| |
Essure |
Tubal
ligation [1] |
Vasectomy |
|
| Who
has the procedure? |
Women |
Women |
Men |
|
| How
effective is the procedure? |
99.81%
at one-year
99.78% by two-years
Data not available beyond 2 years |
99.45%
at one-year
99.16% by two-years
99.15% at 10 years |
99.85%
at one-year |
|
| How
is the surgical procedure performed? |
The
device is routed through the vagina, cervix and uterus into the
fallopian tubes, where the devices are placed. No incisions are
required. |
The
fallopian tubes are either cut, burned (cauterized) or clamped using
either:
Laparoscopic tubal ligation (most common method), where 1-3
incisions are made in the abdomen to access the fallopian tubes using a
telescope type device. The tubes are then blocked with clips or rings or
burned.
Open surgery (called a laparotomy or mini-laparotomy), which
requires a larger incision (usually 2 3 inches) in the abdomen. |
The
two tubes (the vas deferens) that carry sperm from the testicles to the
penis are cut or blocked. This is achieved by:
Making a small incision in the scrotum. This is the most common
method
Making a small puncture in the scrotum |
|
| How
long does the procedure take? |
Average
procedure time is 35 minutes |
Average
procedure time is 30-45 minutes for laparoscopic method. May be longer
if open surgery |
Average
procedure time is 1530 minutes |
|
| How
many visits to the doctor does it require, and what type of follow-up is
required? |
Three
visits. One consultation visit, one visit to place the micro-inserts,
and one follow-up visit at 3 months to check for tubal occlusion and
proper micro-insert location. |
Three
visits. One consultation visit, one visit to perform the tubal ligation,
and one follow-up visit at approximately 2 weeks to check the incisions. |
Three
visits. One consultation visit, one visit to perform the vasectomy, and
one follow-up visit at 3 months to make sure that the vasectomy was
effective. |
|
| How
is pain or discomfort typically controlled during the procedure? |
Local
anesthetic and/or intravenous sedation |
General
anesthetic, spinal block or epidural anesthesia is typically used |
Local
or general anesthetic |
|
| Can
I rely on it right away? |
No.
There is a three-month waiting period when another form of contraception
must be used. You will need a hysterosalpingogram (a special kind of
x-ray) before you can rely on Essure. The purpose of this test is to
make sure that both of your tubes are blocked and both of your devices
are in the correct position. You must continue to use another form of
contraception until your doctor instructs you that you can rely on
Essure for birth control. |
Yes.
You may resume intercourse when you have recovered from the procedure,
following your doctors advice, typically about a week after the
procedure. |
No.
There is a 2-3 month waiting period required to flush out any existing
sperm. Sperm counts are taken to demonstrate the success of
vasectomy i.e. when the sperm count is zero. You must use another method
of contraception until then. |
|
| What
should I be doing to help the recovery process after the procedure? |
Rest
for 45 minutes following the procedure before going home. Follow your
doctor's instructions to report any unusual pain, bleeding or high fever
Consider having someone to drive you home |
Most
women are ready to go home 2-4 hours after the procedure
Must have someone to drive you home
The incision will need to be kept dry for a few days
Follow your doctors instructions to report any unusual pain,
bleeding or high fever |
Rest
for about 30 minutes following surgery
Consider having someone to drive you home
Apply ice packs to the scrotum and wear supportive underwear to
minimize bruising/swelling
Follow your doctors instructions to report any unusual pain,
bleeding or high fever |
|
| When
can I return to regular activities? |
Typically,
within 1-2 days of the procedure. |
For
laparoscopic tubal ligation, typically within 4-6 days. For tubal
ligation performed by an open procedure, typically within 9-10 days. |
Typically,
in 2 days. |
|
| What
are the typical temporary effects following the procedure? |
Cramps
(like menstrual cramps)
Discharge (like a light menstrual flow or spotting)
Mild nausea or vomiting associated with the procedure
Fainting or light-headedness following the procedure |
Cramps
(like menstrual cramps)
Discharge (like a menstrual flow)
Mild nausea or vomiting associated with general anesthesia or
the procedure
Pains in the neck or shoulder
Pain in the incision
A scratchy throat if a breathing tube was used
Feeling tired and achy
Swollen abdomen, which resolves as gases are absorbed
Bruising around the incision that fades |
Swelling
and bruising. If this occurs it usually resolves within two weeks
following procedure
A dull ache in the testicles that usually fades during the
first week |
|
| What
are the major risks of the procedure? |
You
may become pregnant several years after undergoing the procedure.
Ectopic pregnancy occurs more often in women who have had a
sterilization, if they become pregnant.
For a percentage of women (14% in clinical studies) it may not
be possible to place the micro-inserts in the fallopian tubes during the
first placement procedure
Despite micro-insert placement, a small percent of women (3% in
the clinical studies at the 3-month follow-up) may not be able to rely
on the micro-inserts for birth control due to incorrect position of the
devices or lack of tubal blockage.
Although death and serious injury following hypervolemia were
not reported in the Essure clinical trials, hypervolemia can lead to
serious injury and death. |
You
may become pregnant several years after undergoing the procedure.
Ectopic pregnancy occurs more often in women who have had a
sterilization, if they become pregnant.
Major complications such as infections, bowel injuries,
bleeding, burns, or complications from anesthesia occur in about 2%2
of women who have the operation by laparoscopy and in about 6%3
of women who have the operation by laparotomy (open procedure). Internal
bleeding is the most common and may require an open operation to stop
the bleeding.
Other injuries such as damage to the bladder or burns to the
bowel may also require additional surgery.
Other risks such as blood clots and death, are rare. |
Pregnancy
may occur several years after undergoing the procedure.
1.6% of men experience bruising on the scrotum1
1.5% of men experience infection of the incision/puncture in
the scrotum1
Painful testicles (epididymitis) is experienced in about 1.4%
of men1
Sperm may leak into the surrounding tissue (less than 1%
leakage rate1) forming small lumps (granuloma). This process
generally subsides spontaneously, although pain medication may be
required. |
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