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[Complications in women after operative sterilization (author's transl)].

In the last thirty years sterilisation was applied in 26(15.02%) women vaginally and in 147(84.97%) women by lower medial laparotomy. In 86(46.71%) cases the binding of the tubes was performed as an additional operation during caesarean section. The binding of the tubes was carried out by Madlener's method and in some cases by Pomeroy's method. In three cases there was repeated pregnancy. All early complications (fever, pneumonia, thrombophlebitis, paresis intestini, subileus, peritonitis, suppuration of a suture, dehiscence) were within percentage limits given by other authors. These complications are not meant to be connected with the binding of the tubes. All the patients declared that after operation they were feeling much better regarding their sexual life (there was no fear of possible pregnancy) and that they did not notice any reduction of the libido or any change in this field.

Female

Factors influencing the outcome of microsurgical tubal ligation reversals.

Seventy-three patients who underwent a microsurgical tubal reversal were reviewed in an effort to determine what factors influenced outcome. A 64% intrauterine pregnancy rate was achieved 6 months to 4 years postoperatively. There was a 4.4% incidence of ectopic pregnancies in this group. On the basis of a preoperative laparoscopy, no reversals were performed unless a total tubal length of 4 cm or more could be obtained. The final tubal length, the time interval from sterilization to reversal, and the site of reanastomosis did not influence the eventual outcome. The reversals were then evaluated by the type of sterilization procedure performed (Pomeroy, coagulation, falope ring, and Irving). The pregnancy rate was not statistically different in each group. Sterilizations performed by coagulation, however, were only reversible 58% of the time compared to 91% for the noncoagulation procedures because of extensive tubal destruction (p less than 0.001). It also took longer for the coagulation patients to conceive, with the average conception occurring in 13.0 months compared to 6.7 months for the noncoagulation group (p less than 0.001). A higher incidence of ectopic pregnancies occurred in the thermal burn patients as well. The longer interval for conception and the higher ectopic pregnancy rate may represent mucosal damage in coagulation patients beyond the anastomotic site.

Adult

Puerperal laparoscopic sterilization.

One hundred sixty-eight cases of puerperal laparoscopic sterilization are presented. The operative technique, complications, and morbidity are discussed. Intraoperative and postoperative complications occurred in six patients (3.6%). Operative time (21 minutes) and postoperative stay (2.4 days) compared favorably with those of the concurrent series of 148 open postpartum ligations. It was concluded that puerperal laparoscopic sterilization in expert hands is a safe, viable alternative to laparotomy.

Female

Safety of postabortion sterilisation compared with interval sterilisation. A controlled study.

406 women--about one-fifth of those requesting an induced abortion and sterilisation over a thirty-three-month period--volunteered to be allocated randomly to either a concurrent induced-abortion/sterilisation group or a group which was sterilised six weeks after abortion. The abortion-attributable and sterilisation-attributable complication rates of 3.8% and 5.2%, respectively, for the concurrent group did not differ significantly from the 6.7% and 6.9% rates for the interval group. The estimated 2%-10% of women who would have changed their minds must be set against the 4% of women who became pregnant again before being sterilised. Efforts should be made to identify women likely to regret sterilisation.

Abortion, Induced