A number of patients have contacted us about removing Essure devices
The first thing is to say that we do not know if removal of these devices will change anyone in any significant way. We have set an all-inclusive fee of 4500 dollars for this procedure. More about our fees on the “Price “ page.
There does seem to be a thread of common symptoms in some Essure users. We hear about heavy bleeding, cramps, joint problems, metallic taste in the mouth and other problems. We have not removed enough of these devices to say for sure if removal is helpful in all patients. Most patients have some relief, in some it is dramatic.
We do have experience with Esssure removal to restore fertility and what we are now offering is essentially half of that operation, microsurgical removal of the Essure without reimplantation of the tubes. This operation would remove the Essure devices without restoring the patient’s fertility.
A word of caution. Some patients have been told the only way to remove these devices is with a hysterectomy and that is very dangerous and wrong. The only reasonable way to get rid of an Essure is with microsurgical removal. This is one thing I know for sure. There is no way to remove these devices by pulling them out and no way to take them out with a laparoscope. The Essure is a fragile plastic core about the width of a pencil lead surrounded by a metal coil that grows into the tissue of the tube. We will remove your Essure with an outpatient procedure in less than an hour and a scar 2 inches long at your pubic hair line. If you have a job, you should miss no more than 3 days including travel.
The manufacturer recommends that they not be used in patients with nickel allergy. The coil that surrounds the core is made of stainless steel and nitinol both materials contain nickel. Between 10 and 15% of all women are allergic to nickel so this may be the source of some of the problems women have. The tail of the Essure device sticks into the cavity of the uterus like an IUD. IUD’s are known to cause bleeding problems so that may be the reason for that sort of problems. If you are considering In vitro (IVF) you should have your Essure devices removed. Don’t let anyone tell you they can pull them out or take them out with laparoscopy (belly button surgery). If you have IVF without removal of the Essure devices, the tails that stick in the uterine cavity will act like an IUD and prevent the fertilized embryo from implanting in the uterus. The uterus acts like it “knows” something foreign is inside and tries to get rid of it. It is the same reflex action that tries to expel an Essure or an IUD when it first is placed or push out a pregnancy that no longer is viable. Don’t waste your money on IVF unless your Essure is carefully and completely removed.
People ask me why we take the time to remove Essures with microscopic guidance. The reason is that they grow into the tissue of the uterus. The coating on the spring part of the Essure causes tremendous inflammation as the body reacts to it. The substance nitinol is known to get human tissue inflamed, that’s why they use it. This outer spring becomes surrounded with tissue. It has to be carefully removed so as to do as little damage as possible and More importantly, to get all of it out.
The Essure removal is complicated by the anatomy of the fallopian tube that makes a sharp turn where it meets the uterus. You have to feel this turn with your finger. You cannot feel this turn with laparoscopy and you for sure cannot feel it from inside the uterus. Remember the Essure device grows into the tissue of the uterus and tube, you cannot safely and completely remove it by pulling it out like the drawstring in your pajamas. The Essure stainless steel outer spring is made of steel that is about the thickness of aluminum foil. It will break very easily. During Essure removal, if you break the spring you have to find the piece left in the tissue, this requires magnification and care to find it with minimal damage to the tissue.
The plastic core of the Essure is thinner than pencil lead and also very easy to break. If Essure removal is what you want, you need to remove all the Essure and you need as little damage done to your uterus and tube as possible
Our 4500 dollar fee includes everything, even a stay at a local hotel. All lab work. the services of anesthesia. Use of our surgical center, and the doctor’s fee are included. This is the end of it, you will not be asked to get lab work before you come, pay a premium because of your weight or any other “suprises” We have available a company that will precert your insurance to try to recover from your insurance. . There now is what’s called a CPT code for Essure removal which means doctors have been asking insurance companies to pay for Essure removal. This does not mean they will pay for this but it means it’s worth a try to get them to. The company that we use to precert with your insurance has an excellent track record in getting insurance companies to pay. A final word of caution, no one has any experience that we can rely on to tell you that your insurance will pay for your Essure removal
Essure Removal Procedure:
The schedule for removal is the following:
- You must pay for the procedure 2 weeks before you come.
- You arrive at our facility at 9:00am for consents and examination
- We send you to a nearby lab for your lab work (all included in your 4500 dollar fee.)
- You come back to the office and we do your Essure removal under general anesthesia
- You go to a local hotel (again included in your fee) for the night
- The next morning, you come to the office for a brief incision check and afterwards you go home.
- Unless your job is very strenuous, you should be able to go to work the next day.
- No further follow-up is needed, your stitches all are inside and dissolve on their own.
If I have an Essure removal will I get pregnant?
You should be every bit as safe without your Essure. Essure removal does not restore your fertility. This Essure removal procedure is ½ of our Essure reversal procedure, we do not connect the tubes back to the uterus in the Essure removal procedure.
What if I decide at a later date that I want to get pregnant after Essure removal?
You would be in great shape for Essure reversal or IVF once your Essure is removed.
How bad is the recovery after Essure removal?
The recovery after Essure removal is about the same as it is for Essure insertion.
Will the problems that I have with pain,bleeding, tiredness, sore joints,and metallic taste in my mouth go away with having my Essure removed?
We don’t know, most patients report improvement but all these things can be due to things other than having an Essure. When we remove your Essure we will ask you to help us figure out if the removal of the Essure has made a difference to you.
Why is it important to remove the Essure with microsurgery the way you do?
The device has to be completely removed to get any reasonable chance of improvement. The Essure device works by causing local inflammation. That’s what blocks the tube, your body’s reaction to the plastic, spring and the coating on the spring. If you leave part of the device buy pulling on it until it breaks or some laparoscopic fiasco you won’t stop the tissue reaction that caused the problems in the first place. Microsurgery also disturbs your normal anatomy very little. We will just carefully cut around the Essure ( it’s very small) and remove it. We will leave the rest of you just like you were before the Essure was inserted.
I think I’m going to have a local doctor try to remove my Essure. I’ve known him/her a long time and I like her/him. If they cannot remove it will you try?
The problem with this is that the only person with a good chance is the first person to do an Essure removal for you. The Essure device is small and fragile. If you break it trying to get it out it could be difficult trying to find the pieces left behind. Very difficult.
Why is it so important to remove the part of the Essure that “hangs out” in the uterine cavity?
If you have a copy of the doctor’s note for the Essure insertion, you will notice that several coils were left in the uterine cavity. These act like an IUD. IVF with these coils still in place is a waste of money. The way any foreign object in the uterus works is to prevent implantation of a fertilized embryo. In IVF; the doctor takes the egg from your ovary, or a donated egg, and mixes that with sperm from your partner. The fertilized egg is then put in your womb. If you have an Essure, it acts like an IUD to prevent the fertilized egg from implanting and growing into a baby.
I have talked to someone that disagrees with you, who should I believe?
I have enough trouble answering for my own short-comings, I’m not getting into commenting on others apparent faults. I personally and this surgical center have done very well by sticking with accepted facts and being very careful to educate patients in an honest way. We will always tell you when something is known or a matter of speculation and I sometimes am saddened by health care professionals apparent inability to separate fact from fiction.
RELATED INFORMATION ABOUT ESSURE: