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At least 955 records · Page 53Linked to original sources
PubMed1980

Technical failures in tubal ring sterilization: Incidence, perceived reasons, outcome, and risk factors.

Six centers participated in comparative studies of female sterilization conducted by the international Fertility Research Program. The incidence of technical failures (or failed attempts) was compared between patients sterilized with the tubal ring and those sterilized with other tubal occlusion techniques. The tubal ring was associated with a higher failure rate than electrocoagulation, the Rocket clip, or the modified Pomeroy technique. Of 1,035 tubal ring sterilizations, there were 38 technical failures. Reasons given by the operators for the failures, by frequency of occurrence, were surgical complications, conditions preexisting in the patients, and problems with the instruments. Most of these failures were remedied by changing to other techniques. In two patients, the procedure was completed by changing the approach from laparoscopy to laparotomy. In five others, sterilization was not completed. Case-control analysis was performed and three risk factors were delineated: obesity, prior use of an intrauterine contraceptive device and previous abdominal operations.

Abdomen↗
PubMed1988

A clinical study comparing the performance of three IUCDs (Multiload Copper 250, Copper T 200, and Lippes Loop C).

300 Women at Cairo's Al-Zahraa Hospital, using 1 of 3 different IUds (CuT 200, multiload Cu250, and Lippes loop size C) to compare the rate of complications encountered among the 3 groups. Failed insertion was highest among the Cu T200 group with a rate of 3.24/HWY, hundred woman years. Accidental pregnancy was highest among that group as well. With a rate 2.16/HWY compared with 1.10/HWY among the ML Cu250 group and none among the Lippes Loop group. The spontaneous expulsion rate was the same for the Cu T200 and Lippes Loop, i.e., the rate was 4.32/HWY and 4.44/HWY for the 2 groups, respectively, compared with 1.10.HWY for the ML Cu250. The highest removal rate because of pain or bleeding was encountered among the ML Cu250 users, i.e., the rate was 4.41.HWY compared with 3.33/HWY among the Lippes Loop group and 1.08/HWY for the Cu T200 group. The overall failure rate was 8.82/HWY for ML Cu250, 11.89/HWY for Cu T200, and 11.10/HWY for the Lippes Loop group.

Africa↗
PubMedDate not supplied

Outpatient interval female sterilization at the University College Hospital, Ibadan, Nigeria.

Between September 1975 and April 1981, 258 patients were sterilized at the University College Hospital (UCH), Ibadan, using minilaparotomy and laparoscopy. Selected sociodemographic data as well as the technical and surgical difficulties encountered have been reviewed in this article. The mean age at sterilization was 38.3 years whilst the mean parity was 7.2. In all, there were 215 minilaparotomy sterilizations and forty-three laparoscopic sterilizations. Surgical difficulties were reported for 12.1% of minilaparotomy and 11.6% for laparoscopic procedures. The most frequently reported difficulties were obesity and pelvic adhesions. The failure rates were 1.4% for minilaparotomy and 2.3% for laparoscopy.

Abdomen↗
PubMed1983

Sterilization by laparoscopy.

Today, female sterilization is most easily accomplished by single-puncture laparoscopy and, ideally, is carried out under local anesthesia. In experienced hands, electrocoagulation offers slightly fewer failures if a large portion of tube or two segments are destroyed. Fulguration of a small portion of tube, bands, or clips offer a better chance of reversal. It is extremely important that the operator be familiar with and use proper equipment, along with following a rigid format, if complications are to be kept to a minimum. The underlying theme for this article, and all of the articles published, shows that, regardless of the method employed to interrupt the tubes, the complication and failure rates are usually more a function of the experience of the operator than of the method employed.

Anesthesia↗
PubMed1978

The bipolar needle for vasectomy. I. Experience with the first 1000 cases.

A battery-powered, bipolar electrocoagulator has been specifically developed for sealing the cut ends of the divided vas at vasectomy. With a minimum of electric power, the electrocoagulator destroys only the mucosa and one or two muscle cell layers of the vas, which leads to optimal fibrosis of the cut ends. This instrument has been used in more than 1000 vasectomies without a known failure and with a minimum of complications. An analysis of these cases is reported with emphasis upon the method's success in sealing the vas.

Adult↗
PubMed1979

Use-effectiveness and client satisfaction in six centers teaching the Billings Ovulation Method.

