Satisfaction and tolerance with office hysteroscopic tubal sterilization

Abstract

Objective: To evaluate women's satisfaction and tolerance of hysteroscopic sterilization.

Design: Prospective analysis of case series.

Setting: Gynecology department in a teaching hospital.

Patient(s): A total of 1,630 women who underwent hysteroscopic sterilization by placement of Essure microinserts (Conceptus, Inc., Mountain View, CA) from January 2003 to June 2006.

Intervention(s): Transvaginal ultrasound examination, pelvic x-ray examination, and hysterosalpingography 3 months after sterilization with Essure microinserts. Satisfaction was assessed by a visual analog scale. Adverse effects and tolerance also were recorded.

Main outcome measure(s): Transvaginal ultrasound and pelvic x-ray confirmation of correct localization of microinserts and patient's satisfaction and tolerance after a 3-month follow-up.

Result(s): The rate of successful insertion was 99%. Most of women returned to their daily activities on the same day of insertion, and 86.5% considered the procedure painless or scarcely painful. All the patients were highly satisfied after hysteroscopic sterilization: 91% of subjects by visual analog scale (on a 0 to 10 scale) rated the method at 10 (high satisfaction degree), and none of the subjects rated it under 8. For patients, the most valuable aspects of the procedure were absence of surgery room (52.7%), method's quickness and comfort (19.9%), and permanent sterilization (18.2%). More than 97% of the patients said that they would recommend the procedure to others.

Conclusion(s): This study provides evidence that Essure microinserts can be placed in a usual gynecologic consultation room in standard conditions without any type of anesthesia or sedation and are associated with great overall patient satisfaction. Women also have high tolerance for the procedure and describe minor postoperative pain.