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PubMed1990

Characteristics of women who considered or obtained tubal reanastomosis: results from a prospective study of tubal sterilization.

The Collaborative Review of Sterilization is a prospective study of women undergoing tubal sterilization at selected medical centers in the United States. This analysis examined 5817 study participants who were asked whether they had sought information on tubal reanastomosis after their sterilizations and whether they had actually obtained reanastomosis surgery. Characteristics that predicted the likelihood of seeking reanastomosis information were examined in multivariate, logistic regression models that included age, race, number of living children, history of abortion, education, timing of sterilization in relation to pregnancy, initial marital status, and change in marital status. Among the women studied, 6.2% reported that they had sought information on reanastomosis. Women who were younger than 30 years old at the time of sterilization were twice as likely to seek such information as women aged 30-34, and women who had experienced changes in martial status after sterilization were 2.8 times as likely to seek information as women with unchanged marital status. Thirteen women had actually obtained reanastomosis. Compared with the overall study population, these women were more likely to be white, to have lower gravidity, to be younger, and to have experienced changes in marital status.

Abortion, Induced↗
PubMed1979

[Long-term outcome of sterilization as a function of the indication, marital status, age, number of children and concurrently performed therapeutic abortions (author's transl)].

On the basis of questionnaires 1084 sterilized women were interrogated concerning their satisfaction with sterilization. 769 (70.9%) fully completed questionnaires could be evaluated. 96.4% of women were satisfied with their sterilization. 1.3% of patients requested reversal of sterilization. Non satisfactory results occured mainly in women where the indication for sterilization was on non-social basis, in single women and in cases where an interruption of pregnancy was performed at the same time. No correlation was found between age or parity and the satisfactory outcome of sterilization.

Abortion, Therapeutic↗
PubMed1981

A study of menstrual patterns following laparoscopic sterilization with silastic rings.

The menstrual patterns of 281 women undergoing laparoscopic sterilization with silastic rings were studied prospectively. A significant increase in dysmenorrhea and irregular periods was seen soon after sterilization but this was transient, returning to presterilization levels by 12 months. Menorrhagia was not observed and the amount of menstrual blood loss showed a trend towards normal following sterilization. No permanent adverse effects on menstrual patterns were seen in the 1st year after sterilization. It is suggested that factors other than the sterilization procedure may be responsible for the high prevalence of menstrual dysfunction that has been reported following sterilization.

Dysmenorrhea↗
PubMed1980

Pregnancy after laparoscopic sterilization.

The authors compare their experience with pregnancies after laparoscopic sterilization with thos reported in the literature. When misidentification and luteal phase pregnancies are excluded, the true failure rate for laparoscopic sterilization varies between 0.9 and 6 per 1000 sterilizations, depending in part on the technique used. This rate is similar to that of nonlaparoscopic techniques. The mechanical methods have a slightly higher rate than do the electrical methods. Pregnancies that occur after a method failure have a high risk of being ectopic. Reversal of laparoscopic sterilizations has now been reported with most methods. Reimplantation of the tube into the uterus and microsurgical techniques appear to produce similar results in patients sterilized by electrosurgical methods. Patients sterilized by mechanical methods are best managed by microsurgical reanastomosis.

Female↗
PubMed1980

Timing of laparoscopic sterilization in abortion patients.

A total of 1604 laparoscopic sterilization procedures with variable time intervals after first trimester therapeutic abortion were performed at the Severance Hospital of the Yonsei University College of Medicine, Seoul, Korea, from May 1973 to October 1975. Two hundred fourteen women were sterilized immediately at the time of abortion; 359 were sterilized between 1 and 42 days later; and the remaining 1031 women were sterilized 43 or more days after abortion. Electrocoagulation and tubal ring application were the tubal occlusion techniques used. The findings indicate that patients who underwent the combined abortion-sterilization procedure did not encounter higher rates of technical problems and/or complications than the other 2 groups. Only a few of these 1604 women studied had potentially serious complications that necessitated subsequent laparotomy, hospitalization after sterilization, and/or hospital readmission.

Abortion, Therapeutic↗
PubMed1980

The potential impact of reversibility on selection of tubal sterilization.

