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Essure
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Tubal ligation
[1]
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Vasectomy
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Who has
the
procedure?
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Women
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Women
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Men
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How
effective is the
procedure?
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99.81% at
one-year
99.78% by two-years
Data not available beyond 2
years
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99.45% at
one-year
99.16% by two-years
99.15% at 10
years
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99.85% at
one-year
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How is the
surgical procedure
performed?
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The device is routed
through the vagina, cervix and
uterus into the fallopian tubes,
where the devices are placed. No
incisions are
required.
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The fallopian tubes
are either cut, burned
(cauterized) or clamped using
either:
* Laparoscopic tubal ligation
(most common method), where 1-3
incisions are made in the abdomen
to access the fallopian tubes
using a telescope type device.
The tubes are then blocked with
clips or rings or burned.
* Open surgery (called a
laparotomy or mini-laparotomy),
which requires a larger incision
(usually 2 ñ 3 inches) in
the abdomen.
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The two tubes (the
vas deferens) that carry sperm
from the testicles to the penis
are cut or blocked. This is
achieved by:
* Making a small incision in the
scrotum. This is the most common
method
* Making a small puncture in the
scrotum
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How long
does the procedure
take?
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Average procedure
time is 35
minutes
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Average procedure
time is 30-45 minutes for
laparoscopic method. May be
longer if open
surgery
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Average procedure
time is 15-30
minutes
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How many
visits to the doctor does it
require, and what type of
follow-up is
required?
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Three visits. One
consultation visit, one visit to
place the micro-inserts, and one
follow-up visit at 3 months to
check for tubal occlusion and
proper micro-insert
location.
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Three visits. One
consultation visit, one visit to
perform the tubal ligation, and
one follow-up visit at
approximately 2 weeks to check
the
incisions.
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Three visits. One
consultation visit, one visit to
perform the vasectomy, and one
follow-up visit at 3 months to
make sure that the vasectomy was
effective.
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How is
pain or discomfort typically
controlled during the
procedure?
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Local anesthetic
and/or intravenous
sedation
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General anesthetic,
spinal block or epidural
anesthesia is typically
used
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Local or general
anesthetic
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Can I rely
on it right
away?
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No. There
is a three-month waiting period
when another form of
contraception must be
used. You will need a
hysterosalpingogram (a special
kind of x-ray) before you can
rely on Essure. The purpose of
this test is to make sure that
both of your tubes are blocked
and both of your devices are in
the correct position. You must
continue to use another form of
contraception until your doctor
instructs you that you can rely
on Essure for birth
control.
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Yes. You may resume
intercourse when you have
recovered from the procedure,
following your doctor's advice,
typically about a week after the
procedure.
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No. There
is a 2-3 month waiting period
required to flush out any
existing sperm. Sperm
counts are taken to demonstrate
the success of vasectomy i.e.
when the sperm count is zero. You
must use another method of
contraception until
then.
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What
should I be doing to help the
recovery process after the
procedure?
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* Rest for 45
minutes following the procedure
before going home. Follow your
doctors instructions to report
any unusual pain, bleeding or
high fever
* Consider having someone to
drive you
home
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* Most women are
ready to go home 2-4 hours after
the procedure
* Must have someone to drive you
home
* The incision will need to be
kept dry for a few days
* Follow your doctorís
instructions to report any
unusual pain, bleeding or high
fever
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* Rest for about 30
minutes following surgery
* Consider having someone to
drive you home
* Apply ice packs to the scrotum
and wear supportive underwear to
minimize bruising/swelling
* Follow your doctorís
instructions to report any
unusual pain, bleeding or high
fever
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When can I
return to regular
activities?
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Typically, within
1-2 days of the
procedure.
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For laparoscopic
tubal ligation, typically within
4-6 days. For tubal ligation
performed by an open procedure,
typically within 9-10
days.
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Typically, in 2
days.
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What are
the typical temporary effects
following the
procedure?
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* Cramps (like
menstrual cramps)
* Discharge (like a light
menstrual flow or spotting)
* Mild nausea or vomiting
associated with the procedure
* Fainting or light-headedness
following the
procedure
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* Cramps (like
menstrual cramps)
* Discharge (like a menstrual
flow)
* Mild nausea or vomiting
associated with general
anesthesia or the procedure
* Pains in the neck or
shoulder
* Pain in the incision
* A scratchy throat if a
breathing tube was used
* Feeling tired and achy
* Swollen abdomen, which resolves
as gases are absorbed
* Bruising around the incision
that fades
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* Swelling and
bruising. If this occurs it
usually resolves within two weeks
following procedure
* A dull ache in the testicles
that usually fades during the
first week
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What are
the major risks of the
procedure?
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* You may become
pregnant several years after
undergoing the procedure.
* Ectopic pregnancy
occurs more often in women who
have had a sterilization, if they
become pregnant.
* For a percentage of women (14%
in clinical studies) it may not
be possible to place the
micro-inserts in the fallopian
tubes during the first placement
procedure
* Despite micro-insert placement,
a small percent of women (3% in
the clinical studies at the
3-month follow-up) may not be
able to rely on the micro-inserts
for birth control due to
incorrect position of the devices
or lack of tubal blockage.
* Although death and serious
injury following hypervolemia
were not reported in the Essure
clinical trials, hypervolemia can
lead to serious injury and
death.
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* You may become
pregnant several years after
undergoing the procedure.
* Ectopic pregnancy
occurs more often in women who
have had a sterilization, if they
become pregnant.
* Major complications such as
infections, bowel injuries,
bleeding, burns, or complications
from anesthesia occur in about
2%2 of women
who have the operation by
laparoscopy and in about
6%2 of women
who have the operation by
laparotomy (open procedure).
Internal bleeding is the most
common and may require an open
operation to stop the
bleeding
* Other injuries such as damage
to the bladder or burns to the
bowel may also require additional
surgery.
* Other risks such as blood clots
and death, are
rare.
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* Pregnancy may
occur several years after
undergoing the procedure.
* 1.6% of men experience bruising
on the scrotum1
* 1.5% of men experience
infection of the
incision/puncture in the
scrotum1
* Painful testicles
(epididymitis) is experienced in
about 1.4% of
men1
* Sperm may leak into the
surrounding tissue (less than 1%
leakage rate1) forming
small lumps (granuloma). This
process generally subsides
spontaneously, although pain
medication may be
required
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