Dr. Berger began performing outpatient tubal ligation reversal surgery at A Personal Choice in 1982. Ten years later Dr. Berger stopped performing in-vitro fertilization and started exclusively specializing in tubal reversal surgery and tubal repair surgery.
In 2008, Dr. Monteith joined Dr. Berger as a tubal reversal surgeon and the two operated together for the next five years. During the time the center has been open over 10,000 women have had tubal surgery. Together Dr. Berger and Dr. Monteith performed the first ever-successful Essure reversal that resulted in pregnancy.
On December 19th 2013 the last patient ever to have surgery at A Personal Choice underwent successful outpatient reversal surgery. It is only fitting that the last surgery ever performed at the old A Personal Choice was an Essure removal.
Monica is from St. Paul, Minnesota and she traveled to see Dr. Monteith because of the problems she has been experiencing since her Essure procedure seven months ago.
Essure problems
Monica is 44 years of age. She is a physical therapy assistant. Her job is to help those who suffer from chronic medical problems, musculoskeletal conditions, and movement disorders. She never thought she would end up like one of her patients.
Monica had been using the Mirena IUD. She did not like the side effects she was experiencing and she decided to switch to birth control pills. The birth control pills adversely affected her thyroid condition and it was then that her doctor talked her into the Essure as a non-hormonal alternative. She then chose to undergo the Essure procedure because it was ‘easy’, ‘non-surgical’, and ‘non-hormonal’. She has since come to regret her decision.
Monica had the Essure procedure in June. By July she was experiencing extreme fatigue and muscle and joint aches. She had become like many of the patients she cares for daily.
Essure symptoms: Fatigue and spinal cord demyelination
The fatigue and muscle symptoms for Monica gradually worsened. Her doctors were dismissive. She was able to get her doctors to order an MRI and it showed she had demyelination changes within her spinal cord. Her nerves were losing their protective coating.
Traveling from Minnesota beacuse of Essure coil migration
Monica also had an ultrasound, which showed her left coil had migrated into the cavity of her uterus. The coil had either not been properly placed or had migrated into the cavity of her 
uterus after placement.
It was then she decided to take matters into her own hands.
First she contacted an attorney because she wanted to be able to take legal action against the manufacturer in case there was some relationship between Essure and her symptoms or in the event some future research would show causation.
Secondly she contacted Dr. Monteith and his staff at A Personal Choice. Monica traveled with her husband David from Minnesota to have her Essure coils removed.
Risks of Essure removal
I sat down with Monica and her husband and we had an extensive discussion about the risks of Essure removal. The surgery as performed at our center is incredibly safe and is often done in under an hour and as an outpatient procedure. The main risk is fracture of the coils during removal and the inability to find the fractured piece. This happens in about 1 out of 15 procedures. Most times the small residual fragment will not be a problem. I informed her we make every effort to not let that happen and if it does, we go the extra mile to try and find it and remove it.
We also discussed the risk that her symptoms could still persist after Essure removal and we discussed the possibility of a coincidental diagnosis. Although we see many patients who have problems directly related to Essure we also see a few women who develop conicidental medical conditions at the time of their Essure procedures. Often times only Essure removal and time will tell.
Essure removal surgery
Monica underwent a successful removal of her Essure coils. The surgery lasted 40 minutes and the estimated blood loss was 4 teaspoons. Her coils were successfully removed intact.
A bittersweet surgery
Monica’s surgery went great and was a success. The saddest part to me about her surgery was that Monica was the last patient to ever have tubal reversal surgery at the center where out-patient tubal reversal surgery was first perfected.
Monica was the last patient to have reversal surgery at the Conner Drive location where Dr. Berger created the A Personal Choice.
It is only fitting that the first ever-successful Essure reversal surgery was described and published as it occurred at the A Personal Choice and that the last surgery ever performed at the center was also an Essure surgery!
New beginnings for Monica and Tubal Reversal Staff
Monica has the title of being the last patient to ever recieve surgery at the facility where Dr. Berger created A Personal Choice. We wish her well and hope she experiences good results from her Essure removal.
Patients who are considering surgery in the future should not be disappointed.
A Personal Choice is not closing. The center is moving to a new and improved location. Future patients will have closer access to Raleigh Durham International airport and more transportation options. They will also have their choice of two luxurious hotels and stay within the boutique North Hills Mall located in mid-town Raleigh. Future tubal surgery patients will be within walking distance of many, many great restaurants, shops, and placed of entertainment.
Monica, future patients, and staff of the reversal center will all have a new chance to start over and experience a new beginning.
A Personal Choice is moving to 3613 Haworth Drive, Raleigh, North Carolina. For more information on their move and the new location visit their website: A Personal Choice.
Submitted by Dr. Charles Monteith
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