I saw my ob/gyn last week and she mentioned a new procedure called "Essure" that she says is much easier to do than a tubal (ligation) and can be done in her office. I didn't think to ask her how effective it is compared with a tubal ligation. Do you recommend the Essure procedure?

Answer: Essure was approved by the Food and Drug Administration in late 2002 as a minimally invasive way of performing permanent, non-reversible female sterilization. Unlike a tubal ligation, it does not require general anesthesia and can be performed in your doctor's office.

The technique is simple: Thin, flexible metal inserts are placed into the fallopian tubes using a catheter passed from the vagina through the cervix and the uterus. Once these inserts are in place, they induce tissue to grow in and around the micro-insert to form a permanent barrier that will prevent sperm from reaching an egg.

To verify Essure's success, an X-ray test is done at three months post-procedure where dye is inserted into the uterus to confirm that the fallopian tubes are completely blocked. Essure reports that complete occlusion can be expected in 96.5 percent of women at three months, with the remainder occluded by six months. Additional forms of birth control must be continued until success is confirmed.

In terms of its efficacy, the Essure procedure is 99.8 percent effective at four years post-procedure. That works out to a failure rate of 2 women per 1,000. In comparison, tubal ligation has a failure rate of 1 in 1,000.

To learn more about Essure, check out its Web site: http://www.essure.com

Doctor describes prostate as 'boggy'

A: Bogginess is a subjective description for a prostate that feels softer than normal. By digital rectal exam, the prostate should have the consistency of the tip of your nose. It also should feel smooth without nodules, as those are suspicious for prostate cancer.

What one doctor might describe as boggy, another doctor might describe as "a bit soft, but normal." A soft, fluctuant, boggy prostate - especially one that's tender - is suspicious for inflammation or infection of the prostate gland (i.e., prostatitis). With prostatitis, you'll usually have tenderness of the prostate, as well as discomfort with urination or ejaculation. The PSA blood test may also be elevated due to prostate gland inflammation and infection. BPH, the benign enlargement of prostate tissue seen with age, does not cause a boggy prostate.

If your PSA level is normal and not dramatically higher than the last PSA, if there's no tenderness on palpation of the prostate gland, and if there's no evidence of infection, I wouldn't be worried if your doctor thought your prostate gland felt a little bit soft.