Outcomes after a Uterine-Sparing Approach to Essure Contraceptive Device Removal.

Autor:	Arabkhazaeli M; Department of Obstetrics & Gynecology, Minnesota Women's Care, Maplewood, MN., Umeh G; Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY., Virani V; Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY., Plewniak K; Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY.
Jazyk:	angličtina
Zdroj:	JSLS : Journal of the Society of Laparoendoscopic Surgeons [JSLS] 2022 Oct-Dec; Vol. 26 (4).
DOI:	10.4293/JSLS.2022.00072
Abstrakt:	Background and Objective: To analyze long-term effectiveness of a conservative, uterine-sparing approach to laparoscopic Essure removal. Specific outcomes of interest include patient satisfaction, symptom resolution, and subsequent surgical intervention. Methods: A retrospective case series and follow-up survey. Patients who underwent laparoscopic Essure removal without concomitant hysterectomy between January 1, 2016 and December 31, 2019 were identified. Greater than 18 months after removal participants completed a survey assessing outcomes. Results: Twenty-nine patients underwent conservative Essure removal and there were 19 survey respondents. Among survey respondents, the mean length of time from Essure placement to removal was 56.7 months (range 5 - 117), and the mean length of time from removal to survey administration was 48.3 months (range 23 - 63). The most frequently reported symptoms were pain (100%), bleeding (52.6%), headache (42.1%), and dyspareunia (42.1%). Methods for removal included laparoscopic salpingectomy (58.6%), a combined hysteroscopic and laparoscopic approach (34.4%), and cornuectomy (6.9%). Regarding symptom improvement after Essure removal, 47.4% of patients reported total improvement, 36.8% reported almost total improvement, 5.3% reported some improvement, and 10.5% reported no improvement. Most patients (89.5%) reported satisfaction with their surgical results, and only two patients required subsequent surgical intervention for symptom management. Conclusions: Most patients in our cohort reported total or almost total improvement in symptoms almost two years after Essure removal, with low rates of reintervention. A uterine-sparing approach to Essure removal, using laparoscopic and hysteroscopic modalities, may be a feasible and effective approach to addressing Essure-attributed symptoms. (© 2022 by SLS, Society of Laparoscopic & Robotic Surgeons.)
Databáze:	MEDLINE
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