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PubMedDate not supplied

[Intrapartum and interval tubal sterilization].

BACKGROUND: Brazil is a country with a high prevalence of tubal ligation, which is frequently performed at the time of delivery. In recent years, an increase in tubal reversal has been noticed, primarily among young women. OBJECTIVES: To study characteristics correlated with the procedure, determine frequency of intrapartum tubal ligation, measure patient satisfaction rates and tubal sterilization regret, in a sample of post-tubal patients. METHODS: Three hundred and thirty-five women underwent tubal ligation. The variables studied were related to the procedure: age at tubal ligation, whether ligation was performed intrapartum (vaginal or cesarean section) or after an interval (other than the intrapartum and puerperal period), health service performing the sterilization, medical expenses paid for the procedure, reason stated for choosing the method and causes related to satisfaction/regret: desire to become pregnant after sterilization, search for treatment and performance of tubal ligation reversal. The women were divided into two groups, a group undergoing ligation in the intrapartum period and a second group ligated after an interval, to evaluate the association between variables by using Fisher's exact test and chi-squared calculation with Yates' correction. The study was approved by the Ethics Committee of the institution. RESULTS: There was a predominance of Caucasian women over 35 years of age, married, and with a low level of education of which 43.5% had undergone sterilization before 30 years of age. Two hundred and forty-five women underwent intrapartum tubal ligation, 91.2% of them had cesarean delivery and 44.6% vaginal delivery. In both groups undergoing intrapartum tubal ligation and ligation after an interval, 82.0% and 80.8% reported satisfaction with the method. Although 14.6% expressed a desire to become pregnant at some time after sterilization, consultation regarding sterility occurred in 3.4% and 2.3%, respectively, and one woman underwent tubal reversal. The most frequent reasons for choosing the method were satisfaction with the number of offspring (35.5% and 46.7%) and medical indication (41.6% and 32.2%), respectively. CONCLUSION: The incidence of intrapartum tubal ligation was higher when the last delivery had been a cesarean section. No difference was detected among the groups regarding rates of satisfaction and regret after performance of the sterilization procedure.

Adult↗
PubMed1983

[Request for reversal of tubal sterilization. Survey conducted by the National College of French Gynecologists and Obstetricians].

A retrospective enquiry was carried out by the National College of French Gynaecologists and Obstetricians to try to specify more clearly indications and contra-indications for tubal sterilization in sixty centres. 377 requests were analysed over the years 1979-1980-1981. The average age of these women was 33 and the interval following sterilization was of a mean of 5 years. Remarriage is the main reason for asking. Those women most likely to ask for reversal of sterilization were patients who were sterilized when young or who had had only one or two children, or who had been sterilized during Caesarean operation. Half the requests for reversal could not be granted, usually because the techniques used for sterilization were too mutilating (40% of the patients could not be operated on); even if the sterilization is to be considered as final these techniques should not be used.

Adult↗
PubMed1991

Tubal sterilization or vasectomy: how do married couples make the choice?

OBJECTIVE: To examine the relative importance of husband, wife, and couple factors as determinants of sterilization method choice. DESIGN: Married couples seeking sterilization interviewed before surgery and again 1 year later. SETTING: Kaiser Permanente Medical Care Program subscribers seeking care at the Kaiser Foundation Hospital, Santa Clara, California. PARTICIPANTS: Two hundred married women seeking a tubal sterilization and their husbands and 200 married men seeking a vasectomy and their wives. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Sterilization method chosen. RESULTS: In a logistic regression model, nine predictor variables correctly classified 94.9% of 395 couples (P less than 0.000). CONCLUSIONS: The choice of a sterilization method is achieved primarily through processes that involve both spouses. The motivations of both husband and wife, their mutual influence and communication, their present pattern of contraceptive use, and what they know about the satisfactions or dissatisfactions of other people who have had sterilizations are all factors that should be taken into account when the clinician helps a patient make the method-choice decision.

