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PubMed1993

[Spontaneous pregnancy, independent of treatment, in sterile couples].

The spontaneous pregnancy independent of treatment in sterility is a frequently observed event in this group of couples. The spontaneous pregnancy appears up to 61% of women with antecedents of sterility and in selected populations of healthy women; a third of them experience, once in their lives a subfertility episode. The characterization of this event in a population with sterility, will help to define the capacity of different diagnostic methods, as well as therapeutic methods in terms of efficacy. The objective of this study was to identify women with diagnosis of sterility and spontaneous pregnancy; to describe the main characteristics: clinical, of laboratory, of gabinet, and to discuss some implications of biological variability useful in the interpretation of these tests. One hundred and eleven patients with sterility and spontaneous pregnancy, in a descriptive and retrospective design, were analyzed. Operational definitions for the main factors related with sterility, were used, as tuboperitoneal, endocrine-ovarian, cervico-vaginal and masculine. The pregnant patients related to any type of treatment, were excluded. Two study groups were established: Group I (n-46) and Group II (n = 65) with primary sterility and secondary sterility, respectively. Average age for both groups was similar (mean = 29 years old). The time of sterility was 46.52 and 43.52 months, for Group I and II, respectively. The time of pregnancy from the point zero (admission), was, in average 6.21 and 4.9 months for Group I and II. The following factors were identified as abnormal: endocrine-ovarian 28.60 by menstrual pattern, progesterone and endometrial biopsy: tuboperitoneal 12.67% by hysterosalpingography and laparoscopy; masculine 12.67 by direct spermatobioscopy.(ABSTRACT TRUNCATED AT 250 WORDS)

Biopsy↗
PubMed1986

Mortality associated with sterilization: preliminary results of an international collaborative observational study.

Sterilization is the contraceptive method most widely used worldwide, yet the case-fatality rate of deaths attributable to sterilization is not known. We used data collected from 1971-1979 from 28 countries by Family Health International to estimate case-fatality rates. We adjusted these rates for individuals lost to follow-up. Of 41,834 sterilizations, 23 resulted in deaths temporally associated with the procedure used. The adjusted attributable case-fatality rates were 13.4 per 100,000 for interval procedures, 53.3 per 100,000 for postabortion procedures, and 43.4 per 100,000 sterilizations after vaginal delivery. Multiple factors contributed to the deaths, including pre-existing health problems, infection and anesthesia. Prevention of deaths resulting from sterilization depends on complete ascertainment of deaths associated with sterilization and careful investigation to determine preventable risk factors. We conclude that, overall, sterilization in these programs was conducted with very low attributable mortality.

Female↗
PubMed1986

Presterilization counseling and women's regret about having been sterilized.

A study was designed to assess satisfaction with presterilization counseling, contentment with being sterilized and the effect of variables, such as age, number of children at the time of surgery and ethnic background, on the level of contentment with being sterilized. A total of 1,716 questionnaires were distributed at various hospitals and clinics. Questionnaires were collected from 492 women, who had ranged from 17 to 46 years of age at the time of sterilization. The majority of the women were married, and their average number of children was two. Of 487 women who replied, 30% did not receive any presterilization counseling from a physician; 15% of 480 women received their counseling from a nurse. Of 487 women, 2% fully regretted their sterilization, and the majority of them wanted more children. A positive correlation was found between the degree of satisfaction with presterilization counseling and the level of contentment with being sterilized. It was also found that 6 of the 53 women who were under 25 years of age at the time of surgery fully regretted their sterilization. The ethnic backgrounds of the women and their number of children at the time of surgery had no significant effect on their contentment with sterilization.

Adaptation, Psychological↗
PubMed2005

Postpartum sterilization choices made by HIV-infected women.

OBJECTIVE: To assess if HIV-infected women made different choices for postpartum sterilization after implementation of the Pediatric AIDS Clinical Trials Group protocol 076 (November 1, 1994) compared to before implementation. STUDY DESIGN: A retrospective cohort study in which medical records were reviewed to obtain demographic, obstetric and HIV-related data from January 1993 through December 2002. HIV-infected women who completed a pregnancy by birth or abortion were divided into two comparison groups: "Pre-076" and "Post-076". The primary outcome was sterilization by postpartum tubal ligation.Results. Forty-two women (74%) in the Pre-076 group chose sterilization compared to 139 of 310 women (45%) in the Post-076 group (unadjusted OR 3.44, 95% CI 1.83, 6.47). Seventy-one percent of women younger than 21 years of age in the Pre-076 Group chose sterilization compared with only 35% of women younger than 21 years in the Post-076 group (p = 0.0136). Similarly, 78% of primiparous women chose sterilization after their first pregnancy in the Pre-076 group, compared to 14% in the Post-076 group (p < 0.001). CONCLUSIONS: Since the implementation of PACTG 076 protocol in November 1994, fewer HIV-infected women chose postpartum sterilization. The typical woman who now chooses postpartum sterilization is less likely to be young or primiparous than those who chose sterilization before PACTG Protocol 076 implementation.

