Abstract

PIP: Puerperal sterilization techniques are evaluated with an emphasis upon contemporary patient and physician needs. focus is on preoperative considerations, intraoperative considerations (timing, anesthesia, incision, preferred methods, and other methods). The Pomeroy and Oxford methods of sterilization, performed under an anesthesia of choice during the first 48 hours post partum, are today's most economic, simple, and efficacious puerperal procedures. These methods have adequate potential for reversal. When any chance of failure is intolerable, the Irving method is an attractive choice, particularly at the time of cesarean section. The Uchida method, although more elaborate, appears equally fool-proof. Future developments in tuboocclusive devices may improve operative speed and prospects for reversal. Laparoscopic sterilization should not be performed in the immediate puerperium. The procedure offers no advantage over conventional methods, requires costly and sophistricated equipment, and risks blind entry into the abdominal cavity in the presence of a large uterine fundus and vascular, edematous adnexae.