Hysteroscopic sterilisation The Essure TM method of permanent birth control uses very small coils, which are inserted through the cervix and uterus into the fallopian tubes. After the coils are placed, scar tissue develops around them, causing the tubes to become sealed shut. This process happens gradually over time, and the woman must therefore use another form of birth control for three months after the coils are placed. At this time, an x-ray test called a hysterosalpingogram (HSG) is performed to confirm that the tubes are blocked. Hysteroscopic sterilisation costs less, allows the woman to spend less time in the hospital, is well tolerated, and causes less severe post-operative pain. The disadvantages of hysteroscopic sterilisation include: the possibility that the coils cannot be successfully placed in both tubes (<2 percent) the need for another method of birth control for three months after the coils are placed the need for a test to confirm that the procedure has been successful the some women may report persistent pelvic pain the spotting from 2 weeks to 6 months while the IUD settles in. a follow-up visit will be made for 3-4 weeks to check on the placement and the bleeding pattern.