Sterilisation technique offers quicker recovery for women

By MARTIN JOHNSTON health reporter

An Auckland doctor has introduced a new sterilisation method to New Zealand that promises a quicker recovery for women.

Ashton Parker, a gynaecologist based at Ascot Hospital, has so far used the technique on only two women here, but it has been used on more than 6000 women in Australia, North America and Europe since it was introduced in 2001.

The Essure method uses flexible, nickel-titanium coils containing Dacron fibres. They measure 4cm long and 2mm wide.

Using a tube called a hysteroscope inserted through the vagina, the gynaecologist places a coil in each fallopian tube. The coils induce tissue growth which blocks the tubes, usually within three months, preventing conception.

Mr Parker said it was less invasive than the usual method, tubal ligation, which involved cutting or blocking the fallopian tubes by laparoscopic surgery through small incisions in the abdomen.

"The benefit is that it can be done under local anaesthetic. Tubal ligation almost always in New Zealand is done under general anaesthetic."

He said the new method cost about $500 less than tubal ligation in private practice. It was unlikely to replace tubal ligation, but because of its lesser anaesthetic needs it could be attractive to public hospitals where women faced long waits for sterilisation.

Dr Keith Allenby, head of women's health at Middlemore Hospital, said women's access to sterilisation from the Counties Manukau District Health Board was inadequate, but better than last year. Women considered high priority now wait up to two months for sterilisation.

But he is in no hurry to adopt the new procedure. "Gynaecologists do rush into new technology - we've seen that with incontinence technology - and a few years down the line they find it's not very good."

A College of Obstetricians and Gynaecologists spokesman, Dr Alastair Haslam, said he was pleased Essure had been brought to New Zealand, but a drawback was its irreversibility.

"Most people going into sterilisation don't want it reversed but things do happen with marriages and children.

"Depending on the technique ... there may be a 50 per cent chance of reversal [with tubal ligation]."

Conceptus, the company which makes Essure, said women who had the coils implanted found they could return to regular activities in one or two days, compared with four to six days with tubal ligations.

Once proven by an x-ray after three months to have blocked the fallopian tubes, the new method was, like tubal ligation, more than 99 per cent effective.

How it works

Usual method: Tubal ligation Fallopian tubes are cut, clamped, tied or burned shut.

Reversible in about half of cases.

Costs about $3500, but free to women in public hospitals.

New method: Implanted coil Flexible coil in fallopian tubes induces tissue growth to block them.

Irreversible procedure.

Costs about $3000. Not yet available in public hospitals.