Last June I wrote about a FDA approved non-surgical sterilization procedure for women called Essure. Since then, I have learned of another: Adiana.  Both have big benefits over getting a tubal ligation.

I had a chance to interview Dr. Schwartz, Adiana logo who has a good deal of experience in performing both procedures, and asked him to give me a comparison of the two.

What both procedures have in common

Both Essure and Adiana work by first putting an insert into the fallopian tubes. Then tissue grows around the insert to create a natural barrier so that eggs (oocytes) will not reach the beginning of the fallopian tube, and sperm won’t reach eggs.

Both procedures take very little time, don’t require anesthesia, and don’t require any incisions, as the inserts come in through the vaginal opening. Each requires a follow up visit 90 days after the procedure to ensure the tissue has grown; in the somewhat rare event it has not, the procedure can easily be done a second time.

Both have comparable failure rates: about 99% effectiveness.essure

Both are far more cost effective than a tubal ligation. Essure and Adiana cost about $3200. That is what the insurance company is billed, so given your coverage, the out of pocket cost will vary. They both can often be done in the doctor’s office, in which case there may only be a copayment. A tubal ligation typically costs about $15,000.

How they are different

Essure insertThe inserts are different. Essure’s insert is shaped like a coil, is made of stainless steel, polyethylene fibers and nickel titanium, and is about 3.6 centimeters long. The Adiana insert is shaped like a grain of rice, is made of pure silicon (not the kind of silicon that had been used in breast implants), is flexible and lubricous, and is .4 centimeters long.

The placement of the inserts is a bit different: the Adiana insert is placed 1.4 cm into the intramural portion of the fallopian tube (the part of the tube which is in the wall of the uterus). The Essure coil is placed 3.6 cm into the fallopian tube.

While both are made of materials that the body accepts, sometimes women have a reaction to the nickel, which would prevent them from doing the Essure procedure.

The size, placement and composition of the Essure insert can cause post-procedure discomfort, including cramping, and bleeding.  The smaller size, placement and composition of the Adiana insert, however, make for no post-procedure discomfort.

Which to choose?

Although Essure had been on the market longer (Adiana was approved by the FDA in 2009 and Essure in 2002), Dr. Schwartz predicts Adiana will eventually take a larger share of the market. In his opinion, “..the Adiana device is easier to insert and better for the patient since no part of it protrudes into the uterine cavity or out into the fallopian tube” (which can create the post-procedure discomfort).

In a word, “Essure is good, but Adiana is better.” That is why Dr. Schwartz chooses to the Adiana procedure with his patients.

He is also a doc to put on the Ohio Doc Friendly list when it comes to sterilization! Thank you, Dr. Schwartz.

Anyone familiar with both procedures? Write in what you know!

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