Risks and Benefits of Culdoscopic Female Sterilization

Autor: Lynda Painter Cole, Margaret F. McCann
Rok vydání: 1978
Předmět:
Zdroj: International Journal of Gynecology & Obstetrics. 16:242-247
ISSN: 0020-7292
DOI: 10.1002/j.1879-3479.1978.tb00436.x
Popis: The risks and benefits of the culdoscopic approach to female sterilization are reviewed in an analysis of 2153 culdoscopic sterilization procedures (1123 Pomeroy or modified Pomeroy method 143 fimbriectomy/salpingectomy 766 tantalum clip and 113 tubal ring) performed at 11 centers in 9 countries (Asia Middle East and the Caribbean). Inability to occlude the tubes as planned was reported for approximately 6.0% of the cases including 1.4% in which 1 or both tubes could not be occluded by any technique. Surgical difficulties were reported for about 13.0% of the procedures and surgical complications of which the most frequent was torn or bleeding tubes occurred in 2.0% of the cases. At 7-21 days follow-up complications had occurred for a significantly higher proportion of fimbriectomy patients (11.7%) than for Pomeroy (4.0%) tantalum clip (5.0%) and tubal ring (6.5%) patients. There were technical failures for 76 (6.8%) of Pomeroy procedures 18 (2.3%) of the tantalum clip procedures and 3 (2.7%) for the tubal ring procedures. These failures were most often related to difficulties at surgery (3.7%) than to surgical complications (1.1%). Pregnancy rates were significantly higher for patients whose tubes were occluded by tantalum clips (7.7/100 women at 12 months) indicating that this is not the preferred technique of tubal occlusion; the 12-month life table pregnancy rates were .1/100 women for tubal ring and .0/100 for Pomeroy and fimbriectomy. Comparison of these data with similar pooled data on laparoscopy and minilaparotomy indicates that culdoscopy is associated with greater technical difficulty and mobidity. Thus abdominal procedures will continue to be preferred for use in most large-scale programs.
Databáze: OpenAIRE
Externí odkaz: