Due to our extensive experience with Essure removal surgery we often have inquiries from potential patients about Essure related complications.
One of the most common questions we receive is can the Essure coils migrate (move) out of position?
This photo was taken during one of our Essure reversal surgeries. The Essure coil has migrated out of the wall of the uterus.
Although Essure coils can move they don’t move in the way most people conceptualize.
Essure coil movement
Most Essure coils will not move after they are placed; however, some can move after insertion. The most common reason this happens is because the doctor does not insert the coil far enough or because the doctor inserts the coil too far into the fallopian tube.
Not inserting Essure far enough
When the coils are not inserted far enough into the fallopian tube the contractions from the uterus or tubal muscle can cause the coils to expel into the uterine cavity. The coils can either remain in the cavity and cause heavier periods and cramping or they can be expelled during a menstrual cycle. The coils are so small they may not be seen when they are leaving the uterus.
We have seen patients who have had coils remain in the uterine cavity after expulsion and we have had to extract them during Essure removal surgery.
Inserting Essure coils too far
Equally likely are the coils may be inserted too far into the fallopian tube. When this happens the contractions from the uterus or the tubal muscle can cause the coils to be expelled into the end of the tube, the pelvis or the abdominal cavity.
Although Essure coil expulsion is not common, it does happen. When it happens it will usually be within the first several days to weeks after the initial insertion procedure.
We have removed Essure coils from the inside the abdomen after they have been expelled from the tube.
Do Essure coils move?
Essure coils can move but it is often because of improper placement. Uterine and tubal contractions immediately after the procedure will cause expulsion of the Essure devices within hours to weeks. Once the coils cause formation of scar tissue they then become securely anchored in the tube and should not move.
Women do not have to worry about delayed migration of coils once they have been confirmed to be in place at the time of the HSG confirmation test.
Essure complications: Migrating Essure coils
We recently helped a patient who wanted reversal of Essure so she could become pregnant again. Her Essure procedure was uncomplicated and her Essure confirmation HSG confirmed her tubes were blocked and the coils seemed to be in the correct location.
The image shows what we found at the time of Essure reversal. The right Essure coil had perforated the uterus near the area of where the right fallopian tube exited the uterus. The left coil was in its proper location inside the tube and cannot be seen in this photo.
We confirmed during surgery her right tube was blocked and we were able to extract the coil and reverse her Essure procedure. After surgery we discussed the findings with her. Looking back she did report more cramping and pain on the right but these symptoms were not felt to be severe.
Likely this happened at the time the Essure coils were inserted. The Essure coil either damaged her tube enough to cause closure or the very tip of the coil remained in the tube enough to cause tubal blockage.
Women can be assured they will not experience delayed coil migration.
Any movement of the coils will happen around the time of insertion and once the coils are anchored in place by scar tissue they will usually remain in location.
As this patient’s experience shows, HSG testing may not always be 100% accurate because the HSG x-ray cannot show the Essure placement in relation to the tubes.
If you are someone who experienced an Essure complication, have coils which are not in their proper location, and want your Essure coils removed then give our office a call and one of our nurses can answer any questions you may have.
Readers are welcome to call our office at (919) 968-4656 for more information.
Submitted by Dr. Charles Monteith