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, Hachem Djeffal, MD Department of Diagnostic Imaging and Interventional Radiology, Caen University and Medical Center , Caen , France Search for other works by this author on: Oxford Academic Marie Blouet, MD Department of Diagnostic Imaging and Interventional Radiology, Caen University and Medical Center , Caen , France Université de Caen Basse-Normandie , Caen , France Search for other works by this author on: Oxford Academic Anne-Cécile Pizzoferato, MD, PhD Department of Obstetrics and Gynecology, Centre Hospitalier Universitaire de Caen , Caen , France Search for other works by this author on: Oxford Academic Delphine Vardon, MD Department of Obstetrics and Gynecology, Centre Hospitalier Universitaire de Caen , Caen , France Search for other works by this author on: Oxford Academic Frederique Belloy, MD Department of Diagnostic Imaging and Interventional Radiology, Caen University and Medical Center , Caen , France Université de Caen Basse-Normandie , Caen , France Search for other works by this author on: Oxford Academic Jean-Pierre Pelage, MD, PhD Department of Diagnostic Imaging and Interventional Radiology, Caen University and Medical Center , Caen , France Normandieuniversité, UNICAEN, CEA, CNRS, ISTCT-CERVOxy , Caen , France Search for other works by this author on: Oxford Academic
British Journal of Radiology, Volume 91, Issue 1090, 1 October 2018, 20170686, https://doi.org/10.1259/bjr.20170686
Published:
13 July 2018
Article history
Received:
10 September 2017
Revision received:
26 April 2018
Accepted:
30 May 2018
Published:
13 July 2018
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Hachem Djeffal, Marie Blouet, Anne-Cécile Pizzoferato, Delphine Vardon, Frederique Belloy, Jean-Pierre Pelage, Imaging findings in Essure-related complications:a pictorial review, British Journal of Radiology, Volume 91, Issue 1090, 1 October 2018, 20170686, https://doi.org/10.1259/bjr.20170686
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Tubal sterilization with Essure inserts has become a prevalent alternative to laparoscopic sterilization because of its minimal invasiveness. It is a well-tolerated ambulatory procedure that provides reliable permanent contraception without the risks associated with laparoscopic surgery and general anesthesia. Correct positioning of the Essure device is necessary to achieve the fibrotic reaction induced by the polyethylene terephthalate fibers, subsequently resulting in tubal occlusion usually within 3 months. After uneventful procedures with satisfactory bilateral placement, only the correct position of the devices needs to be confirmed at follow-up. The imaging techniques used to asses Essure devices may vary depending on the country and its recommendations. The gold-standard test to ascertain tubal occlusion remains the hysterosalpingography but after uneventful procedures, vagin*l-ultrasound proved to be a reliable alternative to confirm the proper position of the inserts. Radiologists have been increasingly confronted to post-procedural evaluations and despite the efficiency rate of the Essure device, its use still exposes to a low risk of complications and malfunctions such as unwanted pregnancies, device misplacement, tubal or uterine perforation, and chronic pelvic pain. Unintended pregnancies are mostly due to patient or physician non-compliance and misinterpretation of post-procedural examinations by radiologists which emphasizes the importance of their training in Essure device assessment. This pictorial review discusses the imaging methods used to asses Essure implants and illustrates the possible complications related to them.
© 2018 The Authors. Published by the British Institute of Radiology
This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)
Subject
Obstetrics and Gynaecology
Issue Section:
Pictorial review
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