Adult↗
PubMed1985

Comparative risks and costs of male and female sterilization.

Couples who are considering elective sterilization should compare the risks and costs of male and female sterilization procedures as part of the decision process. Morbidity, mortality, failure rates, and short-term costs associated with male and female sterilization procedures were estimated from data available in previous case series. Male sterilization procedures were found to have zero attributable deaths and significantly less major complications when compared to female sterilization procedures. No less than 14 deaths a year can be attributed to female sterilization procedures in the US. Male and female sterilization procedures have efficacy rates that are not significantly different from each other. The short-term costs of female sterilization are 3.0 to 4.1 times that of vasectomy.

Adolescent↗
PubMed1998

Surgical sterilization in the United States: prevalence and characteristics, 1965-95.

OBJECTIVES: This report presents national data on the prevalence of surgical sterilization from 1965 to 1995 among women 15-44 years of age. Data are shown by type of sterilizing operation and demographic characteristics of the women. For the 1995 survey data, reasons for the three most common sterilizing operations (tubal ligation, vasectomy, and hysterectomy) are shown, as well as the desire for reversal among those with potentially reversible operations. METHODS: Data are based on nationally representative samples of women 15-44 years of age: the 1965 National Fertility Study (NFS), and the 1973, 1982, 1988, and 1995 cycles of the National Survey of Family Growth (NSFG). RESULTS: After rising from 16 to 42 percent between 1965 and 1988, the prevalence of surgical sterilization among married women 15-44 years old remained stable at 41 percent in 1995. Age, parity, religious affiliation, and education continued to be strongly associated with overall surgical sterilization levels. Tubal ligation and vasectomy were equally prevalent in the 1965 and 1973 surveys, but since 1962, tubal ligation has been more prevalent than vasectomy. CONCLUSIONS: Several factors contributed to the rise in reliance upon surgical sterilization among women 15-44 years old over the last 3 decades: (a) aging of the post-World War II Baby Boom women (and their partners) through the primary reproductive years; (b) relatively high contraceptive failure rates, particularly among socioeconomically less advantaged women; and (c) higher expectations for contraceptive effectiveness, safety, and convenience. Overall sterilization prevalence may be leveling off among women 15-44 years old, in part due to greater delay of first and subsequent births, thus making sterilization less of a concern while women are in this age range.

Adolescent↗
PubMed1991

Impact of tubal sterilization and vasectomy on female marital sexuality: results of a controlled longitudinal study.

To determine if female or male sterilization affects long-term female marital sexuality, we prospectively compared baseline data and 5 consecutive years of follow-up data from 152 tubal sterilization women, 106 vasectomy wives, and 83 women not planning sterilization. By follow-up year 5, no group of women expressed any change in satisfaction with their own sexual response; however, all groups showed a significant decrease across time in satisfaction with their sexual relationship, in coital desire, and in coital frequency. There were no group differences in overall net changes or in rates of change over the 5-year period. However, two short-term group differences were noted: a decrease in coital desire among women not planning sterilization between baseline and follow-up year 4, compared with increases for both sterilization groups, and an increase in coital frequency at the first follow-up year only in the tubal sterilization group. These data indicate that there are no detrimental effects and some short-term benefits of both sterilization procedures on female marital sexuality.

Adult↗
PubMed1992

Tubal sterilization and risk of subsequent hospital admission for menstrual disorders.

OBJECTIVE: Our objective was to investigate tubal sterilization and subsequent hospitalization for menstrual disorders. STUDY DESIGN: Automated discharge data were used in a population-based cohort study of 7253 women aged 20 to 49 years with tubal sterilization (1968 through 1983) at Group Health Cooperative of Puget Sound. Comparisons were with an age-matched cohort of 25,448 nonsterilized women and a nonmatched cohort of 5283 spouses of men with vasectomies. RESULTS: In the sterilization cohort, 282 had hospitalization for menstrual disorders (curettage, n = 191; hysterectomy, n = 66; nonsurgical, n = 25). Risk of hospitalization for menstrual disorders was 2.4 times greater after tubal sterilization (95% confidence interval 2.0 to 2.9). This risk was 6.1 times greater for sterilized women aged 20 to 24 years (95% confidence interval 0.72 to 3.2). Compared with the risk for nonsterilized women whose spouses had a vasectomy, the risk was 1.6 times greater (95% confidence interval 1.3 to 2.1). Hospitalization for menstrual disorders was not more common after unipolar sterilization than after other methods, as might have been expected if the menstrual disorder was related to impaired uteroovarian circulation. CONCLUSIONS: Tubal sterilization is associated with a greater risk of hospitalization for menstrual disorders. A biologic association is not supported by these results.

