Female sterilization involves removing the function of the Fallopian tubes by excising, interrupting or plugging them. The Essure device is placed in the junction between the uterus and Fallopian tubes, in a procedure done in the office under local anesthesia. Over the next three months, tissue grows over the devices and then occludes the tubes. Three months after insertion, a special x-ray is performed in the hospital to make sure the tubes are fully blocked. One must use another form of birth control until then. The delay in effectiveness and need for two procedures leads me to not offer the Essure in my practice.
To interrupt the tubes (“tubal ligation”) or remove them (“salpingectomy”) requires a minor surgery procedure. This requires general anesthesia and a half-day in the hospital but is immediately effective. Overall, this is easier for the patient than an Essure.
All of these methods are extremely effective and have only rare failures. The risks of Essure are pain, infection after the first procedure, and failure of the device to occlude the tube, which would require a second approach.
Tubal ligation and salpingectomy have similar side effects, these being anesthesia reactions, bleeding during surgery and infection. In 34 years of practice I have never seen any of these. Salpingectomy is preferred to tubal ligation in women who have an increased risk for pelvic cancers, some of which arise from the Fallopian tubes.