Use-effectiveness of the Billings Ovulation Method (OM) is reported for 1139 clients from six centers who were followed for at least 24 months. Method failure rates were 1% when calculated by either Pearl formula or life table analysis. Combined method and user failure rates were 20% when calculated with the Pearl formula, and 16% at 12 months and 23% at 24 months by life table analysis. Pregnancy rates were higher for couples using OM alone, than for couples using OM in combination with additional fertility awareness methods or together with barrier methods. The difference was significant when estimated by the Pearl formula but not when analyzed by the life table. The emotional implications underlying the apparent contradiction between a desire to avoid pregnancy and the deliberate coital use of fertile days are reflected in the differences between method and user failure rates, the high client satisfaction levels reported with "user failure," and 56% continuation rate at 24 months. The will require in-depth exploration.

Abortion, Legal↗
PubMed1995

Sexual behaviour and sexually transmitted diseases in Dutch marines and naval personnel on a United Nations mission in Cambodia.

OBJECTIVES: To determine the sexual risk behaviour and the incidence of sexually transmitted diseases (STD) among Dutch marines and naval personnel during a United Nations (UN) deployment. METHODS: Surveillance by post deployment questionnaire, administered to 2289 persons in three successive battalions who served for 6 months on a UN deployment in Cambodia during June 1992-November 1993. On site the medical history of all individuals was kept up to date in a database. All personnel received extra education on STD prevention prior to deployment. Condoms were freely obtainable during deployment. RESULTS: 1885 persons (82%) handed in the questionnaire of whom 842 (45%) reported to have had sexual contacts with prostitutes or local population. Being younger and single were independent risk factors for having contact. Out of these 842 persons, 750 (89.1%) reported condom use at all times, while 82 (9.7%) reported inconsistent use and 10 persons (1.2%) reported not to have used condoms. Risk factors for inconsistent and non use were being 40 years or older and a higher number of contacts. From the 832 (750 + 82) condom users, 248 (30%) reported condom failure. Risk factors for failure were: inconsistent condom use, having had more than six contacts and being in the second battalion. The patient recording database showed 43 STD cases registered in the total population of 2289 persons (1.9%). CONCLUSIONS: A low STD incidence was found despite a considerable number of reported sexual contacts. The reported condom use was high but the failure rate was considerable and needs further attention.

Adolescent↗
PubMed1980

Vasectomy: efficacy of placing the cut vas in different fascial planes.

The inadvertent failure to achieve sterility in 8 to 40 vasectomy procedures afforded a rare opportunity to study the efficacy of placing the two cut ends of the vasa in different fascial planes. Interposition of the fascia was performed in 12 patients and was not performed in 28 others, with no significant difference in the failure rates of the two groups. Histologic examination of vasal tissue from one patient in each group revealed that a sperm granuloma can erode fascia and the wall of the vas.

Fasciotomy↗
PubMed1990

Female sterilization failure after bipolar electrocoagulation: a 6 year retrospective study.

A 6 year retrospective study was conducted from January 1983 till December 1988. During this period there were 13,014 births, 1,776 registered spontaneous abortions and 200 tubal pregnancies. 1,437 sterilizations were performed in the same period via bipolar electrocoagulation. 11.5% of the ectopic pregnancies were in patients who had previously undergone a tubal sterilization. The failure ratio following bipolar coagulation was 1.18%, and all failures were extra-uterine pregnancies, with an average interval between sterilization and ectopic pregnancy of 28.8 months. This reflects the importance of previous sterilizations as an etiologic agent in ectopic gestations. We will discuss the possible etiological factors for our sterilization failures and how these failures can be avoided or minimized. Also diagnostic difficulties and management of an extra-uterine pregnancy (EUP) following sterilization will be presented.

Electrocoagulation↗
PubMed1987

Late sequelae after laparoscopic sterilization in the pregnant and non-pregnant woman.

To determine the frequency of late sequelae after laparoscopic sterilization performed at the time of induced abortion, we compared data on 114 women who underwent induced first-trimester abortion and concurrent laparoscopic sterilization, with 288 women who had sterilization performed at least 3 months after induced abortion. The period of observation was 12-95 months, median 49 months. We found no statistical difference between the groups with respect to failures, low abdominal pain, dyspareunia, change in bleeding pattern, sexual life and regrets. The results of these findings, discussed here, support the practice of performing the combined procedure.

Abortion, Induced↗
PubMed1991

Method failures of laparoscopic tubal sterilization in a residency training program. A comparison of the tubal ring and spring-loaded clip.

