The FDA on November 1, 2016, has required that the product packaging for the Essure devices have warnings about adverse effects.
I doubt any women who have these devices implanted see the box they come in. What really is needed is a required consent that the patient has to sign. IUD devices used to have such consents but I believe it was to cover the manufacturer’s liability not for the patient’s information. I always feel obligated when discussing Essure devices to point out that most people do very well with them. They are more difficult to reverse than other types of tubal ligation. If a patient just wants them removed without restoration of her fertility it can be easily done as an outpatient.
We recently have seen a description of a technique to remove the Essure devices by cutting a hole around them where they enter the uterus. I feel this is not a good idea from a safety standpoint. The uterine blood supply comes up the side of the uterus and turns out along the underside of the fallopian tube. Right where the Essure goes into the uterine wall these large blood vessels turn and they can bleed terribly if they are accidentally cut. In my opinion, this is not something that should be done outside a hospital with plenty of blood available.