CASE REPORT   

Gazzetta Medica Italiana Archivio per le Scienze Mediche 2017 December;176(12):691-3

DOI: 10.23736/S0393-3660.17.03467-2

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

Allergic reaction to Essure® contraceptive devices: a case report

Lara CASEIRO ¹ ✉, Ana REGALO ¹, Cristina BRAGANÇA ², Maria J. JANEIRO ², Telma ESTEVES ¹

¹ Department of Obstetrics and Gynecology, Hospital Espírito Santo E.P.E., Évora, Portugal; ² Hospital José Joaquim Fernandes, ULSBA E.P.E., Beja, Portugal

Hysteroscopic tubal sterilization, Essure®, is a minimally invasive option for permanent contraception that includes a nickel-titanium alloy which may cause an allergic reaction. This is rare but it requires the devices’ removal for the symptoms’ regression. A 36-year-old woman, Caucasian, G4P3, was submitted to Essure® insertion for definitive contraception. Insertion of the right Fallopian tube device had to be repeated three months later because the first one was displaced. One day after the second procedure of hysteroscopic Essure® placement, the patient developed a pruriginous rash. Nickel hypersensitivity was confirmed in a patch test and consequently the removal of the devices was performed, in a procedure combining hysteroscopy and laparoscopy. One of the devices was extracted by hysteroscopy 9 months after its insertion, while the other tuba occluding device that had been implanted 3 months later was removed by laparoscopy. The symptoms regressed after removal of the implants. Nickel allergy to Essure® devices is rare but led to disabling symptoms and consequently to its removal. Although it has been reported in the literature that hysteroscopic removal is possible only up to 6 weeks after initial insertion, the extraction of a device inserted 9 months ago was successful.

KEY WORDS: Contraceptive devices - Nickel - Hypersensitivity - Hysteroscopy - Laparoscopy