A prospective, randomized study of 365 women undergoing interval laparoscopic tubal sterilization in a residency training program was undertaken to compare method failures. Two occlusive techniques were compared, the spring-loaded clip (Hulka-Clemens) and the tubal ring (Falope Ring). Patients were randomized to either Falope Rings or Hulka-Clemens clips as the primary method. Demographic characteristics, educational level and operator experience were similar in the two groups. Follow-up at an average of 16 months (range, 6-24) revealed eight pregnancies (4.5%) in 176 women in the clip group and five pregnancies (2.6%) in the ring group. The Hulka-Clemens clip and the Falope Ring have similar incidences of method failure when employed by inexperienced operators. We question the usefulness of chromopertubation utilizing methylene blue dye to ensure proper placement of the occlusive device.

Adult↗
PubMed1988

Analysis of sterilization failure in Brazil.

A study of 13,423 female sterilization procedures performed from 1981 to 1984 in Rio de Janeiro, Brazil, was conducted to determine the level of sterilization failure. The lifetable cumulative failure rate was 0.54 at 12 months per 100 initial sterilizations, increasing to 1.04 at 48 months. Results of a multivariate analysis indicated that the differential in the rate of sterilization failure by woman's age at sterilization at 12 and 24 months was statistically highly significant. However, the differential rate of failure by the other variables such as whether sterilized during a training period, number of sterilizations per surgeon per day, and year of sterilization were not statistically significant.

Actuarial Analysis↗
PubMed1978

Failures following fimbriectomy: a further report.

In 1977 we reported on seven patients who presented with intrauterine pregnancy in spite of previous fimbriectomy; in a detailed morphologic study one tuboperitoneal fistula was documented in each of four patients. In the present study three more patients are reported with pregnancy following fimbriectomy, and another four tuboperitoneal fistulas are morphologically investigated and their possible etiology is discussed. In spite of a failure rate of almost 2.6%, the concept about the reliability of fimbriectomy need not necessarily be condemned. This concept can be judged only if information is available both about the total number of fistulas subsequent to a certain technique and about the number of those fistulas which contributed to pregnancy.

Fallopian Tubes↗
PubMed1997

A case of failure of tubal sterilization using Pomeroy's technique.

With reference to a case of pregnancy of a patient formerly subjected to tubal sterilization using Pomeroy's technique, the authors define the possibility for tubal stumps to recanalise. Despite the low percentage of failure in tubal sterilization using Pomeroy's technique, the authors conclude that it is advisable to make the earliest possible diagnosis of both intrauterine and extrauterine pregnancy on the basis of suspected symptoms in order to, especially for tubal pregnancies, avoid any tubal sterilization.

Female↗
PubMed1988

Vasectomy: how much is enough?

Bilateral vasectomy was performed in 30 men. The vasa were tied with radio-opaque ligatures and X-rays taken to assess the separation of the ends. There was good correlation between the length of vas excised and the resulting separation of the markers. In order to achieve a separation greater than that of sperm granulomas associated with vasectomy failure, at least 7 cm of vas would have to be removed. However, excision of this length cannot be recommended because of subsequent difficulties with vasovasostomy. It is suggested that as well as excising a length of vas during vasectomy, a second method is also used to prevent spontaneous recanalisation.

Humans↗
PubMed1985

Interval tubal sterilization in obese women--an assessment of risks.

Obesity is considered to be a complicating factor in most surgical procedures, but very few studies have investigated whether this is true for tubal sterilization. We used a large international data set to investigate the effect of obesity on tubal sterilization. Each of the 159 women delineated as obese (greater than 50% above the mean ideal weight) was matched with a woman of normal weight on important provider variables such as center, operator, and type of surgical procedure. Incidences of anesthesic, surgical, and early postsurgical complications were comparably low and of a mild nature for both the obese and the nonobese groups. Incidence of surgical difficulties was higher, and as a result, the technical failure rate was also higher and the surgical time longer for obese women than for nonobese women. However, none of these surgical difficulties or technical failures led to serious consequences. The difference in surgical times was small and is probably of little practical significance. It appears that the surgical difficulties of tubal sterilization in moderately obese women can be easily overcome.

Anesthesia↗
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↗
PubMed1981

The titanium/silicone rubber clip for female sterilization.

A composite titanium/silicone rubber clip has been developed for female sterilization. The 12.7 mm long metal clip is lined with silicone rubber and is bent round the Fallopian tube by means of an applicator that can be used laparoscopically. As tubal necorsis occurs, the rubber expands to keep the lumen blocked. The tube eventually divides and the stumps heal closed. Since the Mark 3 version of the clip was introduced, over 5700 women in several countries have been sterilized. The first 540 British women who were followed-up for five to 17 months experienced one method failure (ectopic) and tow operator failures, to total failure rate of 5.5/1000. Clip-related complications were minimal and long-term sequelae were comparable to tubal ligation. The clip causes minimal destruction but still seems effective for tubal occlusion and it can accommodate thick tubes.

Adolescent↗