Sterilization Information
Your Questions (hopefully) Answered
Failed Essure Experience 
4th-Dec-2008 02:09 pm
My Essure appointment was for Monday, December 1, 2008.

 

Medications (to be picked up before surgery as some had to be taken night prior to surgery):

  • Ibuprofen 600MG
  • Diazepam 5MG
  • Hydrocordone/APAP 5MG/500MG
  • Doxycycline Hyclate 100MG
  • Ondansetron 4MG
  • Misoprostol 200MCG

(all this cost me ~$15 because of my insurance)

I followed the instructions on the pills and took several of them the night before and one on the morning of the procedure. I brought the remainder of the pills to my appointment.

Appointment:

My appointment for Essure was at 1:45, but I had to be there at 11:30. My husband dropped me off and, when the time came, he picked me up. The doctor’s office did not insist on this. I did. And I’m glad I did. I wouldn’t have wanted to drive myself home after all that. I was dopey and in a fair amount of pain.

When I got to the office, I paid my $500 deductible and was told I’d be billed for 10% of the balance the insurance company agreed to pay. I waited for about fifteen minutes before I was called back to an exam room. My nurse administered some of the pills I brought with me. I was sent back out to the waiting room and sat another ~45 minutes. At that point, the nurse called back again and gave me a shot in the hip to further soften my cervix.

I was allowed to turn off the lights and lay there listening to soothing music while I got pretty stoned. The doctor came in and gave me about five shots to my cervix. None of them really hurt. It was uncomfortable, but I’d give it about a 3 on a scale of 1-10 (1 being the lowest and 10 being the highest). The doctor left the room to give the shots time to take effect. I listened to music for another ~30 minutes, and the doctor returned and started the procedure.

Nothing hurt at all. The doctor warned that I’d feel some pressure when he removed my IUD, but I didn’t. Then, he began inserting the Essure Coils. I watched some of it on the television, but I was squeamish about it and ended up just chatting with the doctor and nurse. After a very short time, the doctor said he had bad news. He said he could insert the coils into my fallopian tubes, but the coils would not open up due to my tubal anatomy. Now this I had to watch on the screen. He could slip the little thread into the tube, but the spring would not deploy. The doctor said it was because there wasn’t enough pressure in my tubes to cause the coils to open. In other words, my tubes were not narrow enough to cause the springs to deploy. What luck, huh?

The doctor suggested Plan B, which was for me to get a laparoscopic tubal ligation and the Novasure endometrial ablation all in one fell swoop. This operation would have to be done at the surgery center under general anesthesia. I decided to go for it because, otherwise, I wasn’t going to be able to get sterilized, and getting sterilized was/is important to me. The doctor’s office was able to schedule me for the tubal/ablation two days after the failed Essure experience. So that meant it would be on Wednesday of that same week.

I had some fairly severe cramping while I waited for my husband to come pick me up--as in the kind where I was sweating and thinking I might vomit. Hubby came to get me, and I went home and languished on the couch the rest of the day wondering if I was making the right decision going through with the tubal ligation. In the end, I decided to throw caution to the wind and let the chips fall where they may for reasons that may or may not be acceptable to anyone but me.

I believed both procedures had pros and cons, and the only reason I felt as strongly as I did about having the Essure as opposed to the tubal was the fact that Essure could be done in the doctor’s office, thus, saving me from any hospital rigmarole. On the other hand, I liked the tubal because there is no waiting period, no HSG, and the ablation could be done the same day. There was a lot of “six of one; half a dozen of he other” when I compared the two. So, since the Essure placement had failed, I decided to be like those old Nike commercials and just do it.

The tubal and ablation were scheduled for Wednesday, December 3, 2008. They both went a lot better. I figured it was fate that the appointment was open, and I could have the whole mess over and done with before the end of the year. Originally, I thought I’d lose my $500 deductible on 12-31-08 at the end of the calendar year. When I was figuring out exactly what getting this whole sterilization thing over and done with would cost, though, I got some good news. Because my deductible was met so late in the year, it carries over to next year.

This is great news for several reasons. My husband has some upcoming surgery for hemorrhoids (of all things), for which he just couldn’t take off to have done this year--vacation is based on seniority, blah, blah, blah. I’m glad to know we won’t have to pay the deductible again.

