For Physicians:
As a private practice physician and independent researcher for the Essure
Hysteroscopic birth control procedure, I often receive emails asking for any
"tricks of the trade" to help ensure a successful procedure.
One of the topics in particular is that of tubal spasm and microinsert
placement.
Ok, so- here it is:
First, remember that the FDA trial for the current Essure
system (305)showed a 96.9% ability to place the inserts bilaterally first attempt!
That's reassurring. Futuremore, for those requiring a second attempt,
80% were able to have the procedure completed. Again- very reassuring.
If tubal spasm seems to be fighting with you, the surgeon, remember these points:
1. Warm Hysteroscopic fluid may aid in spasm relief
2. Don't "jabb" the tube- your not boxing with it!
Rather, slow constant pressure will aid in spasm relief.
3. If unusual resistant is noted- take a second, reevaluate- BREATHE-
and relax. It WILL fade.
Also, the "cytotec" issue must be addressed.
While various studies have shown cytotec to be a great aid on cervical softening
before hysteroscopy- Hysteroscopic sterilization may be different.
Cytotec's paradoxical reaction in causing uterine body contraction may actually
facilitate tubal resistance!! Just keep that in mind.
Lastly, I recently had a new manuscript accepted for
publication in which we investigated a sublingual medication to
relieve tubal "spasm" when encountered. AND... it worked!
This medication is cheap, has very low side effects, and has been on the market
for a long time. Although it is off label for how it was studied
here-- no adverse events were noted.
What is it???..... Well, you are gonna have to wait
for it to be in print soon!!
Stay tuned.
The response above is not industry sponsored and reflects the thoughts
and opinions of the author, Hector O. Chapa, M.D. Dr Chapa is a medical consultant to Comceptus, Inc.
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