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Hysteroscopy and Contraception

  • Andreas L. Thurkow
Chapter
  • 67 Downloads

Abstract

The various relationships between hysteroscopy and contraception are discussed, including hysteroscopic sterilisation, hysteroscopic placement of long-acting reversible contraception (LARC) devices, and hysteroscopic methods of solving problems related to contraceptive devices (sterilisation and intrauterine contraceptive devices).

Since the last hysteroscopic sterilisation method (Essure®, see the relevant passage in the text) was removed form the market, all techniques described are mainly of historic value. However possible future methods are described as well.

Keywords

Hysteroscopy Sterilisation Sterilisation Contraception Hysteroscopic sterilisation Hysteroscopic sterilisation Transcervical sterilisation Transcervical sterilisation Intrauterine contraceptive devices Long-acting contraceptive devices 

Supplementary material

Video 21.1

Chiroxia® compound injection into fallopian tubes (MOV 603152 kb)

Video 21.2

Ovabloc® sterilisation (MOV 303607 kb)

Video 21.3

Ovabloc® tip removal prior to laparoscopic removal of the intratubal portion in case of symptoms of postmenopausal pain (MOV 86763 kb)

Video 21.4

Ovalastic® procedure during a live surgery case at the AGE Congress Berlin 2014 (non-edited, no sound) (MOV 599840 kb)

Video 21.5

Essure® procedure, vaginoscopic approach, no anaesthesia, unedited (4.5 min) (MOV 1804590 kb)

Video 21.6

Adiana® procedure, vaginoscopic approach, with explanation of the use of the proprietary generator (MOV 1116431 kb)

Video 21.7

Altaseal® procedure as performed in an experimental clinical study, with explanation of the handling of the inserting catheter (MOV 310406 kb)

Video 21.8

Removal of an IUD with missing strings, due to folding back of the threads into the cervical canal. Note the vaginoscopic approach of the entire procedure, including local anaesthesia using a paracervical block via a catheter introduced through the working channel of the hysteroscope. Usually the latter is not necessary since the procedure is less painful than retraction using a speculum, but in this case even touching the external os was very painful; after anaesthesia the action was painless (MOV 204693 kb)

Video 21.9

Removal of a Chinese IUD without strings. Chinese IUDs were designed not to be removed easily due to the former “one child per family” policy and were inserted immediately after birth of the placenta (MOV 1275477 kb)

Video 21.10

Hysteroscopic view of a young girl with persistent pain and spotting showing a complete transverse position of a Mirena® with one horizontal arm penetrating into the anterior uterine wall. Repositioning of the IUD solved the problem in an easy ambulatory setting (not shown in the video) (MOV 90464 kb)

Video 21.11

Hysteroscopic view of a patient with heavy menstrual bleeding and pain showing a 90° rotation of a Multiload® IUD with the string attachment in the right tubal cornua. Note the possibility of following the strings to reach the uterine cavity. Increasing the pressure would probably have given a better view of the cervical canal, but in this case it was decided to leave the pressure at a low level (around 60 mmHg), not to cause more pain in this patient already experiencing continuous uterine cramping. A type 2 myoma in the anterior wall is visible, possibly the cause of the malposition of the IUD. Repositioning solved the pain, but eventually a hysteroscopic resection of the myoma was performed for increasing menstrual blood loss (MOV 174524 kb)

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Andreas L. Thurkow
    • 1
    • 2
  1. 1.Amsterdam University Medical Centre (Location Academic Medical Centre)AZ AmsterdamThe Netherlands
  2. 2.Bergman Clinics Vrouwenzorg, Building TKO “De Rode Luifel”AZ AmsterdamThe Netherlands

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