In closing, I’ll say this about the Essure: The experience was positive, and I can’t recommend the doctor I used or his staff enough. My age (backside of 35) may have been a huge factor, but I got nary a bingo. If you’re in the Houston, Texas area and in the market for a wonderfully sympathetic and nice gynecologist, you really ought to look into the Women’s Centre for Well Being.

On the Essure, stuff like anatomical problems that cause insertion to fail are apparently nearly impossible to diagnose ahead of time. I did some internet research after I got home from my appointment and turned up an article which mentioned a particular study that showed 58% of the women who had a failed Essure placement had been IUD users--like me. The name of the article is "Success rate and patient satisfaction with the Essure™ sterilisation in an outpatient setting: a prospective study of 857 women." It appears in BJOG: An International Journal of Obstetrics & Gynaecology, Volume 114, Issue 6, Pages 763 - 766. The listed authors are M Miño, JE Arjona, J Cordón, B Pelegrin, B Povedano, and E Chacon. Despite some searching, I have been unable to find the full text of the article for free online, but here is a google search that turns up a link to buy the article and quotes the passage I'm talking about. Maybe someone who is better at this stuff than I am can turn up something more conclusive.

If you are going to have a large out-of-pocket expense on the Essure like I did, it might be worth your while to look further into the Laparoscopic Tubal. I certainly wish I had done so. It would have saved me some $$$. I also guess I should mention that if a vasectomy for your partner is even a remote possibility and desired for the both of you, it might be worth looking into as well. I'm not one of those women who, because my Essure experience didn't work out, am saying you should run far, far away with your fingers in your ears if anyone even whispers Essure around you. I'm just trying to put a reminder out there that your procedure may not work out for reasons you or your doctor could not have predicted.

Expenses: For the Essure, I spent $500 to meet my deductible, and I am sure I will be billed for 10% of what the insurance approves to pay. I spent ~$15 on prescriptions. Luckily one was a fairly large amount of ibuprofen, which I can use for other stuff down the road. The rest of the stuff was used the the Essure placement failed. I also spent ~$5 on a shot of depo, the necessity of which was negated by the tubal I got yesterday. I would prefer not to have these hormones in my body, but the effects of them will be finite as I won’t be getting another shot of Depo. (And, by the way, other than spotting, I haven’t had any trouble with it.)

Please note:  I'm not, in any way, saying this is what Essure would cost across the board.  I have insurance that picked up some of the cost, and, in some cases, some plans might cover even more than mine did!  

The sunny side is that the deductible carries over, and the medications didn’t really cost all that much. The shot of depo probably thinned my uterine lining so the doctor had an easier time seeing what he was doing for the hysteroscopic ablation. I would have had to pay the office visit for the consultation and the ultrasound anyway.

...And the sun’ll come out tomorrow.... <grins>

Anyway, I’m not trying to tell anyone what to do or what not to do. Be aware, though, that the Essure placement can fail, and, if it does, you have to start all over. I’ll share my experience with the tubal/ablation in my next post.

 

Comments 
4th-Dec-2008 10:48 pm (UTC)
Thanks for the post! I think that the biggest downside to Essure is the fact that a certain percentage of women just can't get the coils placed, and then you're back at square one. I was very worried about it before my procedure, and the moment I saw the doctor afterward I jumped on him for news (I was IV sedated during the procedure, so a little too loopy to chat or register if he commented on how things were going). I was lucky -- in my case, everything worked fine. Failure rates have dropped (the failures that could be prevented, that is) as doctors have grown more experienced, but there's still a certain percentage in your situation, where it just isn't possible.

I also lucked out and paid nothing but the $15 for my consultation -- the procedure and everything that followed were completely free. Did your insurance coverage (percentages, co-pays) differ for Essure vs tubal?

Edited at 2008-12-04 10:49 pm (UTC)
5th-Dec-2008 12:19 am (UTC) - Copays, etc.
platypus--Unfortunately, my insurance was exactly the same for vasectomy, tubal, or essure. No office copay, none of that nice stuff. I had to first meet the $500 deductible. Then, the insurance company would pick up 90% of the adjusted fee, and I would be responsible for the remaining 10%. They basically considered it a surgery done in the physician's office. The only $$$ I saved with Essure was the fee for the use of the ambulatory surgery facility--which I paid anyway when I got my lap tubal and ablation. My 10% of the fee for the surgery facility was ~$450. I was just amazed that at what the balance had to have been.