Cohort Studies↗
PubMed1987

Pregnancy following minilaparotomy tubal sterilization--an update of an international data set.

Seventeen pregnancies were reported from an international tubal sterilization data set comprising 1,862 minilaparotomy cases between 1978 and 1984. Of these 17, seven (41.2%) were diagnosed as luteal phase pregnancies. Of the 10 pregnancies due to sterilization failure, one was an ectopic pregnancy which occurred much later (20 months poststerilization) than the intrauterine pregnancies (10 months or less). Poststerilization pregnancy risk was greater among gravid women (those undergoing sterilization at the time of abortion or soon after childbirth) than among non-gravid women (those undergoing interval sterilization). These findings are, in general, consistent with those of previous studies using a much larger data set of primarily laparoscopic sterilizations. Pregnancies occurred with every type of mechanical tubal occlusion techniques included for study (the tubal ring, the Rocket Clip, the Secuclip and the Filshie Clip), and a frequently reported reason for failure was incorrect placement of the device. No pregnancies occurred in women sterilized with the non-mechanical Pomeroy/modified Pomeroy techniques. Findings of this analysis suggest that in minilaparotomy sterilization, for the mechanical tubal occlusion techniques to be as effective as the Pomeroy/modified Pomeroy techniques, more care and skill are required for the operator.

Adult↗
PubMed1996

An evaluation of the Filshie clip for postpartum sterilization in Austria.

Voluntary sterilization is a popular method of family size limitation. Among other techniques for surgical induction of female sterility, the application of various kinds of clips to the Fallopian tubes has been introduced. The Filshie clips consist of rubber-lined titanium and their use for interval sterilization has been repeatedly published. So far, there are only a few reports regarding the use of Filshie clips during the postpartum period, when tubes are edematous and more friable. Therefore, 300 women voluntarily requesting postpartum surgical sterilization for the purpose of family size limitation were enrolled into a prospective trial. Within 72 h of delivery, 282 women were sterilized under general anesthesia using a subumbilical minilaparotomy approach and Filshie clip application. Of these women, 251 were available for follow-up examination at 6 weeks, 240 at 6 months, 234 at 12 months, and 209 at 24 months after the sterilization procedure. Complication rates were low, and there were no pregnancies during the follow-up period. These results indicate that the application of Filshie clips is a safe and efficacious method of surgical female sterilization in the postpartum period.

Adult↗
PubMedDate not supplied

The provision of sterilization services by private physicians.

Obstetrician-gynecologists are 4-5 times more likely to perform female sterilizations, and urologists are 2-3 times more likely to perform vasectomies, than are general surgeons or general or family practitioners. Catholics are less likely to perform either procedure than are non-Catholics. Participation in a group practice and having a practice in the North Central region of the country are associated with carrying out a larger average number of both male and female sterilizations. More than half of female sterilizations are performed as inpatient hospital procedures, and most of the remainder are done in hospitals on an outpatient basis. Two-thirds of vasectomies, on the other hand, are performed in doctors' offices, while most of the rest are performed as hospital outpatient procedures. About one vasectomy in 12, however, is performed on an inpatient basis--possibly because general anesthesia is used, or the procedure is performed along with other surgery. The average cost for an inpatient female sterilization in 1982 was $1,335. The cost for a hospital outpatient sterilization was not much less than that. The total cost of a vasectomy ranged from an average of $511 for an inpatient procedure to $240 for one performed in the office. The average cost is higher when the sterilization is performed by an obstetrician-gynecologist or a urologist than when the service is provided by a general surgeon or general/family practitioner. Fifty-eight percent of physicians performing female sterilizations accept Medicaid reimbursement, and 12 percent reduce their fees to accommodate low-income patients. The proportions for doctors who perform vasectomies are 51 percent and 12 percent.(ABSTRACT TRUNCATED AT 250 WORDS)

Catholicism↗
PubMed1985

Factors associated with married women's selection of tubal sterilization and vasectomy.

