Tubal ligation Archives - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Rev Bras Ginecol Obstet. 2018;40(6):332-337
To determine which mode and potency of electrocoagulation, using a modern electrosurgical generator, yields the smallest unobstructed area of the Fallopian tubes.
In an experimental study, tubes from 48 hysterectomies or tubal ligation were evaluated. Tubes were randomly allocated to one of the following groups: group A) 25 W x 5 seconds (n = 17); group B) 30 W x 5 seconds (n = 17); group C) 35 W x 5 seconds (n = 18), group D) 40 W x 5 seconds (n = 20); group E) 40 W x 5 seconds with visual inspection (blanch, swells, collapse) (n = 16); group F) 50 W x 5 seconds (n = 8). Bipolar electrocoagulation was performed in groups A to E, and monopolar electrocoagulation was performed in group F. Coagulation mode was used in all groups. Digital photomicrography of the transversal histological sections of the isthmic segment of the Fallopian tube were taken, and themedian percentage of unobstructed luminal area (mm2) was measured with ImageJ software (ImageJ, National Institutes of Health, Bethesda, MD, USA). The Kruskal-Wallis test or analysis of variance (ANOVA) was used for statistical analysis.
Ninety-six Fallopian tube sections were analyzed. The smallest median occluded area (%; range) of the Fallopian tube was obtained in the group with 40 W with visual inspection (8.3%; 0.9-40%), followed by the groups 25 W (9.1%; 0-35.9%), 40 W (14.2; 0.9-43.2%), 30 W (14.2; 0.9-49.7%), 35 W (15.1; 3-46.4%) and 50 W (38.2; 3.1-51%). No statistically significant difference was found among groups (p = 0.09, Kruskal-Wallis test).
The smallest unobstructed area was obtained with power setting at 40 W with visual inspection using a modern electrosurgical generator. However, no statistically significant difference in the unobstructed area was observed among the groups using these different modes and potencies.
Summary
Rev Bras Ginecol Obstet. 2018;40(6):332-337
To determine which mode and potency of electrocoagulation, using a modern electrosurgical generator, yields the smallest unobstructed area of the Fallopian tubes.
In an experimental study, tubes from 48 hysterectomies or tubal ligation were evaluated. Tubes were randomly allocated to one of the following groups: group A) 25 W x 5 seconds (n = 17); group B) 30 W x 5 seconds (n = 17); group C) 35 W x 5 seconds (n = 18), group D) 40 W x 5 seconds (n = 20); group E) 40 W x 5 seconds with visual inspection (blanch, swells, collapse) (n = 16); group F) 50 W x 5 seconds (n = 8). Bipolar electrocoagulation was performed in groups A to E, and monopolar electrocoagulation was performed in group F. Coagulation mode was used in all groups. Digital photomicrography of the transversal histological sections of the isthmic segment of the Fallopian tube were taken, and themedian percentage of unobstructed luminal area (mm2) was measured with ImageJ software (ImageJ, National Institutes of Health, Bethesda, MD, USA). The Kruskal-Wallis test or analysis of variance (ANOVA) was used for statistical analysis.
Ninety-six Fallopian tube sections were analyzed. The smallest median occluded area (%; range) of the Fallopian tube was obtained in the group with 40 W with visual inspection (8.3%; 0.9-40%), followed by the groups 25 W (9.1%; 0-35.9%), 40 W (14.2; 0.9-43.2%), 30 W (14.2; 0.9-49.7%), 35 W (15.1; 3-46.4%) and 50 W (38.2; 3.1-51%). No statistically significant difference was found among groups (p = 0.09, Kruskal-Wallis test).
The smallest unobstructed area was obtained with power setting at 40 W with visual inspection using a modern electrosurgical generator. However, no statistically significant difference in the unobstructed area was observed among the groups using these different modes and potencies.
Summary
Rev Bras Ginecol Obstet. 2017;39(7):344-349
To evaluate the trends in definitive contraception in a ten-year interval comprising the years 2002 and 2012.
Retrospective analysis of the tubal sterilization performed in our service in 2002 and2012,analyzingthedemographiccharacteristics,personalhistory,previouscontraceptive method, definite contraception technique, effectiveness and complications.
