-80. doi: 10.1046/j.0004-8666.2003.00102.x.
The current recommendation to check the position of the Essure permanent birth control (PBC) micro-insert device after its insertion is by abdominal X-ray 3 months after insertion. We propose that ultrasound imaging is more suited for this purpose and gives reassurance much earlier. The sonographic appearance of the micro-inserts and the reliability of this modality in localising the devices is described in the present study.
To ascertain the appearance of the Essure PBC device at transvaginal and transabdominal ultrasound scanning and to determine the reliability of this approach in localising the contraceptive device.
All patients who had the Essure PBC procedure between June 2002 and January 2003 at our centre were offered an ultrasound scan to check device position.
The micro-inserts were easily distinguished by their echogenic coil-like appearance within each uterine cornua extending into the proximal fallopian tube. Of the 15 patients examined, 14 pairs of devices were seen: one device was malpositioned in the lower part of the uterus. In one patient, only one device was seen in the correct position but the other device was not identified and presumably expelled after a notably difficult insertion.
Ultrasound appears to be well suited for micro-insert localisation. An early post insertion ultrasound scan is recommended to reassure about correct positioning of device and may potentially alleviate patient anxiety, or diagnose malposition early.
目前关于在插入Essure永久性节育（PBC）微插入装置后检查其位置的建议是在插入后3个月进行腹部X光检查。我们认为超声成像更适合此目的，并且能更早地让人放心。本研究描述了微插入装置的超声表现以及这种检查方式在定位装置方面的可靠性。
确定在经阴道和经腹部超声扫描时Essure PBC装置的外观，并确定这种方法在定位避孕装置方面的可靠性。
2002年6月至2003年1月在我们中心接受Essure PBC手术的所有患者均接受超声扫描以检查装置位置。
微插入装置很容易通过其在每个子宫角内呈回声增强的螺旋状外观被区分出来，该外观延伸至输卵管近端。在接受检查的15名患者中，看到了14对装置：有一对装置位置不正，位于子宫下部。在一名患者中，仅看到一个装置处于正确位置，但另一个装置未被发现，推测在一次特别困难的插入后已排出。
超声似乎非常适合微插入装置的定位。建议在插入后尽早进行超声扫描，以确保装置定位正确，并可能减轻患者的焦虑，或早期诊断位置不正。
