Bayer’s Essure birth control is permanent female sterilization. But, women may have Essure removed.
Some women may reverse the procedure to have a child naturally. Others may need to remove Essure coils if they suffer serious Essure side effects.
Procedures to remove Essure can cost anywhere from $4,000 to $8,000. The cost varies depending on the severity of side effects and type of surgery.
Most insurance plans should cover Essure removal. Patients should verify with their insurance provider.
Women who say Essure injured them filed Essure lawsuits against Bayer. Essure lawsuits say the birth control device is difficult to remove and may lead to several surgeries.
Diagnosing Essure Problems
Not all doctors are familiar with Essure and the problems it may cause. Symptoms of Essure problems range from chronic pelvic pain to hair loss. Common Essure symptoms include pain, infections and excessive vaginal bleeding.
It is important to find a gynecologist, urogynecologist or pelvic surgery specialist who has experience with Essure.
Dr. E Scott Sills is an IVF and fertility expert at the Center for Advanced Genetics in California. Several women have come to him for Essure reversal and removal surgery.
“I’ve had patients that have brought me their medical charts. They had 25 doctor’s visits in the year following Essure implantation for pelvic pain, painful intercourse and painful bowel movements,” Sills told Drugwatch. “These were healthy women who only went to the doctor maybe once a year. They don’t want to get pregnant, they just want their life back.”
Dr. Christopher Walker of UroGyn Specialists of Florida noticed a surge in the number of women coming to him with Essure issues. He does an exam in the office to diagnose Essure problems.
“Based upon the patient’s history of having Essure implanted and an examination in the office, we determine that it is the device causing problems,” Walker told Drugwatch.
Essure Removal Options
Women who wish to remove Essure have a few surgical options. Surgery can range from a simple outpatient procedure to a hysterectomy.Sometimes, women may need to have more than one surgery.
Essure embeds in scar tissue. This makes it more challenging to remove. Surgeons will use X-rays, ultrasounds or scopes to locate the device in the fallopian tube before surgery.
A salpingotomy is a technique where surgeons cut a small hole in the fallopian tube to remove the Essure coils. Surgeons leave the tubes intact.
This is not to be confused with salpingectomy. Salpingectomy is total removal of fallopian tubes.
In Bayer’s Physician Training Manual, the company recommends using salpingotomy, salpingectomy or cornual resection to remove the device. Cornual resection removes part of the uterus.
How Salpingotomy Works
Bayer’s insert instructs physicians to make a small cut in the tube. The cut should be about 2 cm in length. It should be directly above the device. Doctors then remove the device through this opening.
In order to reach the fallopian tubes, surgeons enter the body through the abdomen using laparoscopic surgery. Laparoscopic surgery is a minimally invasive technique performed with tiny incisions in the abdomen.
- Not a preferred technique for most doctors.
- Few surgeons have experience with making incisions in fallopian tubes.
- Essure coils can fracture if surgeons pull them too hard.
- Essure fragments may remain in the tubes.
Women who have Essure removed may end up undergoing a hysterectomy.
During a hysterectomy, surgeons remove the uterus, fallopian tubes and cervix. Some surgeons maintain that this minimizes the risk of leaving fragments in the body.
Surgeons can perform hysterectomies through the abdomen with laparoscopic surgery. Or they can perform surgery through the vagina.
Some studies show laparoscopic surgeries allow for quicker healing times and less blood loss.
“Hysterectomy has been something that a lot of primary care gynecologists have been advocating as the answer to Essure symptoms.”
- Some surgeons may use a power morcellator to perform hysterectomy. Morcellators may spread undiagnosed uterine cancer.
- Hysterectomies increase the future risk of pelvic organ prolapse, incontinence and some cancers.
- Organ damage during surgery.
- Infection is the most common complication of hysterectomy.
Uterine Preserving Surgery
Women who want or need Essure removed may choose to keep their uterus. This may cause fewer complications and allows them to conceive a child naturally.
In these cases, surgeons can perform a tubal anastomosis. Surgeons carefully dissect the fallopian tubes, remove Essure and reconnect the tubes to the uterus. This allows women to reverse sterilization and conceive naturally.
In some cases, doctors can perform Essure removal on an outpatient basis.
“My approach to patients who have had problems with Essure is to help them get rid of the problematic item — which is the Essure device itself — while conserving the healthy tissues,” said Sills, who specializes in uterine preserving surgery.
Sills uses a minimally invasive approach that takes about an hour and a half to two hours.
“It’s done like a bellybutton surgery,” Sills said. “The incision points are about as big around as a pencil. Patients are typically home by lunch time.”
- Women who wish to get pregnant may not be able to.
- Scar tissue may develop in the fallopian tubes.
- Nearby organs may be injured.
- Women may have a 4 to 8 percent chance of ectopic pregnancy (pregnancy outside the uterus).
Recovery from Essure Removal
Recovery times depend on the Essure removal technique and how long the device was in the body. Outpatient procedures allow women to go home the same day.
More extensive surgery such as a hysterectomy will require a longer recovery time that may last weeks. Women who had an outpatient procedure can expect to feel relief from symptoms within days.
“Once [Essure] is removed, women may expect to recover within two weeks.”
Complications from the procedure may lengthen recovery time. Complications include infection and organ damage. Leftover pieces of metal or fibers from Essure may also cause problems.
Women should follow up with their doctor to make sure they are healing well after Essure removal surgery.
Please seek the advice of a medical professional before making health care decisions.