(1) Background: Complications arising from hysteroscopically-placed
intratubal micro-insert devices are uncommon. Partial and complete
perforations occur in approximately 0.9% to 2.6% while movement of the micro-insert device within the abdomen is even more rare.
(2) Case : In this case report, the initial placement of the Essure® microinsert device was uncomplicated, but concerns of cornual or fallopian tube perforation were apparent on the confirmation hysterosalpingogram (HSG) when free tubal spill was appreciated. After a succession of hysteroscopic and laparoscopic evaluations, and a final specimen dissection, the microinsert device was found penetrating superior to the tubal ostia and embedded in the myometrium without perforation through the uterine serosa.
(3) Conclusions: Adenomyosis may contribute to the malpositioning of a micro-insert device into the myometrium. Retrograde micro-insert movement may be due to the myometrial inflammatory response. Thorough discussion of a patient’s desires is necessary for proper surgical consent and management.
