Risk of Essure microinsert abdominal migration: case report and review of literature

Figures & data

Figure 1 Hysterosalpingogram.

Notes: Hysterosalpingogram showing tubal occlusion on the right side with correct location of the device (right arrow) and a patent tube on the left side. The left device is abnormally positioned (left arrow).

Figure 2 Flow diagram for study selection.

Abbreviation: MAUDE, Manufacturer and User Facility Device Experience.

Table 1 Overview of published cases of Essure microinsert abdominal migration

Reference	Procedure complications	Symptoms during procedure	Symptoms after procedure and time of occurrence	Side of migration	3-month follow-up HSG	Device location	Bowel or other complication	Evidence of uterus or tubal perforation	Management
Kerin et al^Citation4 case 1	Not reported	Not reported	Not reported	Not reported	Not reported	Parietal peritoneum	No	No	Laparoscopic removal without difficulty
Kerin et al^Citation4 case 2	Not reported	Not reported	Not reported	Not reported	Not reported	Parietal peritoneum	No	No	Laparoscopic removal without difficulty
Kerin et al^Citation4 case 3	Not reported	Not reported	Not reported	Not reported	Not reported	Supposed between loops of small bowel	No	No	Not removed
Vellayan et al^Citation5 case 1	Tubal ostia very lateral	Pain settled spontaneously	Pain 6 days later, settled with antibiotics	Left	Left device improperly sited	Omentum	No	Cornua right perforation	Laparoscopic removal without difficulty
Vellayan et al^Citation5 case 2	No	No	No	Left	Left device improperly sited	Omentum	No	No	Laparoscopic removal without difficulty
Hur et al^Citation6	No	No	No	Left	Left device improperly sited	Douglas pouch	Small adhesions to bowel epiploica	No	Laparoscopic removal without difficulty
Gerritse et al^Citation7	Tubal resistance	Not reported	No	Left	Left device improperly sited	Omentum	No	No	Laparoscopic removal without difficulty
Belotte et al^Citation8	No	No	Pain, gastrointestinal symptoms, 1 month later	Left	*	Midileum	Inflammation and adhesions; small bowel obstruction	No	Laparoscopic removal, lysis of adhesions, left salpingectomy, appendectomy
Povedano et al^Citation9 case 1	Not reported	Not reported	Not reported	Not reported	Not reported	Not reported	No	Not reported	Not removed
Povedano et al^Citation9 case 2	Not reported	Not reported	Not reported	Not reported	Not reported	Not reported	No	Not reported	Not removed
Howard et al^Citation10	No	No	No	Bilateral	Right device improperly sited	Fragments near bladder and in omentum	Extensive pelvic adhesions	Bilateral uterine perforation	One laparoscopy and three laparotomies to remove the devices and the fragments
Mantel et al^Citation11	No	No	Intestinal symptoms, 1 month later	Right	*	Terminal ileum	Bowel strangulation and perforation	No	Laparotomic removal, ileocecal resection, ileocolostomy
Present case	Endometrial cavity adhesions	Pain requiring general anesthesia	No	Left	Left device improperly sited	Omentum	No	No	Laparoscopic removal without difficulty

Note:

* The 3-month follow-up HSG was not performed because the device had to be removed earlier.

Abbreviation: HSG, hysterosalpingogram.

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