Weston Gareth, Bowditch John
Department of Obstetrics & Gynaecology, Monash University, Melbourne, Australia.
Aust N Z J Obstet Gynaecol. 2005 Aug;45(4):312-5. doi: 10.1111/j.1479-828X.2005.00418.x.
Hysteroscopic options for permanent birth control (PBC), such as the ESSURE device, are becoming increasingly popular as an alternative to laparoscopic tubal ligation. The success of the technique hinges upon correct device placement within the intramural portion of the fallopian tube.
To determine the utility of office ultrasound for confirming correct ESSURE PBC device placement at the 3-month check in a general gynaecology practice.
The first 99 patients in a single centre following ESSURE PBC device placement.
Prospective cohort study.
Clinical data was reviewed from patient records, both from the time of the initial procedure and from the follow-up at 3 months. All women underwent an ultrasound at the 3-month check.
The ESSURE PBC devices were placed successfully in 84.8% of cases. Of those cases with apparently successful placement, office ultrasound alone confirmed correct device placement at the 3-month check in 94% of cases. Further imaging was needed in only 6% of cases.
Office ultrasound performed by the general gynaecologist at the 3-month check is more convenient for the patient, and is sufficient to confirm ESSURE PBC device placement in the vast majority of cases. We propose that the protocol for ESSURE PBC device follow-up should be altered to replace X-ray with ultrasound as the first-line investigation.
宫腔镜下永久性避孕（PBC）的方法，如Essure装置，作为腹腔镜输卵管结扎术的替代方法越来越受欢迎。该技术的成功取决于将装置正确放置在输卵管壁内部位。
确定在普通妇科门诊3个月复查时，门诊超声检查对确认Essure PBC装置放置正确的效用。
单中心99例接受Essure PBC装置放置的患者。
前瞻性队列研究。
回顾患者病历中的临床数据，包括初始手术时和3个月随访时的数据。所有女性在3个月复查时均接受了超声检查。
Essure PBC装置在84.8%的病例中成功放置。在那些放置明显成功的病例中，仅门诊超声检查就确认94%的病例在3个月复查时装置放置正确。仅6%的病例需要进一步成像检查。
普通妇科医生在3个月复查时进行门诊超声检查对患者来说更方便，并且在绝大多数情况下足以确认Essure PBC装置的放置情况。我们建议应改变Essure PBC装置的随访方案，以超声检查替代X线检查作为一线检查手段。
