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    Essure and narrow cervix
    Eufemia posted:
    I was supposed to have the Essure procedure done today, but my cervix was so tight they couldn't fit any instruments through. I'm scheduled for a second try under general anesthesia.

    Why and how will it be different then? I could understand it if the dilation caused unbearable pain, but that wasn't the case. I felt some pain before the local anesthetic had fully kicked in. Then almost nothing. It got a bit worse towards the end and my heart started racing. There were, however, lots of bloody tissues in the trash bin... It wasn't a shock to me as I see blood spatter in the bin after a regular PAP smear. And if the saline went into my uterus, some of it could be from there.

    My main concern is safety. I don't want to go through general anesthesia just to find out it didn't work.

    I'm 30 years old and have never given birth.
    Jane Harrison Hohner, RN, RNP responded:
    Dear Eufemia: My best GUESS is as follows. The cervical canal in a woman who has not had a vaginal birth can be more narrow. It may be that they were not even able to get the instrument through the canal and into the uterine cavity. With a general anesthesia more and larger dilators can be used to gently open the canal to a diameter to admit the instruments. If the GYN tries to open the canal without good dilation a "false passage" can be created into the tissues of the cervix.

    There MIGHT also be issues around the internal shape and size of your uterine cavity. This is of importance as the Essure needs to be placed exactly in the opening into the Fallopian tube.

    I would suggest that you ask your important questions of your GYN. They can give you the most "for sure" answer based upon what happened during the office procedure. You have the right to get all questions answered as a part of the informed consent needed for surgery.

    Been There, as Provider AND Patient,
    Eufemia replied to Jane Harrison Hohner, RN, RNP's response:
    Thank you for the answer. I understand that you can only give an educated guess over the net.

    I contacted them today, and we agreed that the GYN will call me before the procedure. Hopefully she'll be more receptive on the phone. The nurse was also able to tell me a bit about the aftercare, although she wasn't there last week. She said that some damage is inevitable. The pain and bleeding could simply be caused by the tenaculum. I was worried I had overexerted, because the pain isn't like menstrual cramps, and now it's milder but constant. But according to her, there shouldn't be any problems once the bleeding stops. (Note to self: next time, ask for appropriate instructions!)
    Jane Harrison Hohner, RN, RNP replied to Eufemia's response:
    Dear Eufemia: Yes, even having the tenaculum applied can prompt marked cramping and heavy spotting. And yes, it is also true that usually once the tenaculum is removed the cramping will resolve. Hopefully you will get as clear an answer from the GYN about your anatomical reasons for a general anesthesia as you got from her nurse about the bleeding/pain.

    Thanks for the follow up. Your experience, and queries, make help another woman in a similar position.

    cjmiller2004 responded:
    I had the essure procedure done in October and just had my scan done to show that it was successful this last week. They had to dilate my cervix which it sounds like what they will do with you. I did mine without the pain meds and it was painful, not unbearable, but not pleasant either. It is like the beginning stages of labor. They will fill your uterus with saline also so that they can maneuver easier. That evening I had some cramping from my uterus shrinking back down and closing. Again, this happens after giving birth so it was bearable if not pleasant. The next day I felt about 80% better and the day after I was back to 100%. We have 4 children and I now have RA and was advised not to get pregnant because of my meds. This was safe, easy, and very effective. Oh, and you will need to wear a pad or panty liner for a day or two. You will have some minor leaking from the saline and you may have some spotting because of the aggravation to your uterus. My doctor scheduled mine for two days after my period ended because she said my uterus would be softer and slightly opened from that. All in all I would say that it went very well and I would recommend it to anyone wanting to be permanently sterilized.
    Jane Harrison Hohner, RN, RNP replied to cjmiller2004's response:
    Dear cjmiller: Thanks ever so for taking the time to inform other women of your experience with getting the Essure inserts for sterilization. I particularly appreciated your careful descriptions of the sensations during the procedure, and what happened during the initial 72 hours. This should be a great service to those women who find your post via Google.

    In Gratitude,
    Eufemia replied to cjmiller2004's response:
    Thanks for sharing!

    I just remembered this thread and felt like updating, though I haven't yet had the procedure.

    I was told they will have to use excessive force to get past the cervix, which will cause so much pain it needs to be done under general anesthesia. It wasn't exactly reassuring, but I don't have a choice. So I decided to just stop thinking about it. (I generally don't worry much, but based on what my mother told me about her minor surgery, I wasn't sure if I was up to it. We're both hypothyroid, have a low stress tolerance and tend to get hypoglycemic. Fasting = bad BTW, my niece has RA too. )

    Right after the unsuccessful procedure, I had menstrual-like bleeding. The following day I had bouts of weakness, muscle aches and heavy spotting. For one week, I had sharp pains and aching/burning in my lower abdomen. I mentioned these things to a nurse over the phone. She said it had nothing to do with the procedure and told me to contact my GP. To be sure, I called the office, and they said these types of procedures can cause persistent pain. I wish they'd told me that at the hospital. I mean, I know certain types of pain can drag on if left untreated. It would've been a good idea to take over-the-counter pain meds for a day or two to break the cycle. But either way, now I only have some occasional "sensations" like shooting pains, mild cramps and a sense of pressure. On the off-chance there's something wrong, they'll be able to tell when I check in next month.
    Jane Harrison Hohner, RN, RNP replied to Eufemia's response:
    Dear Eufermia: We appreciate the update. Yes, it does sound like you would be better served to not have this as an in office procedure. Hope the actual procedure goes more smoothly, and with less pain, than the initial attempt.

    Eufemia replied to Jane Harrison Hohner, RN, RNP's response:
    I had the procedure this week, and they still weren't able to insert the coils. This time it was because my endometrium was too thick. (Other than the fact that it failed, the whole thing actually went quite well. I've only experienced a bit of nausea and weakness, and very little pain and bleeding.)

    We decided that I'll take combined contraceptive pills for one cycle before the next attempt. I'm in need of advice again The nurse did give me instructions, but they were confusing at best, conflicting at worst. Okay, I'll start taking them on the first day of bleeding, around Feb 21. The procedure is scheduled for March 14. If I understood correctly, I should keep taking them until then. That's about 22 days, 24 if my period starts a few days early again. So there isn't time for a scheduled bleeding. Does that sound right? Will it help thin out the endometrium?
    Conceptus replied to Eufemia's response:
    Please call us, we are representatives of Conceptus, makers of Essure?. We would like to help and are available at (800) 550-0095. If you prefer you can leave a message and ask to be contacted at a particular time and number. We look forward to speaking with you. Thank you.

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