There's an issue with doing NovaSure (the radiofrequency procedure) after Essure. The metal Essure inserts may draw heat away from the endometrium into the fallopian tube, which could result in:
some areas of the endometrium not being zapped completely.
damage to the fallopian tubes.
localized burning (http://www.novasure.com/novasure-procedure/novasure-indications.cfm) to other areas (though again, fallopian tubes are the likely target).
Of those, I find only the last option really off-putting. Though apparently, the Essure info (http://www.essuremd.com/Portals/essuremd/PDFs/L3002%2009_09_09%20smaller.pdf) just says, "Consequently, if using RF energy to perform endometrial ablation, direct contact with the Essure micro-inserts should be avoided." (My doc is comfortable performing NovaSure after Essure, though she has reservations that NovaSure will be less effective because of her placement of the device.) That said, my uterine anatomy makes me contraindicated for NovaSure, so it's likely not our ablation option of choice. We're keeping it on the list, though, as my doc has the equipment in-office, which would make a significant time/financial difference for me.
ThermaChoice, which is one balloon ablation method (though I do not know if there are others), is explicitly okay to be performed after Essure. From the same Essure info:
Bench and clinical studies have been conducted which demonstrate that balloon thermal (THERMACHOICE* Uterine Balloon System) and hydro-thermal (HTA** System) endometrial ablation of the uterus can be safely and effectively performed with the Essure micro-inserts in place. However, balloon thermal and hydrothermal endometrial ablation should only be performed after the 3-month Essure confirmation test.
Of all the ablation methods, it looks like only microwave ablation is an absolute no go. And I'm not totally sure how common microwave ablation is; none of the local providers I've spoken to have performed such a procedure.
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Date: 2010-07-30 05:10 am (UTC)Of those, I find only the last option really off-putting. Though apparently, the Essure info (http://www.essuremd.com/Portals/essuremd/PDFs/L3002%2009_09_09%20smaller.pdf) just says, "Consequently, if using RF energy to perform endometrial ablation, direct contact with the Essure micro-inserts should be avoided." (My doc is comfortable performing NovaSure after Essure, though she has reservations that NovaSure will be less effective because of her placement of the device.) That said, my uterine anatomy makes me contraindicated for NovaSure, so it's likely not our ablation option of choice. We're keeping it on the list, though, as my doc has the equipment in-office, which would make a significant time/financial difference for me.
ThermaChoice, which is one balloon ablation method (though I do not know if there are others), is explicitly okay to be performed after Essure. From the same Essure info:
Of all the ablation methods, it looks like only microwave ablation is an absolute no go. And I'm not totally sure how common microwave ablation is; none of the local providers I've spoken to have performed such a procedure.