Techniques for the interruption of tubal patency for female sterilisation
Background This is an update of a review that was first published in 2002. Female sterilisation is the most popular contraceptive method worldwide. Several techniques exist for interrupting the patency of fallopian tubes, including cutting and tying the tubes, damaging the tube using electric curren...
Gespeichert in:
| Veröffentlicht in: | Cochrane database of systematic reviews 2016-08, Vol.2016 (8), p.CD003034-CD003034 |
|---|---|
| Hauptverfasser: | , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | CD003034 |
|---|---|
| container_issue | 8 |
| container_start_page | CD003034 |
| container_title | Cochrane database of systematic reviews |
| container_volume | 2016 |
| creator | Lawrie, Theresa A Kulier, Regina Nardin, Juan Manuel Lawrie, Theresa A |
| description | Background
This is an update of a review that was first published in 2002. Female sterilisation is the most popular contraceptive method worldwide. Several techniques exist for interrupting the patency of fallopian tubes, including cutting and tying the tubes, damaging the tube using electric current, applying clips or silicone rubber rings, and blocking the tubes with chemicals or tubal inserts.
Objectives
To compare the different tubal occlusion techniques in terms of major and minor morbidity, failure rates (pregnancies), technical failures and difficulties, and women's and surgeons' satisfaction.
Search methods
For the original review published in 2002 we searched MEDLINE and the Cochrane Central Register of Controlled Trials (CENTRAL). For this 2015 update, we searched POPLINE, LILACS, PubMed and CENTRAL on 23 July 2015. We used the related articles feature of PubMed and searched reference lists of newly identified trials.
Selection criteria
All randomized controlled trials (RCTs) comparing different techniques for tubal sterilisation, irrespective of the route of fallopian tube access or the method of anaesthesia.
Data collection and analysis
For the original review, two review authors independently selected studies, extracted data and assessed risk of bias. For this update, data extraction was performed by one author (TL) and checked by another (RK). We grouped trials according to the type of comparison evaluated. Results are reported as odds ratios (OR) or mean differences (MD) using fixed‐effect methods, unless heterogeneity was high, in which case we used random‐effects methods.
Main results
We included 19 RCTs involving 13,209 women. Most studies concerned interval sterilisation; three RCTs involving 1632 women, concerned postpartum sterilisation. Comparisons included tubal rings versus clips (six RCTs, 4232 women); partial salpingectomy versus electrocoagulation (three RCTs, 2019 women); tubal rings versus electrocoagulation (two RCTs, 599 women); partial salpingectomy versus clips (four RCTs, 3627 women); clips versus electrocoagulation (two RCTs, 206 women); and Hulka versus Filshie clips (two RCTs, 2326 women). RCTs of clips versus electrocoagulation contributed no data to the review.
One year after sterilisation, failure rates were low (< 5/1000) for all methods.There were no deaths reported with any method, and major morbidity related to the occlusion technique was rare.
Minor morbidity was higher with the tubal ring than the clip (Peto OR |
| doi_str_mv | 10.1002/14651858.CD003034.pub4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7004248</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1816638457</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5434-70dc17a4cb3dc4f44415767933e8c9da00f6fff5caba5119b122cfda5716baec3</originalsourceid><addsrcrecordid>eNqFkctOwzAURC0EolD4hSpLNi12_Eo2SFBelSqxKWvLcWxilMTBTkD9exL6UGHDypbm3BlfDwATBGcIwvgaEUZRQpPZ_B5CDDGZNV1GjsDZIEwH5fjgPgLnIbz3IEtjfgpGMScpQSk-A4uVVkVtPzodIuN81BY6snWrve-a1ro6ciZqu0yWUSNbXav1D2V0JUsdhZ6zpQ1yIC_AiZFl0JfbcwxeHx9W8-fp8uVpMb9dThUlmEw5zBXikqgM54oYQgiinPEUY52oNJcQGmaMoUpmkiKUZiiOlckl5YhlUis8Bjcb337hSudK162XpWi8raRfCyet-K3UthBv7lNwCElMkt7gamvg3bB3KyoblC5LWWvXBYESxBhOCOU9yjao8i4Er80-BkEx9CB2PYhdD0M46Qcnh4_cj-0-vgfuNsCXLfVaKKcK3-f_4_sn5RvIjZrq</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1816638457</pqid></control><display><type>article</type><title>Techniques for the interruption of tubal patency for female sterilisation</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Cochrane Library</source><source>Alma/SFX Local Collection</source><creator>Lawrie, Theresa A ; Kulier, Regina ; Nardin, Juan Manuel ; Lawrie, Theresa A</creator><creatorcontrib>Lawrie, Theresa A ; Kulier, Regina ; Nardin, Juan Manuel ; Lawrie, Theresa A</creatorcontrib><description>Background
This is an update of a review that was first published in 2002. Female sterilisation is the most popular contraceptive method worldwide. Several techniques exist for interrupting the patency of fallopian tubes, including cutting and tying the tubes, damaging the tube using electric current, applying clips or silicone rubber rings, and blocking the tubes with chemicals or tubal inserts.