The way my insurance works is that the physicians who participate in this plan agree to accept the adjusted fee the insurance will agree to pay. (The insurance is Blue Cross Blue Shield PPO of Texas.) The billing clerk at my doctor's office told me that although they bill ~$3500 for Essure, Ablation, or Tubal, BCBS will only pay about what Medicare/Medicaid (??) of Texas will pay, which is ~$2000.

I hope that answered your question. If not, let me know, and I'll try harder.
4th-Dec-2008 11:28 pm (UTC)
I'm so sorry the Essure didn't work out :( I've never heard of that before, but unfortunately I guess weird things can happen! Good luck to you in the future!


5th-Dec-2008 12:22 am (UTC) - Sometimes Poo Poo Happens, right?
I am sorry it didn't work out, too. I was in quite a bit more pain after the lap tubal and ablation than I was after the attempted Essure. I think I truly could have been up an running within 24 hours had the Essure worked. But, like I say, poo poo happens. If this is the worst that comes of the situation, I'll consider myself lucky. :D
30th-Dec-2008 05:33 am (UTC)
Anonymous
had essure. Immediately had pain. No one would listen to me. Finally after several weeks and 2 vaginal ultrasounds, doctor did xray which showed problem. Had to have major surgery to remove devices. One had perforated my uterus and tube, the other was making its way out into my abdomen. Research, if they place them and there is a problem, you are facing major surgery to remove them and if they have migrated into your abdomen they may perforate other organs. There are issuses with future MRI's, allergies to nickel and it has even been shown that the things can and do sometimes migrate after so called sucessful HSG confirmation. Bad product. I spent alot of money on a procedure that wound up costing me even more because of surgery to remove them. It is hard to find doctors to help you if you have problems because they really don't know what to do. Procedure has too many potential problems. If I had known half of what I know now, I'd never done it.
30th-Dec-2008 05:37 am (UTC)
Anonymous
forgot to add. No problems with placement during procedure. Have pics that show perfect placement right after procedure. Pain began few days afterwards and got worse each day till couldn't stand it anymore. Doctors tried to convince me pain was in my head. Well xray and surgery to remove showed that they had moved after placement. I'm just lucky that I the metal coils didn't perforate any vital organs.
31st-Dec-2008 04:34 pm (UTC) - problems too!
Anonymous
Hello! I had Essure 3/08, we had 2 scopes brake and by the time the Dr placed the second side(left) I was so swollen she even said she was not sure it was going to work. (I was totally awake, NO meds and watched the entire thing) Ever since I have had major pain, my tummy swells to look as much as 6 month pregnant (in the first 4 months, now only about 3 months but never totally goes away). I have had other major problems. I have seen a Neurosurgeon because of a cyst in my brian, the MRI showed a rather enlarged pituitary gland...hormonal! He started asking about any other issues I have and I went on to tell him about essure, having missed many/most periods since it, my hair falling out and the major swelling I have. He believes my headaches have become so bad because of my hormones being so out of wack, (only since Essure was done) I handle pain very well, 2 kids no meds born within 30 minutes of arriving for delivery. Nero Dr sent me to and Endo OBGYN, because the OBGYN who did the essure keeps telling me I am getting better...I am not. The Endo OBGYN ordered another (#5) TVU on Monday (all others were done by the OBGYN who had placed essure). The tech and I were floored by how much of the essure was outside of the tube, only on the left side (all the pain is on the left) it messured to be well over half of the coils. I think most of it is out. Now I am worried that I could have a tubal pregnancy and not even know it because I am in such pain everyday.... I know I must have a complete Hyst. now, I chose essure because I am scared to death of being put under or taking any meds, but now I have no choice. I am trying tofind an OBGYN who will take me on...no one knows enough about this and is scared to touch me. go figure.

Where are you located? Did the placing Dr do your next op? Did you have a complete Hyst? What method was used to remove essure? Did they take your tubes too? How are you now?

I have been told by the Dr who placed them, that I would have to have the tubes and uterus removed at the least, because they have been in for so long now. (I forgot to say that they placed me in the hosp for 2 days because they did not know why I was so swollen, this was 8 weeks post op) They could have taken them out then but I have sever hydosalpinex (sp) that they were scared I was full of infection and would not do the op. Please update me on your situation, there are lots of us out here and we need to help one another, we know more then the Dr's!!

