Hysteroscopic Permanent Female Sterilization Esterilização Permanente Feminina por Histeroscopia GUILHERME HENRIQUE SILVEIRA1; MARCO AURELIO PINHO DE OLIVEIRA2; CLAUDIO PEIXOTO CRISPI3; MARCIO LAMBLET4

Birth control is a necessity in society. Contraceptive methods facilitate family planning. The oral contraceptive pill (OCP) is the most popular temporary method. Female sterilization is a definitive method of contraception. The surgical approaches for female sterilization include laparotomy and minimally invasive techniques such as laparoscopy for tubal ligation (TL), and tubal occlusion by microdevices (ESSURE and ADIANA), guided by hysteroscopy, whose main advantages are: outpatient placement, no incisions and no anesthesia. ESSURE is composed of stainless steel, nitinol and Dacron. Its mechanism of action is attributed to the production of localized fibrous reaction. It is indicated for women who are secure in certain that they want definitive sterilization. It is especially beneficial to those with comorbidities that place them at increased surgical risk. It is contraindicated in pelvic inflammatory disease, steroid use and abnormal uterine bleeding. Other contraceptive methods should be used during the first three months after insertion of the microdevice, at which time an imaging test, such as hysterosalpingogram, plain radiograph (X-ray) or ultrasound should confirm tubal occlusion. The method achieves 99.8% efficacy. The most common complications are utero-tubal perforation and expulsion of the microdevice. Costs are similar to those of tubal ligation by laparoscopy and the learning curve is small.