Objectives
To compare the different tubal occlusion techniques in terms of major and minor morbidity, failure rates (pregnancies), technical failures and difficulties, and women's and surgeons' satisfaction.
Search methods
For the original review published in 2002 we searched MEDLINE and the Cochrane Central Register of Controlled Trials (CENTRAL). For this 2015 update, we searched POPLINE, LILACS, PubMed and CENTRAL on 23 July 2015. We used the related articles feature of PubMed and searched reference lists of newly identified trials.
Selection criteria
All randomized controlled trials (RCTs) comparing different techniques for tubal sterilisation, irrespective of the route of fallopian tube access or the method of anaesthesia.
Data collection and analysis
For the original review, two review authors independently selected studies, extracted data and assessed risk of bias. For this update, data extraction was performed by one author (TL) and checked by another (RK). We grouped trials according to the type of comparison evaluated. Results are reported as odds ratios (OR) or mean differences (MD) using fixed‐effect methods, unless heterogeneity was high, in which case we used random‐effects methods.
Main results
We included 19 RCTs involving 13,209 women. Most studies concerned interval sterilisation; three RCTs involving 1632 women, concerned postpartum sterilisation. Comparisons included tubal rings versus clips (six RCTs, 4232 women); partial salpingectomy versus electrocoagulation (three RCTs, 2019 women); tubal rings versus electrocoagulation (two RCTs, 599 women); partial salpingectomy versus clips (four RCTs, 3627 women); clips versus electrocoagulation (two RCTs, 206 women); and Hulka versus Filshie clips (two RCTs, 2326 women). RCTs of clips versus electrocoagulation contributed no data to the review.
One year after sterilisation, failure rates were low (< 5/1000) for all methods.There were no deaths reported with any method, and major morbidity related to the occlusion technique was rare.
Minor morbidity was higher with the tubal ring than the clip (Peto OR 2.15, 95% CI 1.22 to 3.78; participants = 842; studies = 2; I² = 0%; high‐quality evidence), as were technical failures (Peto OR 3.93, 95% CI 2.43 to 6.35; participants = 3476; studies = 3; I² = 0%; high‐quality evidence).
Major morbidity was significantly higher with the modified Pomeroy technique than electrocoagulation (Peto OR 2.87, 95% CI 1.13 to 7.25; participants = 1905; studies = 2; I² = 0%; low‐quality evidence), as was postoperative pain (Peto OR 3.85, 95% CI 2.91 to 5.10; participants = 1905; studies = 2; I² = 0%; moderate‐quality evidence).
When tubal rings were compared with electrocoagulation, postoperative pain was reported significantly more frequently for tubal rings (OR 3.40, 95% CI 1.17 to 9.84; participants = 596; studies = 2; I² = 87%; low‐quality evidence).
When partial salpingectomy was compared with clips, there were no major morbidity events in either group (participants = 2198, studies = 1). The frequency of minor morbidity was low and not significantly different between groups (Peto OR 7.39, 95% CI 0.46 to 119.01; participants = 193; studies = 1, low‐quality evidence). Although technical failure occurred more frequently with clips (Peto OR 0.18, 95% CI 0.08 to 0.40; participants = 2198; studies = 1; moderate‐quality evidence); operative time was shorter with clips than partial salpingectomy (MD 4.26 minutes, 95% CI 3.65 to 4.86; participants = 2223; studies = 2; I² = 0%; high‐quality evidence).
We found little evidence concerning women's or surgeon's satisfaction. No RCTs compared tubal microinserts (hysteroscopic sterilisation) or chemical inserts (quinacrine) to other methods.