Despite continuing interest in development of reversible sterilization, baseline data regarding how much more acceptable reversible procedures would be than currently available methods have not been available. This study provides such data from 1074 randomly selected obstetric/gynecology patients or reproductive age in metropolitan San Antonio. Basic socio-demographic data and attitudinal information with respect to both permanent and hypothetically reversible tubal ligation were elicited via a self-administered questionnaire. Responses toward permanent and reversible sterilization were compared and analyzed for statistically significant differences. Results indicate that approval of, serious consideration of, intent to eventually undergo, and immediate demand for tubal sterilization would be increased 25%, 95%, 178%, and 163%, respectively, if reversible procedures were available. All increases are statistically significant at P < .0001. These data, confirming pilot study results reported a year ago, indicate that the option of reversibility is exceedingly important to potential candidates for sterilization and its availability would significantly increase the acceptability of female surgical sterilization as an alternative method of contraception.

Adolescent↗
PubMed1996

Psychological long-term effects of sterilization on anxiety and depression.

Two-thousand cases (500 women and 500 men with sterilization; 500 women and 500 men without sterilization) in two counties and two cities in Sichuan, China, were investigated between 15 September 1992 and 30 April 1993. Information was obtained about their age, parity, marriage, contraceptives, social behavior, and present psychological characteristics. CES-D, SAS, and E.P.Q. scales were used to assess the depressive symptomatology, anxiety, and personality of the subjects. The results revealed that sterilization psychologically affected the depressive symptoms and anxiety under the neutral personality. In addition, depressive symptoms and anxiety were related to the subjects' age, educational level, income, operative doctors' attitudes to sterilization acceptors, and subjects' understanding of the sterilization.

Adult↗
PubMedDate not supplied

Regret of laparoscopic sterilization.

A follow-up study with questionnaires was performed 4-8 years after laparoscopic sterilization. The follow-up questionnaires were answered for 90.5%. The study revealed that 7.1% of the women were dissatisfied at some stage with the decision to undergo sterilization. However, only 1.8% requested reversal of the sterilization. 40% of the dissatisfied women were between 25-29 years of age, and every fifth sterilized woman in this age group regretted the sterilization.

Adult↗
PubMed1983

[Is tubal sterilization with the Tupla-clip a reversible method?].

Between 1976 and 1981 402 tubal sterilizations were performed with Tupla-clip most of them by laparoscopic application. 11 tubes were removed between 15 and 47 months following the sterilization with the Tupla-clip. The local changes both macroscopically and microscopically to the tupla-clip were evaluated. The possibility of tubal patency following removal of the clips was tested by carbon dioxide pertubation. The tubal-occlusion with the tupla-clip is definitive since all tubes had a fibrous tissue strand where the clip had been applied which still carried blood vessels. No tube was patent with the carbon dioxide pertubation. The intra-operative testing of correct application of the clip and the documentation of this correct application is again mentioned. This is especially important in view of the recent judgements of the federal supreme court regarding liability in failed tubal sterilizations. The excellent chance of reversal by tubal anastomosis and the 100% success rate of this method of sterilization within the 6 years under observation will increase the acceptance of the tupla-clip as a method for tubal sterilizations.

Female↗
PubMed1980

A review of women requesting reversal of tubal sterilization.

A the Women's Hospital, Crown Street in the past 4 years 64 women who requested reversal of tubal sterilization have been studied. Some of their characteristics at the time of sterilization and the reasons for their request for reversal are examined. It would appear that relatively young women of low parity whose reasons for sterilization are primarily socioeconomic in association with an unstable martial state are those most likely to request reversal. Furthermore, postpartum sterilization in such women is more likely to lead to requests for reversal than interval sterilization. The overwhelming reason for requesting reversal is the establishment of a new marital relationship. However, there is a small group whose reason is the death of the antecedent child, usually a cot death, under the age of 6 months.

Adult↗
PubMed1986

Female sterilization: can the woman who will seek reversal be identified prospectively?

