@article {10540, title = {Essure Permanent Birth Control, Effectiveness and Safety: An~Italian 11-Year Survey.}, journal = {J Minim Invasive Gynecol}, volume = {24}, year = {2017}, month = {2017 May - Jun}, pages = {640-645}, abstract = {

STUDY OBJECTIVE: To describe safety, tolerability, and effectiveness results through a minimum 2-year follow-up of patients who underwent permanent sterilization with the Essure insert.

DESIGN: A retrospective multicenter study (Canadian Task Force classification II2).

SETTING: Seven general hospitals and 4 clinical teaching centers in Italy.

PATIENTS: A total of 1968 women, mean age 39.5~years (range, 23-48~years) who underwent office hysteroscopic sterilization using the Essure insert between April 1, 2003, and December 30,~2014.

INTERVENTION: The women underwent office hysteroscopic bilateral Essure insert placement, with satisfactory device location and tube occlusion based on hysterosalpingography or hysterosalpingo-contrast sonography (HyCoSy).

MEASUREMENTS AND MAIN RESULTS: Placement rate, successful bilateral tubal occlusion, perioperative adverse events, early postoperative (during the first 3~months of follow-up), and late complications were evaluated. Satisfactory insertion was accomplished in 97.2\% of women and, in 4, perforation and 1 expulsion were detected during hysterosalpingography. Three unintended pregnancies occurred before the 3-month confirmation test. Two pregnancies were reported among women relying on the Essure inserts. Postprocedure pain was minimal and brief; in 9 women, pelvic pain became intractable, necessitating removal of the devices via laparoscopy. On telephone interviews, overall satisfaction was rated as "very satisfied" by the majority of women (97.6\%), and no long-term adverse events were reported.

CONCLUSION: The findings from this extended Italian survey further support the effectiveness, tolerability, and satisfaction of Essure hysteroscopic sterilization when motivated women are selected and well informed of the potential risks of the device. Moreover, the results do not demonstrate an increased incidence of complications and pregnancies associated with long-term Essure use. Patients with a known hypersensitivity to nickel may be less suitable candidates for the Essure insert.

}, keywords = {Adult, Fallopian Tubes, Female, Follow-Up Studies, Humans, Hypersensitivity, Hysterosalpingography, Hysteroscopy, Italy, Laparoscopy, Middle Aged, Nickel, Pain, Pregnancy, Pregnancy, Unplanned, Retrospective Studies, Sterilization, Reproductive, Sterilization, Tubal, Surveys and Questionnaires, Young Adult}, issn = {1553-4669}, doi = {10.1016/j.jmig.2017.02.004}, author = {Franchini, Mario and Zizolfi, Brunella and Coppola, Carmela and Bergamini, Valentino and Bonin, Cecilia and Borsellino, Giovanni and Busato, Enrico and Calabrese, Stefania and Calzolari, Stefano and Fantin, Gian Piero and Giarr{\`e}, Giovanna and Litta, Piero and Luerti, Massimo and Mangino, Francesco Paolo and Marchino, Gian Luigi and Molinari, Maria Antonietta and Scatena, Elisa and Scrimin, Federica and Telloli, Paolo and Di Spiezio Sardo, Attilio} } @article {7741, title = {Relevance of random biopsy at the transformation zone when colposcopy is negative.}, journal = {Obstet Gynecol}, volume = {125}, year = {2015}, month = {2015 Feb}, pages = {491}, keywords = {Cervical Intraepithelial Neoplasia, Colposcopy, Early Detection of Cancer, Female, Humans, Papillomavirus Infections, Precancerous Conditions, Uterine Cervical Neoplasms}, issn = {1873-233X}, doi = {10.1097/AOG.0000000000000652}, author = {Wiesenfeld, Uri and Mangino, Francesco Paolo and Toffoletti, Franco Giovanni and Ricci, Giuseppe} }