Essure device removal is possible through several techniques, however patients must understand that symptoms may not improve after it is removed. Many times, imaging is needed to locate the Essure devices, also to rule out other anatomical causes of symptoms. These include irregular menstrual bleeding and pelvic pain. An ultrasound can help identify other issues such as fibroids, adenomyosis and ovarian cysts. If the Essure devices are not seen on ultrasound an X-Ray will be required to locate them. An in-office hysteroscopy may also be recommended to visualize the
amount of Essure device that may be inside of the actual uterine cavity. The devices were not designed to be removed by simply pulling them from the fallopian tubes.
Patients should be cautioned that if advised to do so, it can lead to broken devices. Pieces may be left behind with further complications. The only time such removal is feasible is within the first 3 months after placement. Depending on where the device is isolated; in the cavity, cornua (muscular portion of uterus where the fallopian tube attaches), or fallopian tube alone, a combination of procedures may be recommended.
Procedure options for removal
1. Hysteroscopic removal – if device is easily visualized in the uterine cavity and removed within 3 months of placement.
2. Hysteroscopy and Laparoscopy– to help plan the dissection of the Essure device and/or reassure that the entire device is removed.
3. Laparoscopy – to resect out the entire Essure device from the cornua of the uterus or remove the fallopian tube alone if the device is completely in the last portion of the tube.
4. Exploratory laparoscopy – to search for the device in the abdominal cavity and remove it. Many times, this necessitates the use of imaging tools during the operation to help locate the device in the abdominal cavity, so it can be found.
5. Hysterectomy – removing the fallopian tubes and Essure device along with uterus (with or without ovaries). A hysterectomy is sometimes recommended to increase chances of complete system relief.
Dr. Miklos and Dr. Moore have over 25 years of experience in foreign body removals, making them two of the top surgeons for these kinds of procedures. Known widely for their expertise in removing mesh, Dr. Miklos and Dr. Moore have removed 100’s of foreign bodies over the course of their career.