Demographic socio-economic and decision-making aspects of sterilization and reversal of sterilization were compared in a group of 103 women requesting reversal (RR) and 117 women about to undergo sterilization (S), to determine the practicality of identifying in advance the woman likely to request reversal. The willingness of patients to pay for these procedures and the ethical implications of these decisions were also examined. RR were younger at the first relationship, birth of first child and birth of last child. There were no differences (RR vs S) between the number of full-term pregnancies, living children and therapeutic abortions. The timing of sterilization (puerperal versus interval) did not influence the decision to be reversed. The level of education, partner's level of education and mean family income were lower in the group requesting reversal. Multiple regression analysis revealed three characteristics which were most discriminatory: youth at first birth; lack of spousal support; and failure to choose 'family complete' as a reason for sterilization. The predictability was not strong enough to provide an accurate assessment of the individual woman. RR were of significantly lower socio-economic standing but were more likely to be prepared to pay a large sum of money for the reversal. The ethical implications of this finding are discussed.

Adult↗
PubMed1983

Sterilization in Honduras: assessing the unmet demand.

The purpose of this study was to evaluate and compare the availability of sterilization services at two hospitals in Honduras. Approximately 7,000 women who had given birth at the Hospital Materno Infantil in Tegucigalpa and the Hospital Leonardo Martinez in San Pedro Sula were asked about their desire for sterilization. Of the women who wanted to be sterilized, a considerable percentage had not been sterilized four months after they had given birth--58 percent of those who had delivered at Materno Infantil and 79 percent of those who had delivered at Leonardo Martinez. Twenty-three percent of the women who delivered at Materno Infantil and 4 percent of the women who delivered at Leonardo Martinez were sterilized before they were discharged. The difference may be attributed to the poor quality of the facilities at Leonardo Martinez.

Adolescent↗
PubMed1979

Current status of sterilization.

About 50 per cent of child bearing women in Australia are being sterilized. The selection of patients for the procedure requires careful counseling in order to avoid the risk of regret. Factors increasing the risk of regret are enumerated. Laparoscopy is the most popular method for sterilization, but mini laparotomy is a reasonable alternative for patients not having access to skilled laparoscopists. Clips and rings provide a greater chance of successful reversal of sterilization, and are recommended for use in younger women. The sequelae of sterilization are slight, with failure of technique, infection and temporary regret being the commonest. Serious psychological or physical sequelae are rare. If reversal is required the microsurgical technique is recommended.

Counseling↗
PubMed1979

Legal implications of sterilization of the mentally retarded.

For more than 50 years, sterilization of mentally retarded persons was an accepted practice in many states as a way to reduce the number of persons born with mental defects. In recent years, the practice has come under heavy challenge, both medically and legally. At present, only 19 states have statutes that allow sterilizations for eugenic reasons. This article examines important court decisions regarding eugenic sterilization laws and the legal status of sterilization of mentally retarded adults and minors, as well as the consequent legal implications for physicians. Federal funding restrictions on sterilization of mentally impaired persons are discussed. The requirement of voluntary, informed consent is considered in light of an increasing emphasis on the rights of mentally retarded persons as well as greater awareness of the psychological effects of involuntary sterilization.

Adolescent↗
PubMed1998

Comparison of the effects of gamma radiation and low temperature hydrogen peroxide gas plasma sterilization on the molecular structure, fatigue resistance, and wear behavior of UHMWPE.

The effects of gamma radiation and low temperature hydrogen peroxide gas plasma (HPGP) sterilization on structure and cyclic mechanical properties were examined for orthopedic grade ultra-high-molecular-weight polyethylene (UHMWPE) and compared to each other as well as to no sterilization (control). Density was monitored with a density gradient column and was found to be directly influenced by the sterilization method employed: Gamma radiation led to an increase, while plasma did not. Oxidation of the polymer was studied by observing changes in the carbonyl peak with Fourier transform infrared spectrometry and was found to be strongly affected by both gamma radiation and subsequent aging, while plasma sterilization had little effect. Gamma radiation resulted in embrittlement of the polymer and a decreased resistance to fatigue crack propagation. This mechanical degradation was a direct consequence of postradiation oxidation and molecular evolution of the polymer and was not observed in the plasma-sterilized polymer. Both gamma radiation and plasma sterilization led to improved wear performance of the UHMWPE compared to the nonsterile control material.

