Clinical improvement after Essure® devices removal: a systematic review

Abstract

Purpose

Essure® implant is a permanently implanted minimally invasive birth control device for women (female sterilisation) widely used between 2002 and 2018. Many adverse events were reported by patients. Increasingly removal procedures have been performed in symptomatic patients. However, there is a lack of in-depth studies on clinical improvement after Essure® removal. We aimed to review all clinical studies about symptoms and quality of life (QoL) after removal procedures.

Materials and methods

A review of literature in electronic search in Medline and Embase databases from January 2002 to January 2022 using the following keywords: Essure; Essure removal; quality of life; symptomatology improvement.

Results

Out of 764 articles in the initial database, 18 clinical studies were eligible for inclusion in our literature review. Overall clinical improvement rates after removal ranged from 21% to 98%. All symptoms were less frequent after Essure® removal, although with large discrepancies between studies. Lack of improvement was reported between 1% to 15% of patients. Rate of patients with improvement of QoL after removal ranged from 58 to 98%. The pain was reported as significantly reduced after the surgery.

Conclusions

In the available literature, Essure® removal in symptomatic patients may improve symptoms and quality of life. This should be discussed in the benefits and risks ratio before deciding on the best option of management.

Short condensation

Essure® removal in symptomatic patients may improve symptoms and quality of life.

摘要

目的：Essure®节育器是一种永久性植入的女性微创节育装置(女性绝育), 在2002至2018年间广泛应用。患者报告了许多不良事件。越来越多的有症状患者进行了摘除手术。然而, 目前尚缺乏对Essure®摘除术后临床改善的深入研究。我们的目标是对所有关于摘除手术后症状和生活质量（QoL）的临床研究进行综述。

材料和方法：应用计算机检索Medline和Embase数据库中2002年01月至2022年01月的文献, 检索关键词为：Esure；Esure Removal；生存质量；症状改善。

结果：在初始数据库中的764篇文章中, 有18篇临床研究符合文献纳入标准。摘除后的总体临床改善率从21%到98%不等。摘除Essure®后, 所有症状出现频率都减少, 尽管研究之间存在很大差异。据报道, 1%至15%的患者没有改善。摘除Essure®后QoL提升的患者比例从 58%到98%。摘除后疼痛改善是最明显的。

结论：在现有文献中, 在有症状的患者中摘除Essure®后可能会改善症状和生活质量。在决定最佳管理方案之前, 应该在收益和风险比中讨论这一点。

概述

在有症状的患者中, Essure®摘除可能会改善患者的症状和生活质量。

Keywords:

• Essure
• salpingectomy
• cornuectomy
• hysterectomy
• essure removal
• quality of life

Disclosure statement

No potential conflict of interest was reported by the author(s).