Multivariate analyses of data from 248 married women scheduled for tubal sterilization and 165 wives of men scheduled for vasectomy indicated that male and female sterilization methods were selected for different reasons and under different circumstances. More specifically, the woman who underwent tubal sterilization was more likely to have perceived that she had greater influence than her husband over the sterilization decision, to have had cesarean section or vaginal delivery in association with sterilization, to have chosen tubal ligation because her spouse refused to undergo the alternative procedure or because it was convenient to combine it with delivery or other surgery, and to have had a spouse who was unwilling to be sterilized because of possible side effects associated with vasectomy. The woman whose husband underwent vasectomy was more likely to have been very fearful of surgery in general or especially fearful of reproductive surgery, to have known many men who already had had a vasectomy, to have perceived that her husband was more strongly motivated than herself to terminate childbearing, to have had a spouse who participated in birth control, and to have chosen vasectomy because it was easier or less expensive or because her physician advised against tubal sterilization.

Adult↗
PubMedDate not supplied

Why women don't get sterilized: a follow-up of women in Honduras.

In 1980, a study to determine interest in and access to sterilization for females was initiated at two Ministry of Health hospitals in Honduras. Results of the baseline study showed that 42 percent of women desiring sterilization from the Tegucigalpa hospital and 21 percent from the San Pedro Sula hospital had had a tubal ligation. A second study was conducted two years later, following up the interested but unsterilized women from the baseline study. Results show that 33 percent of women in the Tegucigalpa group, compared to 15 percent in the San Pedro Sula group, had been sterilized. Part of this difference can be attributed to an increase in sterilization facilities in Tegucigalpa over the two years after the baseline study was conducted. Among the major reasons women gave for not having been sterilized were financial and time constraints. Over the two-year period, the authors estimate that, of women interested in sterilization at delivery, 52 percent in total were sterilized in Tegucigalpa and 29 percent in San Pedro Sula.

Adult↗
PubMed1996

Sterility, mechanical properties, and molecular stability of polylactide internal-fixation devices treated with low-temperature plasmas.

The effect of low-temperature plasma on sterility, molecular, mechanical, and crystalline properties of poly (L-lactide), poly (L/D-lactide) and poly (L/DL-lactide) was investigated. Polymers were treated for 15 and 30 min at 100 W with nitrogen, argon, oxygen, and carbon dioxide plasma. All polymers treated with oxygen or carbon dioxide plasma were rendered sterile after 15 min of treatment. Only 70% of the samples treated under similar conditions with nitrogen or argon plasma were sterile. Extension of the exposure time to 30 min and increasing power to 200 W did not improve sterilization efficiency. Plasma sterilization, under the conditions used, caused no significant decrease or increase in overall molecular weight or polydispersity of the polylactides used. In most instances the effect of plasma sterilization was to slightly increase the overall molecular weight of the polymers studied. Treatment with argon plasma led to a more consistent increase in molecular weight than did treatment with nitrogen, oxygen, or carbon dioxide. Analysis of the surface (skin) of a poly(L-lactide) injection-molded rod following plasma sterilization indicated an increase in molecular weight as related to the interior (core) of the rod. Comparison of Mark-Houwink plots for the surface and interior of poly(L-lactide) injection-molded rods following plasma sterilization indicated an increase in chain branching for the surface relative to the interior of the rod. Generally the highly crystalline poly(L-lactide) was less susceptible to change upon plasma treatment than was the less crystalline poly(L/D-lactide) and poly(L/DL-lactide). The mechanical properties (shear strength, bending strength, and moduli) of the polylactides were not affected by plasma treatment. The overall melting temperature and the heat of melting of polylactides studied were not affected by plasma treatment. The melting temperature of the skin of the samples was about 1 degree C higher than the melting temperature of the core due to the chain orientation upon injection-molding. Plasma treatment of the polylactides reduced the melting temperature of the skin by 3 degrees C to 5 degrees C due to the crosslinking or branching at the surface layer.

Analysis of Variance↗
PubMedDate not supplied

A comparison of socio-demographic and fertility characteristics of women sterilized in hospitals and camps.

