Sterilization without surgery well received

By David Douglas

NEW YORK (Reuters Health) - Placement of a device that effectively sterilizes a woman can be performed safely and effectively on an outpatient basis without general anesthesia or sedation, with high rates of patient satisfaction, according to British researchers.

Most women seeking to be sterilized now have their fallopian tubes "tied" or blocked, which involves surgery and 4 to 6 days of recovery. The FDA-approved sterilization device -- Conceptus Inc.'s Essure -- uses a tiny group of coils to sterilize a woman without surgery.

During implantation, the physician inserts one of the devices into each of the two fallopian tubes. This is done with a catheter that is inserted through the vagina into the uterus, and then into the fallopian tube.

The device works by inducing scar tissue to form over the implant, blocking the fallopian tube and preventing fertilization of the egg by the sperm. It takes 3 months to start working reliably.

"In general I think it is an excellent technology," senior investigator Dr. T. Justin Clark told Reuters Health. "It is simple, safe and convenient for women and avoids the need for hospital admission, general anesthesia and surgical incisions and entry into the abdominal cavity."

Clark and colleagues at Birmingham Women's Hospital report their experience with the procedure in 112 women, in the June issue of the medical journal BJOG.

Successful placement of the device was achieved in 92 percent of cases and was deemed optimal in 88 percent. The complications seen in 5 percent of patients were mainly minor reactions, and all of the patients were discharged within 4 hours of their procedure.

To date, no pregnancies have been reported.

Survey responses showed that the women were satisfied and, in fact, most reported being "very satisfied" with the procedure.

The system, said Clark, "should be offered to all women requesting permanent fertility control and is likely to become more widely available as more data from papers like ours are published."

"More data is needed on long term clinical effectiveness," he added, "but the pregnancy rates following the procedure are around 1 in a 1000."

SOURCE: BJOG - British Journal of Obstetrics and Gynecology, June 2007.