Definitive contraception was performed in 112 women in 2002 (group 1) and in 60 women in 2012 (group 2). The groups were homogeneous regarding age, parity, educational level and personal history. The number of women older than 40 years choosing a definitive method was more frequent in group 1, 49.1% (n = 55); for group 2, the rate was 34.8% (n = 23) (p = 0.04). The time between the last delivery and the procedure was 11.6±6.2 and 7.9±6.4 years (p = 0.014) in 2002 against 2012 respectively. In 2002, all patients performed tubal ligation by laparoscopic inpatient regime. In 2012, the bilateral placement of the Essure (Bayer Corporation, Whippany, NJ, US) device was suggested to 56.1% (n = 37) of the patients, while laparoscopy was suggested to 43.9% (n = 29) of them. All women who underwent laparoscopic sterilization had the procedure successfully completed using silastic rings. The overall bilateral device placement rate for the Essure was 91.6%, with only one complication reported. All Essure procedures were performed in an outpatient setting; for the laparoscopy, this rate was 79% (n = 15). No intentional pregnancies occurred until this date.
There is a trend in the decrease in definitive contraception over the years in our institution, maybe as a result of the development of long-acting reversible contraceptives. The hysteroscopic procedure has become a frequent option, as it is performed in an office setting without anesthesia, being a well-tolerated, minimal invasive method.
Summary
Rev Bras Ginecol Obstet. 2017;39(7):344-349
To evaluate the trends in definitive contraception in a ten-year interval comprising the years 2002 and 2012.
Retrospective analysis of the tubal sterilization performed in our service in 2002 and2012,analyzingthedemographiccharacteristics,personalhistory,previouscontraceptive method, definite contraception technique, effectiveness and complications.
Definitive contraception was performed in 112 women in 2002 (group 1) and in 60 women in 2012 (group 2). The groups were homogeneous regarding age, parity, educational level and personal history. The number of women older than 40 years choosing a definitive method was more frequent in group 1, 49.1% (n = 55); for group 2, the rate was 34.8% (n = 23) (p = 0.04). The time between the last delivery and the procedure was 11.6±6.2 and 7.9±6.4 years (p = 0.014) in 2002 against 2012 respectively. In 2002, all patients performed tubal ligation by laparoscopic inpatient regime. In 2012, the bilateral placement of the Essure (Bayer Corporation, Whippany, NJ, US) device was suggested to 56.1% (n = 37) of the patients, while laparoscopy was suggested to 43.9% (n = 29) of them. All women who underwent laparoscopic sterilization had the procedure successfully completed using silastic rings. The overall bilateral device placement rate for the Essure was 91.6%, with only one complication reported. All Essure procedures were performed in an outpatient setting; for the laparoscopy, this rate was 79% (n = 15). No intentional pregnancies occurred until this date.
There is a trend in the decrease in definitive contraception over the years in our institution, maybe as a result of the development of long-acting reversible contraceptives. The hysteroscopic procedure has become a frequent option, as it is performed in an office setting without anesthesia, being a well-tolerated, minimal invasive method.
Summary
Rev Bras Ginecol Obstet. 2001;23(10):621-626
DOI 10.1590/S0100-72032001001000002
Purpose: to compare bone mineral density (BMD) of postmenopausal women with and without the antecedent of tubal ligation, as well as to evaluate the associated factors that affect the bone mineral density of femur and lumbar spine of both groups. Methods: 70 postmenopausal women in each group were analyzed at CAISM-UNICAMP, during the year of 1998. All women answered a questionnaire about some clinical and reproductive characteristics and underwent bone densitometry (Lunar DPX) to measure bone mineral density of the femur and lumbar spine. Statistical analyses were performed using Student's t-test, Fisher`s exact test, Pearson c² test, Bonferroni`s test and multiple regression analysis. Results: mean age of patients was 53.2 years and for controls it was 52.6 years. Mean age of 48 years at menopause was similar in both groups. Mean age at tubal ligation surgery was 33.7 years and time since surgery was 18 years. The multiple comparison of the average bone mineral density of femur and lumbar spine did not show statistical differences between the groups. The percentage distribution of the T-score categories of femur and lumbar spine, classified into normal and altered, also did not show statistical differences between both groups. Multiple regression analysis showed that bone mineral density of femur was directly associated with body mass index, but age was indirectly associated. The variables dark skin, parity, age at menopause, educational level and body mass index were directly associated with bone mineral density of lumbar spine, but age at menarche was inversely associated. Conclusion: these findings suggest that tubal ligation does not seem to cause an additional reduction in bone mineral density when evaluated in postmenopause.