Authors' conclusions
Tubal sterilisation by partial salpingectomy, electrocoagulation, or using clips or rings, is a safe and effective method of contraception. Failure rates at 12 months post‐sterilisation and major morbidity are rare outcomes with any of these techniques. Minor complications and technical failures appear to be more common with rings than clips. Electrocoagulation may be associated with less postoperative pain than the modified Pomeroy or tubal ring methods. Further research should include RCTs (for effectiveness) and controlled observational studies (for adverse effects) on sterilisation by minimally‐invasive methods, i.e. tubal inserts and quinacrine.</description><identifier>ISSN: 1465-1858</identifier><identifier>EISSN: 1465-1858</identifier><identifier>EISSN: 1469-493X</identifier><identifier>DOI: 10.1002/14651858.CD003034.pub4</identifier><identifier>PMID: 27494193</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>Contraception ; Contraception related reviews ; Electrocoagulation ; Electrocoagulation - methods ; Female ; Female sterilisation ; Female sterilization ; Gynaecology ; Humans ; Medicine General & Introductory Medical Sciences ; Methods ; Randomized Controlled Trials as Topic ; Salpingectomy ; Salpingectomy - methods ; Sterilization, Tubal ; Sterilization, Tubal - adverse effects ; Sterilization, Tubal - instrumentation ; Sterilization, Tubal - methods ; Surgical Instruments ; Surgical Instruments - adverse effects ; Techniques</subject><ispartof>Cochrane database of systematic reviews, 2016-08, Vol.2016 (8), p.CD003034-CD003034</ispartof><rights>Copyright © 2016 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5434-70dc17a4cb3dc4f44415767933e8c9da00f6fff5caba5119b122cfda5716baec3</citedby><cites>FETCH-LOGICAL-c5434-70dc17a4cb3dc4f44415767933e8c9da00f6fff5caba5119b122cfda5716baec3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27494193$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lawrie, Theresa A</creatorcontrib><creatorcontrib>Kulier, Regina</creatorcontrib><creatorcontrib>Nardin, Juan Manuel</creatorcontrib><creatorcontrib>Lawrie, Theresa A</creatorcontrib><title>Techniques for the interruption of tubal patency for female sterilisation</title><title>Cochrane database of systematic reviews</title><addtitle>Cochrane Database Syst Rev</addtitle><description>Background
This is an update of a review that was first published in 2002. Female sterilisation is the most popular contraceptive method worldwide. Several techniques exist for interrupting the patency of fallopian tubes, including cutting and tying the tubes, damaging the tube using electric current, applying clips or silicone rubber rings, and blocking the tubes with chemicals or tubal inserts.
Objectives
To compare the different tubal occlusion techniques in terms of major and minor morbidity, failure rates (pregnancies), technical failures and difficulties, and women's and surgeons' satisfaction.
Search methods
For the original review published in 2002 we searched MEDLINE and the Cochrane Central Register of Controlled Trials (CENTRAL). For this 2015 update, we searched POPLINE, LILACS, PubMed and CENTRAL on 23 July 2015. We used the related articles feature of PubMed and searched reference lists of newly identified trials.
Selection criteria
All randomized controlled trials (RCTs) comparing different techniques for tubal sterilisation, irrespective of the route of fallopian tube access or the method of anaesthesia.
Data collection and analysis
For the original review, two review authors independently selected studies, extracted data and assessed risk of bias. For this update, data extraction was performed by one author (TL) and checked by another (RK). We grouped trials according to the type of comparison evaluated. Results are reported as odds ratios (OR) or mean differences (MD) using fixed‐effect methods, unless heterogeneity was high, in which case we used random‐effects methods.
Main results
We included 19 RCTs involving 13,209 women. Most studies concerned interval sterilisation; three RCTs involving 1632 women, concerned postpartum sterilisation. Comparisons included tubal rings versus clips (six RCTs, 4232 women); partial salpingectomy versus electrocoagulation (three RCTs, 2019 women); tubal rings versus electrocoagulation (two RCTs, 599 women); partial salpingectomy versus clips (four RCTs, 3627 women); clips versus electrocoagulation (two RCTs, 206 women); and Hulka versus Filshie clips (two RCTs, 2326 women). RCTs of clips versus electrocoagulation contributed no data to the review.
One year after sterilisation, failure rates were low (< 5/1000) for all methods.There were no deaths reported with any method, and major morbidity related to the occlusion technique was rare.
