Essure Reversal

Essure reversal surgery is a procedure that removes the permanent birth control device Essure from the fallopian tubes. In an Essure placement procedure, a surgeon places micro inserts into the fallopian tubes to physically block sperm from traveling through them. 

Double board certified Dr. Aram Bonni is an expert in microsurgery and has helped thousands of women at PelvicPro, Southern California’s leading essures reversal center. With three locations in Los Angeles, Beverly Hills, and Long Beach, Dr. Bonni will ensure you get the treatment you need if Essure is no longer a part of your family planning. Schedule a free personal consultation with him by calling (657) 888-3008 or by completing our simple online inquiry form.

About Essure

Essure was designed to prevent pregnancy. Micro inserts are made of stainless steel and polymer fibers. The outer coil is made of nitinol, a nickel-titanium alloy. According to the FDA, if the device is placed correctly, there is less than a 1% chance of pregnancy. ⁽¹⁾  Its manufacturer, Bayer, won approval for its use in the United States in 2002. It was a popular alternative to tubal ligation in the early and mid-2000s because procedures were short, minimally-invasive, and less involved than tubal ligation. And unlike some other forms of birth control, Essure did not alter hormone levels. 

An estimated 750,000 women chose Essure as a form of contraception in the 2000s. But, shortly after the release of the device, a small number of patients would return to their doctor with uncomfortable symptoms. Pelvic discomfort, hypersensitivity reactions, and other serious adverse events have been documented. Essure reversal surgery removes these micro inserts, eliminating side effects.

What Happens in an Essure Placement Procedure?

Micro inserts are roughly 4 cm (1 ⅝  in) long and 0.8 cm (5/16 in) in diameter. A surgeon places each micro insert with the aid of a hysteroscope, a narrow telescopic camera that visualizes the inside of the fallopian tubes, and a disposable introducing device. The outer coil then expands, securing the device against the fallopian tube wall. In response to the Essure device, the body produces a foreign body reaction. This causes tissue in the fallopian tubes to grow and surround the device (fibrosis), to anchor it further.   

Removal vs. Reversal

Dr. Bonni sees patients from all 50 states in USA and from abroad, each with their own personal reasons for seeking Essure removal. These women usually want the device removed regardless of their future plans for pregnancy.  And in many cases, patients want to continue permanent contraception, but via a different method. A standard removal procedure will not restore fertility. So for women who want to get pregnant, Essure removal and reversal is the most suitable procedure. This is a more complex surgery that aims to preserve as much of the fallopian tube structure as possible.

Salpingectomy is the removal of the fallopian tube(s), that may be complete or partial. The latter may be used in Essure reversal. If a patient wishes to become pregnant, the fallopian tube structures must be reconnected and remain undamaged in a reversal surgery. 

Partial salpingectomy and Essure removal technique uses specially-designed instruments to excise the device and surrounding fibrotic scar tissue with a small portion of the tube in which the device exists, but aims to preserve the rest of the fallopian tubes. As with any secondary Essure procedure, it is extremely important that both micro inserts are removed in their entirety. 

About Laparoscopic Surgery

Laparoscopic removal of the Essure device is often the most appropriate choice. Laparoscopic surgery is minimally-invasive and less involved compared to procedures that require larger incisions. One of the great benefits of laparoscopic surgery is that healing is usually faster and less complicated. Dr. Bonni creates tailored treatment plans to minimize patient discomfort and make recovery as straightforward as it possibly can be. 

Research indicates patients achieve short- and medium-term improvements in quality of life as well as a reduction in pelvic pain following Essure removal. ⁽⁴⁾ Dr. Bonni will assess the best course of action to remove your Essure device after gathering detailed information from you at your consultation. This may include conducting the necessary imaging procedures and tests to visualize the position of the micro inserts.

Find out more about the benefits of laparoscopic and robotic surgery on the PelvicPro website.

Can I Get Pregnant After Essure Reversal?

Fertility is measured subjectively, as every patient’s chances of conceiving differs, particularly after the removal of a permanent birth control device like Essure. Dr. Bonni determines patients’ fertility prospects on a case-by-case basis, and will inform you of realistic expectations with the information you provide, and the data he gains from testing. 

Essure reversal aims to reconnect the fallopian tubes, but patients must understand that fallopian tube reconnection does not ensure pregnancy. In every instance, Dr. Bonni will select the most effective treatment plan to help his patients reach their goals. Though the chance of becoming pregnant after Essure removal is still quite low, it is not impossible. 

Reasons for Essure Removal

Although most women who use Essure have no issues, patient reports indicate the device has caused problems in a small number of instances. 

Incorrect Positioning

If tissue has not successfully grown around the device, or if there is still patency in the fallopian tubes, it cannot prevent pregnancy. This could be a result of inaccurate placement, migration of the device to the uterine cavity, or perforation if the device goes too far into the fallopian tube. ⁽²⁾ 

Reported Side-Effects

According to the FDA, the following side effects have been reported by Essure users. ⁽¹⁾

What Else Can Go Wrong with Essure?

Overall, the majority of patients have been very satisfied with Essure, but a small percentage of women have reported serious side effects. The most severe adverse events reported include the following. ⁽²⁾

If you are experiencing symptoms like those listed above, seek expert care immediately. Book a personal consultation to assess the cause of your discomfort and discuss Essure removal at PelvicPro.

Essure Removal

If you want your Essure device removed, but do not wish to become pregnant, Dr. Bonni will select one of the following surgery options based on your individual requirements. In any procedure, the Essure micro inserts must be removed in their entirety.

Complete Bilateral Salpingectomy

A complete bilateral salpingectomy removes both fallopian tubes and the Essure micro inserts. In most cases, the laparoscopic approach is preferred because it is less invasive. Research indicates that this procedure may also lower the risk of ovarian and fallopian tube cancers. ⁽³⁾

Partial Bilateral Salpingectomy

Only parts of the fallopian tubes are removed in a partial bilateral salpingectomy. Like a complete salpingectomy, this procedure can be performed laparoscopically. 

Hysterectomy

A hysterectomy procedure removes the uterus. With Essure patients, the fallopian tubes are also removed. Abdominal, vaginal, or laparoscopically-assisted methods may be used, depending on your treatment plan.

For the most cost-effective treatment, check the PelvicPro reservation system for your lowest price urogynecology surgery.

Corresponding Care at PelvicPro

Infertility

Essure reversal and tubal ligation reversal are for women who wish to become pregnant following a permanent sterilization procedure. Receive professional care for fertility issues at PelvicPro. Dr. Bonni can assess your specific goals at a consultation to find out the details of your initial procedure, then determine a treatment path to help you regain fertility.

Gynecological Services

PelvicPro offers comprehensive gynecological care. Dr. Bonni is a leading specialist in female urology and pelvic surgery, and offers preventive, reversal, and reconstructive procedures. Our related services include STD testing, Gardasil vaccination for HPV, biopsy services, and IUD placement.

Cost of Essure Removal in Los Angeles

The cost of your treatment will be determined after a comprehensive assessment of your symptoms, your future family planning goals, your Essure device’s location, and a discussion with Dr. Bonni regarding the treatment options available. See our financing page for our financing options. Book your free consultation at our Los Angeles, Beverly Hills, or Long Beach location to find professional Essure removal and gynecological care.

Read the PelvicPro blog for more information about pelvic health, women’s wellness, and female urological services.

FAQ

References

1. Essure Benefits and Risks. FDA Health Devices, Essure Permanent Birth Control. Published online January 10, 2020. https://www.fda.gov/medical-devices/essure-permanent-birth-control/essure-benefits-and-risks 
2. Djeffal H, Blouet M, Pizzoferato AC, Vardon D, Belloy F, Pelage JP. Imaging findings in Essure-related complications: a pictorial review. The British Journal of Radiology. 2018;91(1090):20170686. doi:10.1259/bjr.20170686
3. Yoon SH, Kim SN, Shim SH, Kang SB, Lee SJ. Bilateral salpingectomy can reduce the risk of ovarian cancer in the general population: A meta-analysis. European Journal of Cancer. 2016;55:38-46. doi:10.1016/j.ejca.2015.12.003