Summary
Rev Bras Ginecol Obstet. 2001;23(10):621-626
DOI 10.1590/S0100-72032001001000002
Purpose: to compare bone mineral density (BMD) of postmenopausal women with and without the antecedent of tubal ligation, as well as to evaluate the associated factors that affect the bone mineral density of femur and lumbar spine of both groups. Methods: 70 postmenopausal women in each group were analyzed at CAISM-UNICAMP, during the year of 1998. All women answered a questionnaire about some clinical and reproductive characteristics and underwent bone densitometry (Lunar DPX) to measure bone mineral density of the femur and lumbar spine. Statistical analyses were performed using Student's t-test, Fisher`s exact test, Pearson c² test, Bonferroni`s test and multiple regression analysis. Results: mean age of patients was 53.2 years and for controls it was 52.6 years. Mean age of 48 years at menopause was similar in both groups. Mean age at tubal ligation surgery was 33.7 years and time since surgery was 18 years. The multiple comparison of the average bone mineral density of femur and lumbar spine did not show statistical differences between the groups. The percentage distribution of the T-score categories of femur and lumbar spine, classified into normal and altered, also did not show statistical differences between both groups. Multiple regression analysis showed that bone mineral density of femur was directly associated with body mass index, but age was indirectly associated. The variables dark skin, parity, age at menopause, educational level and body mass index were directly associated with bone mineral density of lumbar spine, but age at menarche was inversely associated. Conclusion: these findings suggest that tubal ligation does not seem to cause an additional reduction in bone mineral density when evaluated in postmenopause.
Summary
Rev Bras Ginecol Obstet. 2002;24(7):441-446
DOI 10.1590/S0100-72032002000700003
Purpose: to evaluate the reproductive aspects in climacteric women of the Family Health Program in Cuiabá. Methods: it was a cross-sectional study including 354 women, with ages between 40 and 65 years, attended at the Central-Western District Family Health Program of Cuiabá. A pretested questionnaire with specific questions regarding the present study was used. Data were analyzed using the Z test and chi² test for trend. The mean age of the 354 women was 49.7±7 years and the median 48 years. A total of 243 (68.6%) were born in Mato Grosso, and the others were migrants from different states. Most were married (65.8%), white (48.0%), catholic (73.4%), and had low schooling: 62.4% did not finish the elementary school and 19.2% were illiterate. About 84% were occupied only in domestic activities, and more than a half (58.2%) belonged to a lower social class. Results: the average number of pregnancies was 5.4±3.3. Nearly 5% were nulliparous and 7% had more than ten children. Almost 50% had the first pregnancy in adolescence and 14% after the age of 40 years. A total of 229 women (65%) were submitted to pelvic surgery: 78% to tubal sterilization, 20% to hysterectomy, and 7% to bilateral oophorectomy. Menopause was due to hysterectomy/oophorectomy in 25% of the women. Conclusion: almost 65% of the women were submitted to a pelvic surgery. The most frequent surgery was tubal sterilization followed by total hysterectomy.
Summary
Rev Bras Ginecol Obstet. 2002;24(7):441-446
DOI 10.1590/S0100-72032002000700003
Purpose: to evaluate the reproductive aspects in climacteric women of the Family Health Program in Cuiabá. Methods: it was a cross-sectional study including 354 women, with ages between 40 and 65 years, attended at the Central-Western District Family Health Program of Cuiabá. A pretested questionnaire with specific questions regarding the present study was used. Data were analyzed using the Z test and chi² test for trend. The mean age of the 354 women was 49.7±7 years and the median 48 years. A total of 243 (68.6%) were born in Mato Grosso, and the others were migrants from different states. Most were married (65.8%), white (48.0%), catholic (73.4%), and had low schooling: 62.4% did not finish the elementary school and 19.2% were illiterate. About 84% were occupied only in domestic activities, and more than a half (58.2%) belonged to a lower social class. Results: the average number of pregnancies was 5.4±3.3. Nearly 5% were nulliparous and 7% had more than ten children. Almost 50% had the first pregnancy in adolescence and 14% after the age of 40 years. A total of 229 women (65%) were submitted to pelvic surgery: 78% to tubal sterilization, 20% to hysterectomy, and 7% to bilateral oophorectomy. Menopause was due to hysterectomy/oophorectomy in 25% of the women. Conclusion: almost 65% of the women were submitted to a pelvic surgery. The most frequent surgery was tubal sterilization followed by total hysterectomy.