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| Philadelphia
clinic offers Essure procedure |
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Planned
Parenthood of Southeastern Pennsylvania
(PPSP) is part of a pilot program to make
the Essure method of
transcervical sterilization available to
women. In September, the procedure became
available at PPSP’s Surgical Center,
1144 Locust St., Philadelphia.
Two women have undergone the procedure
at the Locust Street surgical center, says
Dayle Steinberg, PPSP’s president
and chief executive officer. Steinberg
reports that the women were satisfied with
the procedure, stating that “they
could not believe how simple it was.” The
procedure took 20 minutes, with a 30-minute
recovery period in each case. No complications
occurred, she says.
The Essure procedure costs $2,000 at the
PPSP Surgical Center, Steinberg says. However,
private insurance and Medicaid offer coverage.
Steinberg expects more women to request
the procedure once word spreads about how
positive the experience was for the women
who have undergone it. |
To determine whether occlusion of both fallopian
tubes has occurred, a woman must undergo a
hysterosalpingogram — an X-ray of the
uterus and tubes using radiopaque dye1— three
months after the procedure. Since no incision
is required with the Essure method, a local
anesthetic may be used, unlike in a traditional
tubal ligation, which typically requires that
the patient undergo general anesthesia.
The Essure method is available to women for
whom tubal ligation is contraindicated, such
as those with medical conditions including obesity,
previous abdominal surgeries, or allergies or
reactions to general anesthesia. The procedure
has the potential to cost less, since it can
be performed in an outpatient clinic or physician’s
office.
Some insurance companies provide coverage for
the procedure, further reducing costs for patients.
Advantages, disadvantages
Although data are not
available beyond two years, the one-year effectiveness
rate of the Essure
method has been shown to be 99.81% and the
two-year effectiveness rate is 99.78%7 at
preventing pregnancy.
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| Insertion (top) and expansion (center)of
Essure microinsert triggers occlusion of
fallopian tubes (bottom). |
Some disadvantages to the Essure method have
been identified. Sterilization is not immediate;
it takes several months for the fallopian tubes
to become blocked with scar tissue. Therefore,
women must use an alternate form of contraception
for at least three months following the procedure.
An intrauterine device (IUD) and intrauterine
system (IUS) are the only forms of contraception
that cannot be used during this time. Another
concern is that it may take more than one attempt
to place microinserts in the fallopian tubes.
(Studies show that in 88% to 90% of women, placement
is achieved on the first try.10,11)
The procedure is not reversible, and surgery
is required to remove the microinserts if that
becomes necessary.
The Essure procedure has undergone extensive
clinical testing in the U.S., Europe, and Australia.
No pregnancies have been reported in two years
of follow-up of more than 650 women who have
undergone the procedure.12
Of the study participants who were employed,
92% resumed work within 24 hours of the procedure.
Within one week of procedure, nearly all study
participants rated their comfort level as “good” or “excellent,” and
98% of the women rated their long-term satisfaction
with Essure as “good” or “excellent.”13
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