Choice Behavior↗
PubMed1997

Microsurgical reversal of tubal sterilization: a report on 1,118 cases.

OBJECTIVE: To review and evaluate a series of patients who underwent microsurgical anastomosis of previously sterilized fallopian tubes. DESIGN: Retrospective clinical study. SETTING: Tertiary care academic center. PATIENT(S): In the 134-month span from January 1980 to February 1991, 1,118 women were evaluated for microsurgical reversal of previous tubal sterilization. MAIN OUTCOME MEASURE(S): Clinical characteristics of patients, pregnancy rates (PRs), and factors influencing the outcome. RESULT(S): Of 1,118 patients, 633 (56.6%) had been sterilized by laparoscopic cautery. Loss of children was a leading reason for requesting tubal reversal. The mean interval between tubal sterilization and reversal was 51.9 months. Nine hundred twenty-two (82.5%) patients were followed up for > 5 years. The overall PR after microsurgical tubal anastomosis was 54.8% (505 of 922) with a delivery rate of 72.5% (366 of 505), and the estimated anatomical success rate was 88.2% (814 of 922). There was no statistically significant difference in the PR or in the interval from tubal reversal to conception among the different operative procedure groups. In addition, no statistically significant difference in the PR was observed regardless of the postoperative tubal length. However, the interval from operation to pregnancy decreased significantly as the postoperative tubal length increased. The pregnant patients (n = 505) were younger and had a longer postoperative tube than the nonpregnant patients (n = 417); these differences were statistically significant. CONCLUSION(S): The pregnancy rate after microsurgical reversal of tubal sterilization was not significantly correlated with the method and duration of sterilization, the operative procedure, or the postoperative tubal length.

Fallopian Tube Patency Tests↗
PubMed1981

The impact of laparoscopy on tubal sterilization in United States hospitals, 1970 and 1975 to 1978.

During the 1970s, tubal sterilization became an important method of fertility control in the United States. Over the same period laparoscopy emerged as an important innovation, one that has been associated with both a shift from postpartum to interval sterilization and a dramatic decrease in length of hospital stay required for sterilization. The use of laparoscopy has also been associated with an increase in hospital-based outpatient sterilization, particularly in the West. The number of sterilizations performed in hospitals and the use of laparoscopy for interval sterilization in hospitals both appear to have peaked. The laparoscope is an example of a technologic advance that has reduced medical care costs.

Adolescent↗
PubMed1987

Tubal anastomosis: pregnancy success following reversal of Falope ring or monopolar cautery sterilization.

The present study reviews pregnancy outcome following tubal anastomosis in 80 previously sterilized women. Thirty of 58 women (52%) sterilized by monopolar cautery techniques delivered a living child as compared to 19 of 22 women (86%) sterilized using the Falope ring method. Cumulative pregnancy curves were calculated for the Falope ring and cautery groups using life-table methods. Following reversal of Falope ring sterilization, the estimated cumulative probability of pregnancy 6, 12, 24, and 36 months after surgery was 28.4%, 48.8%, 69.3%, and 87.2% respectively. The corresponding estimates following reversal of cautery sterilization were lower at 6, 12, 24, and 36 months following surgery: 22.7%, 37.8%, 52.4%, and 57.9%, respectively. The ectopic tubal pregnancy and spontaneous abortion rate were higher among women sterilized with monopolar cautery. A decreased pregnancy rate was associated with ampullary-isthmic anastomosis in the cautery group; however, pregnancy was least likely to occur in women with shortened oviducts of less than 4 cm.

Actuarial Analysis↗
PubMed1989

Male or female sterilization: a comparative study.

