Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(5):230-234
DOI 10.1590/S0100-72032007000500002
PURPOSE: to analyze the factors associated with the reproductive future of patients wishing to become pregnant after having being submitted to tubal ligation (TL), attended at a public service. METHODS: a prospective study including 98 patients previously submitted to TL, who came to the Human Reproduction Center of the University Hospital of Brasilia (HUB), from January 1996 to January 2004, wishing to become pregnant again These patients were followed up from their first appointment till the end of the study, when they answered a structured questionnaire about the social demographic aspects at both the moment they asked for the TL and the reversion of the procedure. RESULTS: the patients’ average age at the TL procedure was 25 years old. Among them, 55.1% were younger than 25, 46.9% had three or more children, and ten of them had only one child. The most common reasons for the TL procedure were: contraception (48%), financial difficulties (25.5%) and marital problems (15.3%). The major causes for wishing a new pregnancy were: a new relationship/marriage (80.6%), the desire of having another child with the same partner (8.2%), and the death of a child (6.1%). The regret time informed by most of the patients was between two and four years, and the search for reversion was between six and ten years. About 83.6% of the sample referred lack of information about the procedure and the difficulties of reversion. Twenty patients were submitted to TL reversal procedure; from the ten who became pregnant, only six delivered babies, after a full-term pregnancy. Eight patients were referred to in vitro fertilization treatment, four of them became pregnant and two delivered healthy babies. CONCLUSIONS: TL in young vulnerable women, not informed about the definitive condition of the method, may increase the search for attended reproduction services and impair their reproductive future, as far as only 8.1% of the sample delivered babies and reached their goal.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(2):105-109
DOI 10.1590/S0100-72031998000200008
The authors describe their experience with videolaparoscopic tubal anastomosis in 10 selected patients operated from June 1994 to February 1996. The time of the first surgery was 4 hours and 30 minutes and the last , 2 hours and 30 minutes. The time was different according to the change of auxiliary team. Half of the reanastomoses were isthmic- isthmic. The minimum size of the remaining tubes was 5cm on each side. We used 7-0 and 6-0 polyglycolic acid monofilament for suture. The tube patency was tested by hysterosalpingogram 3 months after surgery, and it was shown that 88.8% of the operated tubes were free. The patients considered able to become pregnant were followed up for a short period of time and 4 of them became pregnant. The hospitalization lasted 24 hours and there were no surgical or anesthetic complications.