A comprehensive review of female sterilisation--tubal occlusion methods.

Clinical reproduction and fertility Pub Date : 1985-06-01
P H Chick, M Frances, P J Paterson
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Abstract

Female sterilisation using tubal occlusive methods are reviewed. The various techniques, failure rates, mortality, short and long-term morbidity, psychosexual effects and reversibility are discussed. Tubal occlusion is an effective method of female sterilisation but if failure should occur ectopic pregnancies are more likely if tubal diathermy, and less likely if Fallope rings or Filshie clips have been used for the original sterilisation procedure. Mortality rates are low and occur as a once-only risk when compared to ongoing contraception. Short-term morbidity rates are low when sterilisation is performed via the laparoscope, with single portal entry being more likely to result in complications. Mini-laparotomy and laparotomy also have low morbidity levels but complication rates are much higher when a transvaginal approach is used. There is no increase in morbidity when tubal sterilisation is performed at the time of pregnancy termination, providing uterine evacuation is not performed by hysterotomy. In the majority of cases no menstrual disturbance is noted; however, a small increase in menstrual disorders as a direct result of tubal sterilisation cannot be excluded absolutely. Sterilisation does not affect sexual satisfaction. Regret is more likely if the sterilisation is performed (i) post-termination or in the puerperium, (ii) when there is marital disharmony and (iii) for medical rather than social reasons. Low parity is not associated with regret except in cultures where high parity is prized. Microsurgical methods of reversal have higher pregnancy and lower ectopic rates than macrosurgical techniques. Successful reversal is inversely related to the degree of tubal destruction at the initial operation.

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女性绝育——输卵管闭塞方法综述。
本文综述了输卵管阻塞方法对女性绝育的影响。讨论了各种技术、失败率、死亡率、短期和长期发病率、性心理影响和可逆性。输卵管阻塞是一种有效的女性绝育方法,但如果发生失败,输卵管热疗更有可能发生异位妊娠,而在原始绝育过程中使用法洛普环或菲尔希夹的可能性较小。与持续的避孕相比,死亡率低,并且只发生一次风险。腹腔镜绝育术短期发病率低,单门静脉入路更容易引起并发症。小剖腹手术和剖腹手术的发病率也很低,但经阴道入路的并发症发生率要高得多。如果在终止妊娠时进行输卵管绝育,如果不通过子宫切开术进行子宫清理,则发病率不会增加。在大多数情况下,没有月经紊乱;然而,不能完全排除输卵管绝育直接导致的月经紊乱的小幅增加。绝育不会影响性满足。如果在以下情况下进行绝育,更有可能后悔:(i)在终止妊娠后或产褥期进行绝育,(ii)在婚姻不和谐时进行绝育,以及(iii)出于医疗而非社会原因进行绝育。低平等与后悔无关,除非在重视高平等的文化中。显微手术逆转方法比宏观手术技术有更高的妊娠率和更低的异位率。成功的逆转与初始手术时输卵管的破坏程度成反比。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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