The study compares 709 males and 546 females recruited from a well-defined geographic area and sterilized during a 5-year period at the same hospital. Medical records were reviewed and questionnaires sent out. Widespread satisfaction with the sterilization was found. The sterilized women had experienced contraceptive side effects and failures more often than the men. Only 70% of the laparoscopic sterilizations could be carried out during a 1-day admission, 25% of the women complained about long-term sequelae, and there were 1% failures. The vasectomies were carried out on an outpatient basis, there were few postoperative symptoms, and 0.5% failures were recorded. Female sterilization was at least four times as expensive as vasectomy. It is concluded that vasectomy is generally to be preferred to female sterilization, and that the preoperative guidance should involve both man and wife.

Adult↗
PubMed1998

Is there any evidence for a post-tubal sterilization syndrome?

OBJECTIVE: To review the literature on menstrual and hormonal changes in women who under go tubal sterilization. DESIGN: A systematic review through MEDLINE and a literature search identified more than 200 articles in the English literature from which the most relevant were selected for this review. RESULT(S): Many authors have investigated the sequelae of female sterilization. Increased premenstrual distress, heavier and more prolonged menstrual bleeding, and increased dysmenorrhea have been reported. However, failure to control for age, parity, obesity, previous contraceptive use, interval since sterilization, or type of sterilization may have affected study results. Most studies that have controlled for these important variables have not reported significant changes, except in women who undergo sterilization between 20 and 29 years of age. CONCLUSION(S): Tubal sterilization is not associated with an increased risk of menstrual dysfunction, dysmenorrhea, or increased premenstrual distress in women who undergo the procedure after age 30 years. There may be some increased risk for younger women, although they do not appear to undergo significant hormonal changes.

Age Factors↗
PubMed1986

Rare events associated with tubal sterilizations: an international experience.

The results from previous analyses of an international data set collected by Family Health International are reviewed in relation to the incidence, severity, risk factors, and outcomes of rare events associated with tubal sterilization. The rare events included for review, by sequence of their relationship to the tubal sterilization procedure are: luteal phase pregnancy, intraoperative complications (uterine perforation, unintended laparotomy required for completion of the laparoscopic procedure, and technical failure in tubal ring sterilization), deaths, early readmission following laparoscopic sterilization, hysterectomy after laparoscopic sterilization, and pregnancy (intrauterine and ectopic) conceived after tubal sterilization. The widespread use of this method of contraception has important public health implications, and awareness of these events will help clinicians minimize such incidences and better deal with them when they arise.

Female↗
PubMed1992

Performing tubal sterilizations during women's postpartum hospitalization: a review of the United States and international experiences.

A considerable number of tubal sterilizations have been performed while women are still in hospital after delivery in the United States as well as in other countries. There are few review papers exclusively on this sterilization modality. This paper provides a comprehensive review of results reported from recent studies of this approach, and answers the pertinent medical and related questions such as: To achieve maximum safety, what is the best time to perform the procedure during the women's postpartum hospitalization? Specifically, is it advisable for the procedure to be performed while the woman is still on the delivery table? What surgical approach and tubal occlusion technique are preferred? What are the risks that the women undergoing sterilization immediately or soon after delivery may incur the short- and long-term medical sequelae, and to conceive accidental pregnancy? What effect does sterilization have on lactation? And how should the women be screened and counseled to prevent poststerilization regret, generally thought to be more likely to occur in women after postpartum sterilization? Newly-developed mechanical tubal occlusion techniques have been included for consideration. Practical guidelines are given in this paper to help service providers achieve maximum safety and satisfaction for their patients with this convenient and low-cost method of postpartum sterilization.

Anesthesia↗
PubMed1991

Sterilization.

Sterilization has become the most widely used method of family planning in both the developed and developing world. This article discusses the importance of presterilization counseling and describes the timing of the procedure, methods of anesthesia, and occlusion techniques (eg, tubal ligation and the use of rings and clips) in female sterilization. Other topics covered in sterilization of women are long-term follow-up and complications, reversal of sterilization, impact of national sterilization policies, and nonsurgical sterilization. The article includes a short section on surgical contraception for men.

Anesthesia↗
PubMed1990

American Association of Gynecologic Laparoscopists 1988 Membership Survey on Laparoscopic Sterilization.

