Pelvic pain associated with an Essure((R)) device and nickel allergy. In relation to 3 cases

Essure (R) is the first intratubal device for permanent contraception inserted under hysteroscopic guidance. A rare complication of this device is pelvic pain, which can be related to allergy to one or more of its components, mainly nickel. Nickel is the most common contact allergen in the industrialized world, and consequently the number of published reports may not reflect the true extent of this complication in women with an Essure (R) device. We report 3 cases of pelvic pain in patients with nickel allergy that was not detected before Essure (R) insertion. The pain resolved after removal of the device in 2 women. An expectant attitude was adopted in the third woman. Currently, few cases have been reported on this topic. It is generally accepted that the device should be removed in women with pelvic pain lasting for more than 6 weeks. In addition, these women should also undergo testing for nickel allergy. (C) 2012 Elsevier Espana, S.L.U. All rights reserved.