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A comparison of different laparoscopic sterilization occlusion techniques in 24,439 procedures.

Abstract

This investigation assessed the safety and efficacy of five laparoscopic tubal occlusion techniques for female sterilization: electrocoagulation, the tubal ring via conventional and open laparoscopy, the prototype spring-loaded clip, and the Rocket clip. The 24,439 cases make up a data set collected by collaborating staffs at 64 institutions in 27 countries. The five techniques were compared with respect to six commonly evaluated parameters. Rates of surgical difficulties ranged from 2.4% to 12.5% (5.1% overall); rates of surgical complications, from 0.7% to 2.7% (1.7% overall); and rates of technical failures, from 0.6% to 1.0% (0.8% overall). Twelve-month life-table pregnancy rates were less than one per 100 women years. Prospective data on six menstrual parameters revealed that the menstrual cycles of the majority of women were unchanged after sterilization; for those who reported a change, approximately half experienced a change in one direction and half in the other direction. For example, one half reported an increase in the amount of menstrual flow, and one half reported a decrease in the amount of flow. The reported incidence of subsequent pelvic operations was less than 1% at each long-term follow-up. These data indicate that laparoscopic sterilization is safe and effective and that none of the studied techniques has a distinct advantage.

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    MeSH

    Actuarial Analysis
    Adult
    Electrocoagulation
    Evaluation Studies as Topic
    Female
    Follow-Up Studies
    Humans
    Laparoscopy
    Menstruation
    Postoperative Complications
    Pregnancy
    Safety
    Sterilization, Tubal

    Pub Type(s)

    Comparative Study
    Journal Article
    Research Support, U.S. Gov't, Non-P.H.S.

    Language

    eng

    PubMed ID

    6214956

    Citation

    TY - JOUR T1 - A comparison of different laparoscopic sterilization occlusion techniques in 24,439 procedures. AU - Bhiwandiwala,P P, AU - Mumford,S D, AU - Feldblum,P J, PY - 1982/10/1/pubmed PY - 1982/10/1/medline PY - 1982/10/1/entrez KW - Age Factors KW - Clips KW - Comparative Studies KW - Contraception KW - Contraception Failure KW - Contraceptive Usage KW - Demographic Factors KW - Electrocoagulation KW - Endoscopy KW - Equipment And Supplies KW - Examinations And Diagnoses KW - Family Planning KW - Female Sterilization KW - Fertility KW - Gynecologic Surgery KW - Laparoscopy KW - Menstrual Cycle KW - Menstruation KW - Parity KW - Physical Examinations And Diagnoses KW - Population KW - Population Characteristics KW - Population Dynamics KW - Pregnancy Rate KW - Pregnancy, Unplanned KW - Reproduction KW - Reproductive Behavior KW - Research Methodology KW - Sterilization, Sexual KW - Studies KW - Surgery KW - Treatment KW - Tubal Occlusion KW - Urogenital Surgery SP - 319 EP - 31 JF - American journal of obstetrics and gynecology JO - Am. J. Obstet. Gynecol. VL - 144 IS - 3 N2 - This investigation assessed the safety and efficacy of five laparoscopic tubal occlusion techniques for female sterilization: electrocoagulation, the tubal ring via conventional and open laparoscopy, the prototype spring-loaded clip, and the Rocket clip. The 24,439 cases make up a data set collected by collaborating staffs at 64 institutions in 27 countries. The five techniques were compared with respect to six commonly evaluated parameters. Rates of surgical difficulties ranged from 2.4% to 12.5% (5.1% overall); rates of surgical complications, from 0.7% to 2.7% (1.7% overall); and rates of technical failures, from 0.6% to 1.0% (0.8% overall). Twelve-month life-table pregnancy rates were less than one per 100 women years. Prospective data on six menstrual parameters revealed that the menstrual cycles of the majority of women were unchanged after sterilization; for those who reported a change, approximately half experienced a change in one direction and half in the other direction. For example, one half reported an increase in the amount of menstrual flow, and one half reported a decrease in the amount of flow. The reported incidence of subsequent pelvic operations was less than 1% at each long-term follow-up. These data indicate that laparoscopic sterilization is safe and effective and that none of the studied techniques has a distinct advantage. SN - 0002-9378 UR - https://www.unboundmedicine.com/medline/citation/6214956/A_comparison_of_different_laparoscopic_sterilization_occlusion_techniques_in_24439_procedures_ L2 - https://linkinghub.elsevier.com/retrieve/pii/0002-9378(82)90585-3 ER -