Less invasive sterilisation choice for women

The Essure procedure is done as a 10-minute outpatient procedure, without anaesthesia and without the need for surgical incisions. Photo / APN

A less invasive form of sterilisation has become available on the public purse for women in central Auckland and is likely to be offered more widely.

After a successful pilot programme in March, Auckland District Health Board patients who are candidates for sterilisation by the tubal ligation procedure are now also being offered the choice of the "Essure" device.

It can also be used in women who cannot have a tubal ligation operation.

In tubal ligation the fallopian tubes are cauterised, cut and tied or permanently clipped, usually under general anaesthetic and by keyhole surgery.

The Essure procedure, which permanently blocks the fallopian tubes, is done as a 10-minute outpatient procedure, without anaesthesia and without the need for surgical incisions.

A small metal coil, with polyethylene fibres down its centre, is placed in each fallopian tube by using a hysteroscope, a surgical/camera tube inserted through the vagina and cervix.

Scar tissue grows into the coils, blocking both fallopian tubes. Women must use other birth-control methods for three months, until the success of the procedure is established by ultrasound scan or x-ray.

The procedure has been available privately in Auckland since 2004, but it is now starting to be offered by district health boards.

Sarah Firth, the marketing manager of the United States-made device's New Zealand supplier, NZ Medical and Scientific, said yesterday the Auckland and Canterbury DHBs were offering Essure and others were likely to follow soon.

Dr Astrid Budden, an obstetrician/gynaecologist at Auckland DHB, said most women when given the choice preferred Essure over tubal ligation because it was a much less invasive procedure. She considered the degree of invasiveness of Essure to be comparable to male sterilisation by vasectomy.

She said there was a small risk of perforation during placement of the Essure device, but the risks were much lower than for tubal ligation surgery.

The subsequent pregnancy rate was also much lower: 0.16 per cent, compared with 1.5 per cent for tubal ligation patients.

Dr Budden said she began offering the procedure at the DHB because she looked after women who were obese or had diabetes and consequently posed too great a surgical risk to have a tubal ligation operation. But they could have the Essure procedure.

Ms Firth said the cost of the Essure device and procedure in the private sector was around $5500, which was similar to the cost of a tubal ligation.