6th-Jan-2009 06:46 am (UTC) - Re: problems too!
Anonymous
They removed mine laproscopically. They did not do a hysterectomy nor did they have to remove my tubes. The problem with this procedure is that they don't really know what to do when problems occur. It is difficult if not impossible to find doctors to help when there is a problem. This should be a warning to other women considering this procedure. There is another forum Aphrodites which has an archived thread. Some other women have had them removed without hysterectomy or removal of tubes even after being in place for a long time. Mine were removed after 5 weeks. Had to change docs. Original doc did not want to admit problem with essure metal coils. There is a problem with some women being allergic to the nickel in the coils. It might explain some of the other symptons you are having. I have been trolling alot of forums and it really amazes me how little women are really being told about this procedure except how wonderful it is. There is another forum that has reported another pregnancy after having had the confirmation test and 2 years later she's pregnant. These coils can and do come out of place. There is some question about MRI's frying your insides.

I live in Mississippi. I will be glad to help you any way I can.
Please report your problems to the FDA. The doctors and the company are supposed to report any problems with these devices but they aren't. You can report your problems to the FDA. I would encourage you to. Until the FDA recieves enough complaints they won't do anything about this product which has alot of potential to do harm. The so called benefits of this procedure just doesn't out weigh the potential problems. Keep changing docs till you find some one to help you.
1st-Apr-2011 07:26 am (UTC) - Re: problems too!
Anonymous
I had mine done in nov.2007 and I am having bad headaches back pain and stomach pain... I went to the doctor about 2 weeks ago because I thought my husband gave me something turns out he didn't.. (He got checked because I made him) Because of this EESURE I have Cervicitis which yes it can be caused by STD's or by injury to the cervix from a foreign object inserted in the vagina, from birth control devices...So now i'm looking for a doctor in Dallas,Tx to remove my EESURE...Its causing soo many problems and this sucks because I don't know what to do now...If anyone knows where I can get help in or around Dallas,Tx please email me peaches244foru at yahoo thanks TASHA
9th-Sep-2009 07:18 pm (UTC) - failed essure attempt
Anonymous
Had the Essure procedure in May. Felt like I was $ signs to my Doc. In and out. Had major pain and heavy bleeding for days after. I kept calling and asking if there could be a problem and was there anything that they could check to see why I was in so much pain. It felt like I was being burned from the inside. I was told to give it a week... The pain did not stop, I was able to go in and see my Doc. she did an exam, said maybe there is an infection and sent me on my way... Pain is still there, at about a 2 on a constant at this point. When I bend or sit with my knees bent it burns and causes sharp pain in my ovary area. I went in for my HSG/X-ray to be told that in fact the rt. implant is floating around.. and not in place. Go figure. I was right to have felt pain! The left tube was blocked by an air bubble (?) so they were not able to inject dye. I have sched. a Laparoscopy to locate and remove the left implant ( had to demand this! Was told to just leave it in.) and get the tube tied, but am fighting to get the other implant removed so I do not have to go through this again! Looking on-line it is recommended they (the Doc's) take care of both tubes, mine doesn't want to, doesn't feel the need. And Yes, I asked what they would do if it failed. I was told never had a failure yet, but, we will take take of it. There are too many side effects to this procedure! hair falling out, bowels not function correctly, missing cycles, constant pain, and those are just mine! I had NO issues prior to this procedure now my body is a mess! It is so scary when the doctors we count on can't help correct a procedure they completed because they have no idea what to do if something goes wrong!
13th-May-2010 11:22 am (UTC)
Anonymous
I had the procedure when it was new in 2004 after having my second daughter. No pain, no problems. 6 years later I missed my first cycle and I'm a little worried.
1st-Apr-2011 07:28 am (UTC)
Anonymous
I had mine done in nov.2007 and I am having bad headaches back pain and stomach pain... I went to the doctor about 2 weeks ago because I thought my husband gave me something turns out he didn't.. (He got checked because I made him) Because of this EESURE I have Cervicitis which yes it can be caused by STD's or by injury to the cervix from a foreign object inserted in the vagina, from birth control devices...So now i'm looking for a doctor in Dallas,Tx to remove my EESURE...Its causing soo many problems and this sucks because I don't know what to do now...If anyone knows where I can get help in or around Dallas,Tx please email me peaches244foru at yahoo thanks TASHA
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