The 1988 Membership Survey of the American Association of Gynecologic Laparoscopists (AAGL) indicated that the membership continues to perform fewer sterilizations than previously reported. The respondents reported performing 30,480 sterilizations, 41,160 diagnostic laparoscopies and 13,920 hysteroscopies. The distribution of laparoscopic sterilizations by method of tubal occlusion has not changed appreciably since 1985. Complications from diagnostic laparoscopy are consistently higher than those after sterilization; two deaths (4.8 deaths per 100,000 procedures) were identified after diagnostic laparoscopy and no deaths were reported after sterilization. The relative likelihood of ectopic pregnancy is substantially greater after coagulation procedures than after mechanical ones. The decrease in membership performance of laparoscopic sterilization is occurring at the same time as a relative increase in the performance of newer diagnostic and therapeutic endoscopic procedures.

Female↗
PubMed1989

Menstrual pattern change 1 year after sterilization: results of a controlled, prospective study.

To determine if female sterilization is associated with adverse menstrual change, we compared prospectively collected menstrual data from women who underwent sterilization via bipolar cauterization, banding, and Pomeroy ligation with data from women whose husbands obtained a vasectomy and from women who were not planning sterilization. At first-year follow-up, sterilization via banding with Falope rings was not associated with adverse change. After excluding initially abnormal cases: (1) cauterization women were bleeding more heavily than all other groups excepting Pomeroy; (2) cauterization and Pomeroy women experienced more dysmenorrhea than women not planning sterilization; and (3) more cauterization and Pomeroy women (collapsed samples) developed abnormal length cycles than did the two control groups. There were no group differences regarding development of beneficial/neutral change (e.g., decreased dysmenorrhea). However, cauterization and Pomeroy groups experienced a significantly higher average number of adverse changes than did the other groups and were at significantly greater risk of developing one or more adverse changes than were women not planning sterilization. The only pattern of association among adverse menstrual changes occurred significantly more often in the cauterization and next in the Pomeroy groups.

Adult↗
PubMedDate not supplied

Medical and contraceptive reasons for sterilization in the United States.

Over the past two decades, the proportion of sterilizations--for both contraceptive and noncontraceptive reasons--among women of reproductive age (WRA) has risen in the United States. In 1982, more than one in ten WRA were sterilized for noncontraceptive, or medical, reasons. However, the rationales these women had for undergoing sterilization were not always clear-cut; often a mixture of medical and contraceptive reasons were given. In this study, Cycle III data from the National Survey of Family Growth, 1982, were used to investigate the determinants of different types of sterilization decisions--sterilizing for contraceptive, medical, or "mixed" reasons. It is important to recognize this "mixed" component of sterilization motivation. Parity and, to a lesser degree, education have consistent effects on differentiating these types of rationales, which appeared to have somewhat different patterns among black and white women.

Adolescent↗
PubMed2000

An epidemic of corneal destruction caused by plasma gas sterilization. The Toxic Cell Destruction Syndrome Investigative Team.

