Your physician will use local anesthesia to numb the cervix. Some physicians may also offer additional medication that can help you relax and/or minimize any pain. In order to insert the Essure coils, your physician will have to slowly dilate (or open) the cervix.
The cervix can be dilated two ways:
Your physician may use a speculum to hold open the vagina. This is a device that resembles a metal beak of a duck. The instrument is inserted into the vagina, and its dull blades are separated and held open. Your physician will then insert a thin, smooth metal rod gently into the vagina and up into the tiny cervical opening. The rod is briefly left in place, taken out, and replaced by a slightly larger rod. This process is repeated until the cervix is wide enough to allow for the implants to be put in place. This takes about 10 minutes, and you may feel cramping and discomfort caused by the stretching of the cervical muscles to accommodate each rod.
Another way to dilate the cervix is through the use of an osmotic dilator, a device that absorbs moisture from the tissues around the cervix and slowly expands. The expansion of the dilator slowly opens the cervix and usually causes little discomfort. There are two common types of osmotic dilators:
- Laminaria is a small tube made of dried seaweed that is inserted into the cervix 8 to 24 hours before the tubal ligation procedure; it usually requires a woman to come in the day before her procedure to have this inserted. Most of the cervical dilation happens within the first 6 hours, with maximum dilation occurring 12 to 24 hours after it is inserted.
- Dilapan (synthetic dilator) is a dry, sterile sponge that is inserted into the cervix several hours before the Essure procedure. A synthetic dilator tends to be easier to insert and opens the cervix in less time than the laminaria method.
