Abstract

PIP: Hysteroscopic sterilization takes only 3-4 minutes, requires no incision into the peritoneal cavity, and the patient recovers within hours. The new technique, performed under a local intracervical block, involves distention of the uterus with 32% dextran and insertion of a fiberoptic telescope (similar to a cystoscope) for visual examination of the uterine cavity. After the ostia of the Fallopian tubes into the uterus are visualized, an insulated cautery probe is inserted into each. A check several weeks later by hysterography confirms that the tubes are occluded. Results of clinical trials in New York and in Bangkok showed: in the first series of 17 women there were 4 failures (repeat operations were successful in 2 of these); in a series of 10 women there was a potent tube in only one. The author reports 90% success in recent operations and anticipates even better results with more practice in visualizing tubes and controlling the cautery probe. No complications or morbidity have resulted although there is a problem with migration of mucus, air bubbles, or blood clots. He predicts wide use of the method on an outpatient basis.