Office hysteroscopic sterilization compared with laparoscopic sterilization: a critical cost analysis

Abstract

Study objective: To evaluate the actual cost difference in performing Essure hysteroscopic sterilization in the office compared with ambulatory surgery using laparoscopic sterilization in the operating room.

Design: Cost-comparison analysis (Canadian Task Force classification III).

Setting: University hospital and affiliated outpatient office.

Interventions: Hysteroscopic placement of Essure device in an office setting and laparoscopic tubal ligation for permanent sterilization.

Measurements and main results: The various costs associated with the two procedures at our institution were compiled, and a direct cost comparison was made. We used actual institutional costs of the procedures, not billing or reimbursement. We found laparoscopic tubal ligations to cost 3449 dollars compared with hysteroscopic placement of the Essure device that costs 1374 dollars yielding a 2075 dollars difference between the procedures.

Conclusion: In our institution and in our experience, office-hysteroscopic placement of the Essure device is a more cost-effective method than laparoscopic tubal ligation.