Female sterilization. II. A comparison of methods

Abstract

An analysis was made of 1757 female sterilization procedures performed over a 5 1/2-year period. The majority of these were accomplished by one of 8 technics: puerperal abdominal tubal ligation (TL), cesarean section plus TL, hysterotomy plus TL, interval abdominal TL, colpotomy TL, laparoscopic TL, vaginal hysterectomy, and abdominal hysterectomy. The various technics have been compared with respect to 55 variables. The procedures having the shortest hospital stay, lowest morbidity, lowest blood loss, and shortest operating time were interval laparoscopic TL, colpotomy TO, and puerperal abdominal TL. The more major procedures were attended by significantly more morbidity and longer hospitalization and should be used only when specific indications justify the increased cost and risk.

PIP: A retrospective analysis of 1757 female sterilization procedures over a 5 1/2-year period from July 1, 1965 through June 30, 1970 is presented. Almost all of the procedures were performed by either puerperal abdominal tubal ligation (TL), colpotomy TL, laparoscopic TL, interval abdominal TL, cesarean section with TL, hysterotomy with TL, vaginal hysterectomy, or abdominal hysterectomy. Operative complications were present in 90 cases, the most common of which was excessive blood loss (67 cases). Laparoscopic TL appeared to be an excellent method, given its low morbidity (8.4%), low blood loss, and short operating time and hospitalization. Colpotomy TL and puerperal abdominal TL also had favorably low incidences of morbidity and blood loss. The incidence of morbidity and length of hospitalization were considerably greater for the more major sterilization procedures. Several variables related to risk, cost, and gynecological and psychological health should be considered by the surgeon before electing a sterilization procedure.