July 21st, 2018

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Laparoscopic and Hysteroscopic Removal of Bilateral Essure Devices 46 Months After Insertion for Persistent Pelvic Pain: Techniques and Outcome: A Case Report
Authors:  Mohammad S. Mahmoud, M.D.
BACKGROUND: Hysteroscopic sterilization using tubal microinsert devices has generally been reported to be well tolerated in terms of procedure-related pain; however, persistent pelvic pain requiring microinsert removal has been described in a few case reports and series. Most of these removals have been performed at <3 months after initial insertion.

CASE: We present a case of removal of Essure microinserts due to pain symptoms 46 months after insertion using a combined laparoscopic and hysteroscopic approach.

CONCLUSION: Continued monitoring for persistent pain after the Essure hysteroscopic tubal occlusion procedure is appropriate. Consideration may be given to microinsert device removal in cases of intractable and unexplained pain. This can be safely done either laparoscopically or hysteroscopically, even years after initial insertion.
Keywords:  coiled spring; contraceptive devices, female; contraceptive devices/adverse effects; device removal; Essure; fallopian tubes/surgery; hysterosalpingography; laparoscopy; pelvic pain/etiology; pelvic pain/surgery; reproductive/instrumentation; sterilization; sterilization, reproductive/adverse effects
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