Permanent implantable contraceptive intratubal occlusion device(s) and delivery system
HCPCS code
Name of the Procedure:
Permanent Implantable Contraceptive Intratubal Occlusion Device(s) and Delivery System
Common names: Permanent birth control, Non-surgical tubal occlusion
Medical terms: Permanent implantable contraceptive, Intratubal occlusion
Summary
A permanent birth control method where a small device is placed into each of a woman's fallopian tubes to block them. This procedure prevents the sperm from reaching the egg, thereby preventing pregnancy.
Purpose
Medical Conditions:
- Desire for permanent contraception.
Goals/Expected Outcomes:
- Provide a long-term, permanent solution for birth control without the need for daily, monthly, or periodic attention.
- To prevent unintended pregnancies.
Indications
Symptoms/Conditions:
- Women seeking permanent contraception.
Patient Criteria:
- Completed childbearing or do not wish to become pregnant in the future.
- Discussed and comprehended the permanence of the procedure with a healthcare provider.
Preparation
Pre-Procedure Instructions:
- Evaluate with a healthcare provider.
- Possibly avoid certain medications (e.g., blood thinners) before the procedure.
- Follow specific instructions provided by the healthcare team.
Diagnostic Tests:
- Pregnancy test to ensure the patient is not currently pregnant.
- Fertility counseling and thorough patient history review.
Procedure Description
- The patient is usually placed under local anesthesia.
- A hysteroscope (a thin, lighted tube) is inserted through the cervix and into the uterus to guide the placement.
- Small devices are placed into the fallopian tubes through the hysteroscope.
- The devices cause tissue growth that permanently blocks the tubes.
- The procedure typically does not require incisions.
Tools/Equipment:
- Hysteroscope, implantable occlusion devices.
Anesthesia:
- Local anesthesia, sometimes accompanied by mild sedation.
Duration
Typically about 30 minutes to an hour.
Setting
Outpatient clinic, surgical center, or hospital.
Personnel
- Gynecologist or specialist surgeon
- Nurses
- Anesthesiologist (if sedation is used)
Risks and Complications
Common Risks:
- Pain, cramping, or bleeding immediately after the procedure.
- Incomplete occlusion requiring additional procedures.
Rare Risks:
- Infection.
- Perforation of the fallopian tubes or uterus.
- Allergic reaction to the device or anesthesia.
Management:
- Follow-up care to monitor and address any complications.
Benefits
- Permanent birth control solution.
- No need to remember daily medications or regular contraceptive measures.
- Quick recovery time compared to surgical options like tubal ligation.
Recovery
Post-Procedure Care:
- Rest on the day of the procedure.
- Avoid heavy lifting or strenuous activity for a few days.
- Pain relief with over-the-counter medication as needed.
Expected Recovery Time:
- Most women return to normal activities within a day or two.
- Sexual activity can usually be resumed shortly afterward, as advised by the healthcare provider.
Follow-Up:
- A confirmation test (e.g., HSG - hysterosalpingogram) after a few months to ensure the tubes are fully occluded.
Alternatives
Other Treatment Options:
- Tubal ligation (surgical).
- Long-acting reversible contraception (IUDs, implants).
- Hormonal birth control methods (pills, patches, injectables).
Pros and Cons:
- Alternatives like IUDs and hormonal methods
- less permanent but require ongoing management.
- Surgical options
- very effective; involve more significant recovery and surgical risks.
Patient Experience
During Procedure:
- Mild to moderate discomfort due to the anesthesia and the procedure itself; typically well-tolerated.
After Procedure:
- Mild cramping or discomfort.
- Manageable pain levels with over-the-counter pain relievers.
- Minimal downtime and quick return to normal activities.