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tubal ligation; bilateral tubal ligation
bilateral tubal ligation
Indications:
- reproductive sterilization
- *parous women over 30 wishing infertility
- probability of pregnancy was 0% in women > 34 years, 2-8% in women 25-34 years [4]
- 21% of pregnancies are ectopic [4]
Procedures:
- ligation of fallopian tubes*
*Generally considered safe & effective.
Complications:
- hysteroscopic sterilization associated with a lower risk of iatrogenic complications (RR=0.35), but a 10-fold risk of need for repeat procedure compared with laparoscopic sterilization [2]
- hysteroscopic vs laparoscopic sterilization associated lower risk for surgical or medical complications during hospitalization (0.13% vs 0.78%), but higher risk for tubal disorder or surgery at 1 & 3 years (0.70% vs 0.23%) [3]
- unintended pregnancy rare after either procedure (~1%)
- surgical & major medical complications at 30 days (< 0.5%) [2]
Specific
tubal ligation; bilateral tubal ligation
General
gynecologic surgery
reproductive sterilization
References
- Medical Knowledge Self Assessment Program (MKSAP) 11, American
College of Physicians, Philadelphia 1998
- Mao J, Pfeifer S, Schlegel P, Sedrakyan A
Safety and efficacy of hysteroscopic sterilization compared with
laparoscopic sterilization: an observational cohort study.
BMJ 2015;351:h5162
PMID: 26462857
http://www.bmj.com/content/351/bmj.h5162
- Bouillon K, Bertrand M, Bader G et al
Association of Hysteroscopic vs Laparoscopic Sterilization With
Procedural, Gynecological, and Medical Outcomes.
JAMA. 2018;319(4):375-387
PMID: 29362796
https://jamanetwork.com/journals/jama/article-abstract/2670255
- Espey E, Hofler LG.
Evaluating the Long-term Safety of Hysteroscopic Sterilization.
JAMA. 2018;319(4)
PMID: 29362776
https://jamanetwork.com/journals/jama/article-abstract/2670235
- Schwarz EB et al.
Pregnancy after Tubal Sterilization in the United States, 2002 to 2015.
NEJM Evid 2024 Sep; 3:a2400023
PMID: 39189861
https://evidence.nejm.org/doi/10.1056/EVIDoa2400023