Women who come to our center for Essure coil removal do so because they are having Essure side effects and they strongly desire to preserve their uterus and avoid hysterectomy.
We performed our first Essure coil removal procedure in 2009. Since this first procedure, we have performed over 150 surgical procedures to either reverse Essure or remove Essure coils. Due to our experience with removing Essure, we have gradually perfected our technique so the risk of leaving coil fragments inside the uterine cavity or uterine muscle has been greatly reduced. Many of our patients are also concerned about reactive scarring and inflammation around the coils. Not only are we able to remove the coils intact, but we are also able to remove both the coil and surrounding tubal muscularis, while at the same time minimizing damage to the uterus and most of the tubal blood supply.
What is Essure?
Essure is a newer form of female sterilization, which was approved for use in the United States by the FDA in 2002.
During an Essure procedure a small micro-insert composed of two metallic coils is placed inside the opening of each fallopian tube. This causes the tube to heal closed by the formation of scar tissue around the coil and inside the tube. This blockage only occurs in the very beginning of the fallopian tubes.
For a more detailed description of the Essure sterilization system: Essure Micro-insert coil device: A detailed explanation
The Adiana procedure is similar to, but not as common as, Essure. Adiana has been removed from the market and is no longer being performed.
Over the next 10 years over 750,000 Essure procedures would be performed. We began seeing inquires for Essure reversal and Essure removal in 2008 and performed our first Essure coil extraction in 2009. From 2009 to 2014, we have performed over 150 Essure removal surgeries.
Essure side effects
Patients who come to us for Essure removal do so because they began experiencing side effects soon after their Essure procedure.
Most patients who come to our center for treatment do so because of persistent pain and cramping after Essure and these symptoms have not quickly resolved. Others report systemic symptoms of generalized skin rash and joint pain. A few patients have also been diagnosed with other rheumatologic and endocrine conditions; chronic pain, rheumatoid arthritis, and thyroid dysfunction. These patients are often uncertain if Essure caused these abnormalities and they request removal to be certain there is no correlation. They are often realistic in their expectations when they came to us and they chose coil removal to help them diagnose the real cause of their symptoms.
Many women are told they cannot be experiencing side effects after Essure but FDA statistics do support the existence of both Essure related complications and Essure related side effects.
For more information: Essure side effects: FDA statistics
Many women who experience side effects after Essure are often advised by their medical providers to have a hysterectomy or to have their fallopian tubes removed. We do not perform hysterectomy at our center and we do not remove fallopian tubes because of Essure side effects.
Women who come to our center do so because they strongly want to avoid a hysterectomy and prefer to have the Essure coils removed instead. They come to us knowing they are coming to a surgeon who has removed more Essure devices than any other single doctor.
Removing Essure coils: A Personal Choice
We have extensive experience with removing Essure coils. We have perfected our technique over time and now can remove the coils intact, without fragmentation, and with the surrounding scar tissue. Many patients will request we leave their fallopian tubes as normal as possible and maintain the tubal blood supply. Our extraction technique has been developed with these patient requests in mind. Very often we can maintain the tubal blood supply during the Essure coil extraction and remove the coils intact.
Our Essure coil removal surgery is performed as an outpatient procedure under general anesthesia. Utilizing a small 3 to 5 inch incision just over the pubic hairline we can remove both Essure micro-insert devices and the surgery is often under an hour. Many patients can return to work within 1 to 2 weeks after having their Essure coils removed.
For more information on our Essure removal statistics:
Essure removal statistics at A Personal Choice
Can removing Essure help?
The existing Essure studies suggest the chance of having an Essure related side effect one year after the procedure is less than 3%. Most women can be reassured they will not have a complication related to Essure; however, larger prospective studies on the typical use of Essure will need to be performed to more precisely define the risk of side effects, device failure, and the chances of coil migration.
Most women who experience symptoms after Essure will have these symptoms resolve within the first week of insertion. If your symptoms started soon after Essure and do not resolve within the first several weeks then there is a greater chance removal of the Essure coils alone will improve the symptoms you are experiencing.
If your symptoms started years after Essure insertion then it is less clear if Essure is the cause of these symptoms.
We encourage women who are experiencing symptoms to be evaluated by their doctors for other possible causes before considering surgery to remove Essure devices. If other causes cannot be determined then it is reasonable to consider Essure coil removal.
Procedure for removing Essure
For patients who are having symptoms from Essure, want their coils removed, and who do not wish to become pregnant, we recommend Essure removal and tubal occlusion.
This procedure takes less than 60 to 80 minutes and is performed under general anesthesia. An opening is made into each fallopian tube immediately over the Essure coils. The coils are then removed and care is taken to remove the coils intact with the surrounding tubal scar tissue. Care is taken to cause minimal disruption to the tubal anatomy and blood supply.
Each end of the opening created in the tube is then closed (occluded). The closed ends are left minimally separated in the area where the coils were removed to decrease the possibility of pregnancy.
If you are seeking Essure removal because of pain and cramping then we recommend Essure removal alone and tubal occlusion.
When the problems have started soon after Essure insertion then Essure removal and tubal occlusion should help the majority of women who are having Essure related problems.
Removing Essure devices: Is pregnancy your goal?
If pregnancy is desired then we recommend Essure reversal utilizing a tubouterine implantation procedure to provide both the best chance of pregnancy and the lowest risk of tubal pregnancy.
For more information: Recommendations on Essure removal from Dr. Monteith
Many women have been told they need to have a hysterectomy to treat Essure related symptoms.
Although a hysterectomy may help with Essure side effects, a hysterectomy is an overly aggressive treatment for Essure problems and has greater risks of complications. We have found Essure removal alone will help many of our patients who are experiencing Essure related problems.
For more information about the cost of Essure removal, please visit: Cost of Essure removal
More information about Essure removal
As a result of our specialization, we have extensive experience with Essure removal. We have created a new section of our website dedicated to providing health care providers with more information about our practice, tubal reversal surgery, and Essure removal.
If you are a referring health care provider and would like more medically detailed information about Essure removal we encourage you to visit: For Physicians