Essure Removal

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 every symptom but most patients have improvement and it usually is dramatic.

There does seem to be a thread of common symptoms in some Essure users. We hear about pelvic pain, heavy bleeding, cramps, joint problems, metallic taste in the mouth, skin changes, hair loss, depression and other problems..

We do have experience with Essure 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 2 metal coils that grow 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. If an attempt is made to remove the Essures with hysterectomy a part of the devices that is in the tube could be left behind. This is especially likely with a vaginal hysterectomy or laparoscopic assisted hysterectomy.

Women will say if I have you remove my Essure it will be $4500, if I have a hysterectomy my insurance will pay for it. If you consider what you will have to pay for a deductable with your insurance and your lost wages for recovery with hysterectomy (usually 2-3 weeks) it may be cheaper to let us do it. Remember,our fees are all- inclusive. Even your local hotel stay is included.

The manufacturer recommends that they not be used in patients with nickel allergy. The coils that surround the core are 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 parts 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 outer spring is made of an alloy 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

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