You may have noticed Dr. Turner and I never tell people that we are the most experienced or that our results are the best or anything to imply that we are better than anyone else. The reason is it’s against the law in most states and its always unethical. We just did our 3000th tubal reversal last summer, you can see from the testimonials on this website that patients are generally very happy with the service we provide patients, and their outcomes.
We don’t alter our statistics by including ectopic pregnancies because an ectopic pregnancy is not a viable pregnancy. Ectopic pregnancy is a risk of tubal reversal and our rate is 2.5% not 10 – 30%, as we have seen posted at other facilities. We only do Tubal Reversals and Essure Reversal or Removals for women, in our licensed, accredited surgical center. I really don’t know who the best tubal reversal surgeon in the world is. I think I can say for sure that he or she does not say that he or she is and I’m sure Dr. Turner and I are near the top of the list.
Bayer, the current manufacturer of Essures has announced that they will no longer be selling the Essure devices. There is a report that they have spent 413 million dollars defending lawsuits from consumers with these devices. They claim that Essure problems are not the reason for their withdrawal. This announcement will probably cause concern for many women.
The important thing is to make sure that you have not heard about symptoms and have decided that you have those symptoms. Most women do very well with Essures but a minority do not. If you don’t need to have them removed or reversed don’t do it. If you decide that you need them removed do not let anyone talk you into a hysterectomy to remove them.
The things that cause women to seek removal: low back pain, bleeding, skin rashes, hair loss, depression, and metallic taste in the mouth can all be due to things other than your Essure. If you never had your symptoms until the devices were put in you that should raise your suspicion that the Essures are at fault. We have seen some women that did well with their Essures for several years and then developed symptoms. Two things that seem related to the nickel in the Essures are a history of allergy problems with cheap gold jewelry and a metallic taste in the mouth. Most all of the patients who have come to us for Essure removal have noticed immediate and dramatic changes. That having been said, there is no guarantee that removal of Essure devices will alleviate all symptoms you may be having.
Our surgical center is accredited, like a hospital is and part of the requirements is that we “benchmark” or compare our results with similar facilities. The accrediting organization The Accreditation Association for Ambulatory Health Care comes to our center and checks everything from how we protect your privacy, how we look after our equipment, how we check on the people who work here, how we make sure the drugs that we use are not out of date and on and on.
To complete their requirement that we compare our results is difficult because few people that do reversals report results and a lot of what is reported is deceptive. One example is the frequent claim “98% Success”. When you read the fine print they mean 98% of their patients are operated and reversed, not necessarily pregnant. We have seen results reported where ectopic pregnancies were included as part of their total. An ectopic pregnancy is not a success in any way! If you read the fine print, their ectopic pregnancies are 10-30%. Including their ectopics makes their results look better but it’s deceptive. Because we only do reversals on women, dye test our patients to make sure they are fixed right and close the tube in layers our ectopic rate is 2.5%, which is very low. You can see our success rates on our website broken down by age and the type of tubal ligation that the patient had before coming to us.
This started in the blogosphere based on an article published in (Lancet 2014; 384:29-36) that mentioned. patients who miscarry and either take low dose aspirin or don’t. Women who took low dose aspirin after a miscarriage got pregnant quicker than those who didn’t. There was no attempt to see the effect on women who didn’t miscarry to see if it helped them get pregnant more quickly.
The only proven pre-conception need for women is to take a vitamin with folic acid in it. If you miscarry, you might want to take low dose aspirin as long as you don’t have a medical condition that makes it a bad idea. Aspirin allergy is very rare and when associated with nasal polyps (also rare) can be rapidly fatal. Best to ask your doctor if you are not sure.
The take-home message here may be that if you see something on the internet it may not be accurate. In the area if infertility, there is so much ridiculous nonsense floating around that you need to be very careful. The reality is that women who are having problems with reproduction can be searching for something to help them. There are people who take advantage. The Lancet study was to see if there is any advantage to waiting to try to conceive after a miscarriage and there is not. There are other reasons why a woman may not take low-dose aspirin such as being on anticoagulants and a history of bleeding problems, to name a few so stick with the vitamin with folic acid unless you talk to your doctor.
The process that our facility uses we do not cut a hole in the uterus to reverse our Essure patients. We put the tube in the uterus in the hole that’s normally there. The first thing we do is to remove the Essure devices microsurgically, without cutting the uterus in any way. If a patient comes to us to just have the Essures removed we do the same thing, no cutting a hole in the uterus!
For an Essure reversal, when a patient wishes to have more children, the next step is to dilate the tiny natural hole in the uterus. This is done using tiny silver wire dilators that are each slightly larger than the previous one. Once we have used all the silver wire dilators we us stainless steel dilators to get the natural hole large enough to accept the tube. The final step is to sew the healthy tube in the natural hole in the uterus.
We have seen a report about a doctor who cuts a hole in the uterus to reverse Essures having a patient rupture her uterus at 39 weeks. The patient was not in labor. Uterine rupture is frequently fatal to the baby and can be fatal to the mother too. I have no issue with how anyone does reversals. Every doctor has to choose what’s best for his or her patients based on their ability to do the best and safest job. The way we do Essure reversals takes a little longer and requires two surgeons to do but we feel it is the best way for our patients.