BACKGROUND: Toxic endothelial cell destruction (TECD) syndrome after intraocular ophthalmic surgery is rare and can result from exposure to a variety of toxins. During January 8 to 14, 1998, 6 patients developed TECD with corneal edema associated with unreactive or dilated pupils at Hospital A. METHODS: A case patient was any Hospital A patient with TECD within 24 hours after surgery during January 5 to 14, 1998 (epidemic period). A control was any hospital A ophthalmic surgery patient without TECD during the epidemic period. The medical records of hospital A ophthalmology surgery patients during the pre-epidemic (ie, September 1, 1997-January 4, 1998) and epidemic periods were reviewed. Inductively coupled plasma atomic emission spectrometry was used to detect trace inorganic elements on sterilized surgical instruments. Cannulated surgical instruments and laboratory rinsates were perfused directly to the corneal endothelium of isolated rabbit and human corneas. Corneal endothelial ultrastructure and swelling were assessed. RESULTS: The rate of TECD at hospital A was higher during the epidemic than pre-epidemic period (6/12 vs 0/118, P<.001). The only change during the periods was the introduction, on November 5, 1997, of a new sterilization method, AbTox Plazlyte, for sterilization of ophthalmic surgery instruments. Findings from spectrometry revealed that copper and zinc residues were higher in instruments sterilized with Plazlyte than in those sterilized with ethylene oxide (median copper value, 7.64 mg/L vs 0.14 mg/L, respectively, P =.02; median zinc value, 5.90 mg/L vs 1.35 mg/L, respectively, P =.2). Corneal endothelial perfusion of Plazlyte sterilized-instrument rinsates or laboratory solution with copper and zinc produced irreversible damage, similar to toxic corneal endothelial destruction, to rabbit and human corneas. CONCLUSION: A new sterilization method degraded brass to copper and zinc on cannulated surgical instruments resulting in TECD of the cornea. Arch Ophthalmol. 2000;118:1167-1176

Adult↗
PubMed2000

Effects of sterilization processes on NiTi alloy: surface characterization.

Sterilization is required for using any device in contact with the human body. Numerous authors have studied device properties after sterilization and reported on bulk and surface modifications of many materials after processing. These surface modifications may in turn influence device biocompatibility. Still, data are missing on the effect of sterilization procedures on new biomaterials such as nickel-titanium (NiTi). Herein we report on the effect of dry heat, steam autoclaving, ethylene oxide, peracetic acid, and plasma-based sterilization techniques on the surface properties of NiTi. After processing electropolished NiTi disks with these techniques, surface analyses were performed by Auger electron spectroscopy (AES), atomic force microscopy (AFM), and contact angle measurements. AES analyses revealed a higher Ni concentration (6-7 vs. 1%) and a slightly thicker oxide layer on the surface for heat and ethylene oxide processed materials. Studies of surface topography by AFM showed up to a threefold increase of the surface roughness when disks were dry heat sterilized. An increase of the surface energy of up to 100% was calculated for plasma treated surfaces. Our results point out that some surface modifications are induced by sterilization procedures. Further work is required to assess the effect of these modifications on biocompatibility, and to determine the most appropriate methods to sterilize NiTi.

Algorithms↗
PubMed1979

Long-term effects of interval laparoscopic sterilization by bipolar electrocoagulation on menstruation.

We studied the menstrual patterns of 258 patients before and after laparoscopic sterilization by bipolar diathermy. The observed changes were obtained were mainly related to the kind of contraception used before sterilization. The frequency of menstrual disorders after sterilization were compared to those in a control group of non-sterilized women matched for age and parity: 12--42 months after the operation, the sterilized women did not have more irregular cycles, menorrhagia, metrorrhagia, hysmenorrhea or dyspareunia than the control group but the sterilized women did have a slightly higher incidence of polymenorrhea (p less than 0.05) and menses lasting less than 3 days (p less than 0.01). We conclude that interval laparoscopic sterilization by bipolar diathermy can be recommended for patients with normal menstrual cycles.

Adult↗
PubMed1994

Sterilization of dental instruments and devices: an update.

Dental sterilization techniques have become a focus of attention as a result of disclosure of occupational HIV transmission from an infected dentist to a cluster of patients. Although there has never been a confirmed report of a patient acquiring an infectious blood-borne disease from a dental instrument or device, recommendations for universal sterilization of dental handpieces and other devices have recently been implemented. Because of the higher rate of hepatitis B virus transmissability in the dental health care environment, an upgrade in sterilization protocols may be warranted. Stringent sterilization standards are especially necessary in higher-risk institutional dental care settings. However, a high rate of dental sterilization errors has been reported and traced to operator error. Recent institutional dental sterilization policy changes have been developed to reduce the chance of sterilization error, further diminishing the risk of cross contamination.

Dental Equipment↗