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Results for “Tubal Ligation--complications”

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At least 19 recordsLinked to original sources

Laparoscopic sterilization in a free-standing clinic: a report of 1,092 cases.

The five-year experience of 1,092 laparoscopic tubal sterilizations performed in a free-standing clinic in the U.S. with no anesthesiologist under local anesthesia is reviewed. The current technique of the Hasson "open" method and bipolar cauterization is felt to minimize major mishaps and is acceptably comfortable to the patient.

Adolescent↗

Relationships between pelvic pain and prostaglandin levels in plasma and peritoneal fluid collected from women after sterilization.

Prostaglandin levels in plasma and peritoneal fluid were determined in 10 sterilized women with pelvic pain without pathological findings. Another 15 healthy women were regarded as controls. The 6-keto-PGF1 alpha levels in peritoneal fluid collected from patients with pelvic pain were significantly higher than that from the controls (p less than 0.05). The results indicated that prostaglandins might play an important role in pelvic pain following sterilization.

6-Ketoprostaglandin F1 alpha↗

Safety of abortion and tubal sterilization performed separately versus concurrently.

Concurrent abortion and sterilization are preferred by many women to avoid a second hospitalization, operation, and, in some instances, general anesthesia. Several authors have shown concern, however, that the two procedures carry a higher risk of morbidity when performed concurrently versus separately. To determine whether the concurrent performance of sterilization and induced abortion is as safe as the two procedures performed separately, we selected women undergoing these procedures from two separate multicenter, prospective, national United States studies: the Joint Program for the Study of Abortion and the Collaborative Review of Sterilization. Using standard definitions of major morbidity, we calculated the crude rate of one or more major complications to be 0.9% for the abortion-only group, 1.7% for the group concurrent abortion and tubal sterilization. Thus our data suggest that performing concurrent abortion and sterilization is as safe as performing those procedures separately.

Abortion, Induced↗

Sterilization failures and their causes.

To say that a sterilization failure rate is expected does not answer why. Forty-seven cases of repeat sterilization have undergone such surgical and pathologic scrutiny. Resection methods failed most frequently because of spontaneous reanastomosis or fistula formation. Fimbriectomy was particularly vulnerable to reanastomosis because the fimbria ovarica was not removed. Mechanical devices failed when the device was defective, placed improperly, or placed in an improper location. Tissue damage was evident but incomplete when the bipolar electrocoagulation method failures were reviewed, and the endosalpinx remained viable. Unipolar method injuries, in contrast, were complete; they failed by fistula formation. Thus bipolar method failures may occur because of the limited range of electrical power available when using bipolar generators. Some sterilization failures are preventable, but many are not. When medicolegal questions arise, these findings may help answer the question, Why?

Contraceptive Devices, Female↗

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↗

Chlamydia trachomatis and febrile complications of postpartum tubal ligation.

OBJECTIVE: Our goal was to determine whether chlamydia-infected women have a higher rate of febrile complications after postpartum tubal ligation. STUDY DESIGN: Cross-sectional analysis of 1447 women tested for chlamydial infection within 2 weeks of delivery and who underwent postpartum tubal ligation was performed. Subjects were identified with the Regenstrief Institute for Health Care database. Infected subjects were compared with uninfected subjects for incidence of fever not explained by nongynecologic sources. RESULTS: Women infected with Chlamydia trachomatis at delivery were more likely to experience febrile postoperative complications after tubal ligation (p < 0.0001, relative risk 9.5, 95% confidence interval 4.5 to 20.1). CONCLUSION: Women undergoing postpartum tuba ligation may benefit from prompt diagnosis and preoperative treatment of chlamydial infection.

Adult↗

Minilaparotomy under local anesthesia for outpatient sterilization: a preliminary report.

An outpatient sterilization program was started at Silas B. Hays Hospital, Fort Ord, California, and later extended to Malcolm Grow USAF Medical Center and the Walter Reed Army Medical Center. From January 1976 to June 1978, two hundred and eight outpatient minilaparotomy Pomeroy tubal ligations were performed under local anesthesia. The minilaparotomy technique, using standard operating room equipment, is described. The average operating time was 31.8 minutes and the complication rate was 2.5%.

Adult↗

Endometriosis and the development of tuboperitoneal fistulas after tubal ligation.

The present study details gross and histologic findings of 79 previously ligated fallopian tubes from 3 groups of patients. Of 20 oviducts removed after documented sterilization failure (group I), 6 revealed a process compatible with endometriosis. Four of nine previously ligated fallopian tubes removed at the Johns Hopkins Hospital (group II) were successfully injected with India ink. In two patients histologic examination demonstrated the India ink in epithelium-lined spaces that lay beyond the muscle of the tubal wall extending from the tubal lumen to the serosal surface. Fifty oviducts were studied in twenty-five patients requesting reversal of their sterilizations (group III). A higher percentage of fistulas was demonstrated in patients with less than 4 cm of remaining proximal tubal segment. Furthermore, most of these fistulas were demonstrated in patients for whom 3 years had elapsed since the original sterilization procedure. Patients sterilzed by laparoscopic cautery methods were observed to have a higher percentage of fistula formation and histologic documentation of endometriosis at the sterilization site as compared with patients sterilized by other methods. Our observations suggest that ligation of the oviduct within 4 cm of the uterine cornu may predispose to the development of endometriosis and subsequent fistula formation in the tip of the ligated oviduct.

Endometriosis↗

Oestrogen deficiency after tubal ligation.

4 of 7 women who had undergone tubal ligation within the past seven years were found to have oestrogen excretion concentrations at ovulation below the tenth percentile. A disturbance in the oestrogen/progesterone ratio as a consequence of localised hypertension at the ovary, when the utero-ovarian arterial loop is occluded at tubal ligation, is proposed as a possible cause of oestrogen deficiency syndrome, dysfunctional uterine bleeding, and menorrhagia after tubal ligation. Similar pathophysiology may occur after hysterectomy with ovarian conservation.

Adult↗

Failures of laparoscopy sterilization.

Female sterilization by laparoscopy has become widely accepted throughout the United States and Europe. The failure rate of this procedure is still speculative. In the course of 4200 operative sterilization, 32 failures have been identified and 31 of these have been subsequently evaluated. The most common finding was inadequate or superficial fulguration and resection. Operative errors such as round ligament fulguration were also more common than expected.

Adolescent↗

Misdiagnosis of appendicitis in tubally sterilized women.

Sterilization by tubal occlusive methods has a small but definite incidence of failure which is not well recognized among general surgeons. As a result of the failure to appreciate the possibility of ectopic pregnancy after tubal ligation, right-sided abdominal pain in this patient population is commonly misdiagnosed as appendicitis. One such case is presented, and the literature is reviewed and discussed.

Abdominal Pain↗