Cold Temperature↗
PubMed2000

Plasma-based sterilization: effect on surface and bulk properties and hydrolytic stability of reprocessed polyurethane electrophysiology catheters.

Plasma-based sterilization is a promising alternative to ethylene oxide (EO) for reprocessing of electrophysiology catheters. To assess its safety in terms of material damage, modifications of surface and bulk properties as well as hydrolytic stability of sterilized catheters were evaluated. Polyurethane (PU) single-use electrophysiology catheters were subjected to one, five, and ten sterilization cycles by Sterrad-100S and Plazlyte, as well as by pure EO for comparison. Surface analysis techniques (ATR-FTIR, XPS, DCA) showed oxidation limited to the near-surface layer induced by both plasma-based sterilizers, whereas EO induced slight but deeper alkylation. Using bulk analysis techniques (RP-HPLC, SEC), oligomer alteration was observed after all three sterilization techniques, without modification of molecular weights. Hydrolytic stability of catheters was slightly changed by plasma-based sterilization, with a small increase in released oligomers. Finally, although Plazlyte and Sterrad are both plasma-based techniques, they induced different impacts on catheters, such as the degradation of an additive with Sterrad, and a clear difference in coloration with Plazlyte.

Catheterization↗
PubMed2001

Effects of steam sterilization on thermogelling chitosan-based gels.

A new thermogelling chitosan-glycerophosphate system has been recently proposed for biomedical applications such as drug and cell delivery. The objectives of this work were to characterize the effect of steam sterilization on the in vitro and in vivo end performances of the gel and to develop a filtration-based method to assess its sterility. Autoclaving 2% (w/v) chitosan solutions for as short as 10 min resulted in a 30% decrease in molecular weight, 3-5-fold decrease in dynamic viscosity, and substantial loss of mechanical properties of the resulting gel. However, sterilization did not impair the ability of the system to form a gel at 37 degrees C. The antimicrobial activity of chitosan against several microorganisms was evaluated after inoculation of chitosan solutions and removal of the cells by filtration. It was found that, although chitosan was bacteriostatic against the heat sterilization bioindicator Bacillus stearothermophilus, the bacteria could rapidly grow after separation from the chitosan solution by filtration. This indicated that B. stearothermophilus is an adequate strain to validate a heat sterilization method on chitosan preparations, and accordingly this strain was used to assess the sterility of chitosan solution following a 10 min autoclaving time.

Anti-Bacterial Agents↗
PubMed2003

Competition strategies for the decolorization of a textile-reactive dye with the white-rot fungi Trametes versicolor under non-sterile conditions.

A variety of white-rot fungi can oxidize textile dyes under sterile conditions; however, an important consideration for their use in treating wastewater containing textile dyes is whether similar degrees of treatment can be achieved under non-sterile conditions. Four strategies were investigated for their potential in optimizing the use of the fungus Trametes versicolor in non-sterile culture for treating wastewater containing the diazo textile dye C.I. Reactive Black 5 (RB5). Three strategies with suspended culture were designed to increase the decolorization activity in suspended culture from a given amount of T. versicolor inoculum based on its tolerance of low pH (pH reduction in medium), production of extracellular enzymes (use of suspended enzymes alone), and its ability to produce enzymes independent of growth (nitrogen limitation in medium). The results showed that reduction of the medium pH to 3 did not suppress bacterial growth, while enzyme production by T. versicolor ceased. The use of the extracellular enzymes alone would allow the decoupling of the process of fungal growth from wastewater treatment; however, the enzyme activity of an enzyme suspension decreased rapidly under non-sterile conditions. The strategy of limiting nitrogen in the medium to suppress bacterial growth has potential together with the fourth strategy, the cultivation of fungi on organic solids to produce inocula for a decolorization process under non-sterile conditions. A high degree of decolorization of RB5 under non-sterile conditions was achieved with T. versicolor grown on grains as sole substrate. The rate of decolorization was dependent on the amount of fungal inoculum used.

Basidiomycota↗