Socio-demographic characteristics of 5846 women undergoing sterilization in hospitals and 1752 women undergoing sterilization in camps in India are analyzed. The average age of women accepting sterilization was 29.8 years; the mean number of living children was 4.2. Women sterilized in hospitals were of significantly higher age and parity than those sterilized in camps. The mean parity for all women was 4.6. A steep increase in median parity was observed with increasing age in both hospitals and camps. The study indicates that, while the level of education may affect acceptance of sterilization, there is no minimum level of education necessary for its acceptance. Most of the women in the study were not gainfully employed. As expected most of the women were Hindus. Muslims were underrepresented in the hospital series; in camps, however, Muslims showed a much higher rate of acceptance of sterilization. The rate of pregnancy wastage was significantly higher in the hospital and the child loss rate was significantly higher for the camp cases. While the rate of previous abortions was higher for low parity women, the child loss rate was higher for high parity women. The child loss parity ratio was significantly higher for the camps than for the hospital cases. The vast majority of women in both hospitals and camps reported no previous contraceptive practice. Sterilization appears to have been the method of choice for most of these women.

Adult↗
PubMed1982

A new approach to sterilization conditions. The IMO concept.

The sterilization requirements for medical/pharmaceutical applications are traditionally based on an extensive overkill. In the past few years, however, an evolution towards bioburden related sterilization processes has been started (F0 theory). Especially manufacturers of large volume parenterals have - forced by the thermolability of the product - contributed to this development. In this paper both philosophies are combined, resulting in a concept in which the bacteriological and physical bases of the sterilization process are mathematically related by using the F0 theory and by introducing an Imaginary Micro-Organism (IMO). The IMO concept provides the opportunity for anyone in the field of sterilization to raise the quality control level, which can be achieved by: - selecting optimum sterilization conditions without performing pre-sterilization counts: - step by step introducing the pre-sterilization count which results in even more favourable sterilization conditions.

Geobacillus stearothermophilus↗
PubMed2004

Corrosion of orthodontic pliers using different sterilization procedures.

AIM: The aim of this study was to investigate the corrosion resistance of orthodontic pliers from several manufacturers following different sterilization procedures, namely heat sterilization and the use of a disinfectant agent (Sekusept Extra N in an ultrasonic bath. MATERIAL AND METHODS: Employed in this study were ten distal-end cutters and ten Weingart pliers manufactured by Aesculap, ETM and Hu-Friedy, examined under electron microscopy for evidence of corrosion following 500 sterilization cycles. The corrosion data were recorded photographically and graphically. Metallographic microsections were prepared from each pair of pliers and were then analyzed by means of EDX measurements to assess the chemical alloy composition. RESULTS: The light and electron microscopic evaluation showed that both heat sterilization and high level disinfection caused corrosive changes on the pliers. However, the type of corrosion differed between the two sterilization methods. The main type of corrosion with Sekusept Extra N was pitting, while with heat sterilization it was surface corrosion. Heat sterilization was the type of corrosion that caused the most corrosive changes, regardless of which type of corrosion was considered. However, these results must be viewed critically, because pitting corrosion is obviously a more severe problem than surface corrosion. In comparing the pliers of various manufacturers, differences were noted. However, it was difficult to rank them when the correct maintenance regime was adhered to. The soldered joint gap was revealed to be a specific weak point, and that area proved to be inadequate due to qualities related to their production, particularly in the Hu-Friedy pliers. CONCLUSIONS: This study showed that heat sterilization leads to less corrosion than cold disinfection. Corroded pliers can be restored to a useable condition by re-polishing, though it is important that the instructions for their care be strictly adhered to.

Corrosion↗
PubMed1998

[Changes in crystallinity by sterilization and processing of ultrahigh molecular polyethylene used in endoprosthetics].

PURPOSE OF THE STUDY: We wanted to analyze crystallinity changes during sterilization in raw and in UHMWPE components for total joint arthroplasty manufactured. MATERIALS AND METHODS: To analyze the crystallinity DSC measurements and to determine the relative crystallinity infrared spectroscopy was performed. The DSC measurements were based on a comparison between the melting enthalpy of one known material to the unknown material. RESULTS: The raw manufactured non-sterilized sample showed a value for the DSC-measured crystallinity of 55.5%; the sample after gamma-sterilization without air was 56.0%, and with air 56.5%. The crystallinity after ethylene-oxide sterilization was 57.7% and after autoclavation 57.9%. The manufacturing time from the raw to the arthroplasty part showed some what different results. The average crystallinity of the samples differed between 55.4% and 61.6%. The best results were achieved in ETO-sterilized samples and one gamma-sterilized sample without air. The highest values were seen for the Hylamer. CONCLUSION: In summary, the best values for crystallinity were seen in both raw and completed arthroplasty products with ETO sterilization. For medical use cancerogenous factors must be excluded. Gamma-sterilization without air can be accepted as well. Increasing the crystallinity too much can lead to more wear debris.

Crystallization↗