Thread: Essure and what to expect

Thank you for all the details and the invitation to check with you on the procedure. After reading all the scary stories, I am unsure if this is the procedure I want. I may want to check again with my doctor. If it goes smoothly great, but having them move or cause pain during ovulation is not so great.

Have you had any side effects that you would identify as a result of Essure?

I do like that it is non-surgical. Any feedback will be helpful. Thanks, Summer

Originally Posted by LRP in Idaho

I noticed a few questions from women wondering about the Essure procedure and wanted to share mine. I'm 41 years old and my kids will be starting high school next year. Like a lot of people, I've been on birth control pills for the better part of twenty years and have been wanting a more permanent birth control option for the last year or so. My husband and I considered tubal ligation and vasectomy but didn't really feel comfortable with either option.

10-07-2009: After hearing about Essure, I did some research and made an appointment with an OB/GYN in my area who is licensed to perform the procedure. The physician I selected has performed quite a few and has been doing them for over five years--which I think makes a great deal of difference in your overall success rate and experience. During the first appointment, the doctor answered my questions and explained the process in detail. He also performed a speculum and bimanual pelvic exam to assess the position and condition of my uterus and cervix. I made an appointment for the following week and he gave me a prescription for pain medication to take prior to the procedure.

10-13-2009: I ate a light breakfast and took the tablet of Phenergan (anti-nausea), Valium (anti-anxiety), and Vicodin (pain relief) an hour before the procedure. I arrived at the doctor's office and was checked in by the nurse. She administered a shot of Toradol (NSAID to reduce muscle spasm and cramping). She also conducted a urine pregnancy test to ensure that I wasn't pregnant. After confirming that I wasn't pregnant, she gave me a shot of Depo Provera which should last until the follow-up HSG test. She asked that I undress completely from the waist down and gave me a sheet to wrap around me.

The procedure was performed in a regular exam room in the doctor's office which was cozy and beautifully decorated and did not feel at all like a cold, sterile hospital environment which was really nice. They had a chair next to the exam table for my husband to sit in and so he could rub my shoulder and hold my hand which I also appreciated.

The doctor started by helping my into the lithotomy position (similar to the position you're in for an annual exam or pap smear test). He inserted a speculum into my vagina, and swabbed the cervix with an antiseptic solution. He then gave me three injections in my cervix to help numb the area (paracervical block). The first two injections were somewhat uncomfortable like any shot would be, but the last one hurt quite a bit more. I'm not sure if it was the location or the depth of penetration that made a difference, but it felt different than the first two. The good news about shots, is that even when they hurt, the pain is pretty quick and over with. He then waited for a few minutes for the injections to set in and numb up the area. The nurse stayed with me the whole time, talked to me and was setting up equipment during that time.

The doctor returned to the room and talked me through the next few steps. He inserted a cervical dilator for a few minutes to help my cervix expand to accommodate the hysteroscope. The dilation did not hurt, but did result in some mild cramping. After removing the dilator, he gently inserted the hysteroscope into my vagina, through my cervix and into my uterus. They positioned the monitor so that I could watch the procedure and explained what we were seeing. The doctor used the scope to assess the uterus and to make sure that both tubes were open before placing the Essure implants.

The first implant went in quite easily; but the second one was a little more uncomfortable and took longer simply because one of my Fallopian Tubes was sitting at an odd angle and it took more maneuvering to get it in place. At this stage in the procedure I was feeling some moderate cramping (similar to bad menstrual cramps) and also in my legs. If you can, I'd ask about having them use the kind of stirrups that fit under your knees and support your thighs and calves a little better. I think that the regular feet stirrups (while they work well for an annual exam) are more difficult during a procedure simply due to the length of time your legs are in that position.

Once the implants were in place, the doctor checked their position visually with the camera one last time just to make sure everything looked right and then withdrew the hysteroscope. He used a few more swabs and antiseptic gauze to wipe me down, removed the speculum, and helped me move my legs into a more comfortable resting position on the table.

The total time (start to finish) for the whole procedure was 30 minutes. The actual hysteroscope time from insertion to withdrawal was 13 minutes. The only difficulty I had was that my blood pressure dropped significantly at the very end of the procedure which resulted in my feeling dizzy, light-headed, sweaty and on the verge of fainting. The nurse was terrific during this whole time and reassured me that I would be ok and to lie still until I felt better. She brought me cold water and my husband held cold washcloths on my forehead and arms, which helped a lot. Nothing you can do about a vasovagal response--but I felt bad because I had done so well through the whole procedure and felt like a little bit of a wimp to have crashed right at the end! They let me rest until my blood pressure resumed to normal, and then my husband and I drove home. I did have some fairly painful cramping right as the procedure was ending, but it had subsided almost completely by the time we headed home.

I was sleepy from the medication and took a three hour nap that day, but returned to work the next morning. The nurse and doctor had told me to expect some cramping and bleeding, but honestly, I had very minor spotting for the first few hours and then nothing after. The cramping lasted for only an hour or two after the procedure and by the next day, I physically felt great.

I also like that this OB/GYN does his own follow-up HSG's, which is reassuring. (I have a sister who is a radiology tech, and she said HSG's performed by GYN's as opposed radiologists tend to be much more comfortable for the patient). When I asked about it during my initial appointment, his response was 'most of the radiologists haven't been on the working end of a speculum in ten years, and I won't put my patients through that kind of discomfort.' A doctor with a good sense of humor is always a plus!

I know everyone's experience is different--but overall, mine was very positive. I think a lot depends on the skill, competence and bedside manner of your doctor and nurse--so do your research and get recommendations. The team that took care of me was terrific. The benefits for me were: no hospital stay, no general anesthesia, no scarring, short recovery, highly effective, and my husband could be there for support.

I'll go in the first part of January 2010 for the HSG, and hopefully, all will be well. If any of you have opted for Essure and have been through the HSG, I'd love to hear from you in regard to your experience so I know what to expect!

I tried to have Essure done twice but the doctor wasn't skilled enough to do it. So I went to another doctor and he offered Adiana. Similar stuff, but instead of silicon coins, it plastic pallets the size of grain. I love it. I haven't had any issue. The ony thing is my periods are further apart for some reason, but that is a good thing. Its every 6 weeks now.

When I tried to do the Essure, the doctor didn't give me an anesthesia and it was extremely painful. The second doctor did general anesthesia and it was so much more better. I definitely recommend doing it with the anesthesia.