New birth control option

By Lynn Taylor Rick, Journal Staff Writer | Tuesday, August 22, 2006

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For years, permanent birth control meant either tubal ligation or vasectomy. Now there’s another choice.

Approved by the U.S. Food and Drug Administration in November 2002, Essure is the newest way for women to permanently prevent pregnancy, according to Rapid City obstetrics/gynecologist Pamela Schmagel.

The Essure procedure uses a nickel coil that is guided vaginally through the cervix and into each fallopian tube opening. Once in place, the coil is essentially sprung, reaching about one inch in length.

For the next three months, the body naturally causes scar tissue to grow into the springs, eventually blocking the fallopian tubes. During that time, other birth control is required. Once the waiting period is complete, the doctor shoots dye into the uterus to ensure that the tubes are completely blocked.

The procedure is 99.8 percent effective, which is slightly better than both tubal ligation and vasectomy, Schmagel said.

The Essure procedure is not reversible and is only for women who want no more children.

Schmagel began doing the procedure in Colorado in late November 2003. The advantages quickly became apparent to her.

Unlike a tubal ligation, which requires a doctor to make an incision in a patient’s abdomen and either cut, band or burn the fallopian tubes, Essure is done vaginally. This eliminates surgery risks, Schmagel said.

“We’re not poking a sharp instrument into your abdomen,” she said.

The procedure requires almost no recovery time and causes very little discomfort, Schmagel said. It doesn’t require general anesthesia and can be done in a doctor’s office, as long as the appropriate equipment is available.

Schmagel will do her first two Essure procedures in Rapid City in September. At this time, she isn’t set up to do them in her office, so patients must have the procedure at a hospital or surgery center. Eventually, Schmagel plans to do the procedure in her office at Rushmore Obstetrics and Gynecology.

The entire procedure takes less than 10 minutes to complete, she said.

Initially, some insurance carriers were unwilling to cover the new procedure, which is more expensive than a tubal ligation, Schmagel said. Today, however, the majority of insurance companies cover it, she said.

Though easier and less invasive, Essure does require a bit of planning. Because the uterine lining must be thin so the physician can see the fallopian tube opening, patients need to be on a continuous birth control for three months prior. A woman who is post-partum or breast-feeding may not need that waiting period since the uterine lining will already be thin.

Today in the United States, 700,000 women have tubal ligation annually. About 400,000 men choose vasectomy.

Schmagel expects those numbers may change as more women learn about Essure and as more insurance companies increase their coverage.

To find out more about the Essure procedure, go to www.essure.com.

Lynn Taylor Rick can be reached at lynn.taylorrick@rapidcityjournal.com or 394-8414.