Minor morbidity was higher with the tubal ring than the clip (Peto OR 2.15, 95% CI 1.22 to 3.78; participants = 842; studies = 2; I² = 0%; high‐quality evidence), as were technical failures (Peto OR 3.93, 95% CI 2.43 to 6.35; participants = 3476; studies = 3; I² = 0%; high‐quality evidence).
Major morbidity was significantly higher with the modified Pomeroy technique than electrocoagulation (Peto OR 2.87, 95% CI 1.13 to 7.25; participants = 1905; studies = 2; I² = 0%; low‐quality evidence), as was postoperative pain (Peto OR 3.85, 95% CI 2.91 to 5.10; participants = 1905; studies = 2; I² = 0%; moderate‐quality evidence).
When tubal rings were compared with electrocoagulation, postoperative pain was reported significantly more frequently for tubal rings (OR 3.40, 95% CI 1.17 to 9.84; participants = 596; studies = 2; I² = 87%; low‐quality evidence).
When partial salpingectomy was compared with clips, there were no major morbidity events in either group (participants = 2198, studies = 1). The frequency of minor morbidity was low and not significantly different between groups (Peto OR 7.39, 95% CI 0.46 to 119.01; participants = 193; studies = 1, low‐quality evidence). Although technical failure occurred more frequently with clips (Peto OR 0.18, 95% CI 0.08 to 0.40; participants = 2198; studies = 1; moderate‐quality evidence); operative time was shorter with clips than partial salpingectomy (MD 4.26 minutes, 95% CI 3.65 to 4.86; participants = 2223; studies = 2; I² = 0%; high‐quality evidence).
We found little evidence concerning women's or surgeon's satisfaction. No RCTs compared tubal microinserts (hysteroscopic sterilisation) or chemical inserts (quinacrine) to other methods.
Authors' conclusions
Tubal sterilisation by partial salpingectomy, electrocoagulation, or using clips or rings, is a safe and effective method of contraception. Failure rates at 12 months post‐sterilisation and major morbidity are rare outcomes with any of these techniques. Minor complications and technical failures appear to be more common with rings than clips. Electrocoagulation may be associated with less postoperative pain than the modified Pomeroy or tubal ring methods. Further research should include RCTs (for effectiveness) and controlled observational studies (for adverse effects) on sterilisation by minimally‐invasive methods, i.e. tubal inserts and quinacrine.</description><subject>Contraception</subject><subject>Contraception related reviews</subject><subject>Electrocoagulation</subject><subject>Electrocoagulation - methods</subject><subject>Female</subject><subject>Female sterilisation</subject><subject>Female sterilization</subject><subject>Gynaecology</subject><subject>Humans</subject><subject>Medicine General & Introductory Medical Sciences</subject><subject>Methods</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Salpingectomy</subject><subject>Salpingectomy - methods</subject><subject>Sterilization, Tubal</subject><subject>Sterilization, Tubal - adverse effects</subject><subject>Sterilization, Tubal - instrumentation</subject><subject>Sterilization, Tubal - methods</subject><subject>Surgical Instruments</subject><subject>Surgical Instruments - adverse effects</subject><subject>Techniques</subject><issn>1465-1858</issn><issn>1465-1858</issn><issn>1469-493X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>RWY</sourceid><sourceid>EIF</sourceid><recordid>eNqFkctOwzAURC0EolD4hSpLNi12_Eo2SFBelSqxKWvLcWxilMTBTkD9exL6UGHDypbm3BlfDwATBGcIwvgaEUZRQpPZ_B5CDDGZNV1GjsDZIEwH5fjgPgLnIbz3IEtjfgpGMScpQSk-A4uVVkVtPzodIuN81BY6snWrve-a1ro6ciZqu0yWUSNbXav1D2V0JUsdhZ6zpQ1yIC_AiZFl0JfbcwxeHx9W8-fp8uVpMb9dThUlmEw5zBXikqgM54oYQgiinPEUY52oNJcQGmaMoUpmkiKUZiiOlckl5YhlUis8Bjcb337hSudK162XpWi8raRfCyet-K3UthBv7lNwCElMkt7gamvg3bB3KyoblC5LWWvXBYESxBhOCOU9yjao8i4Er80-BkEx9CB2PYhdD0M46Qcnh4_cj-0-vgfuNsCXLfVaKKcK3-f_4_sn5RvIjZrq</recordid><startdate>20160805</startdate><enddate>20160805</enddate><creator>Lawrie, Theresa A</creator><creator>Kulier, Regina</creator><creator>Nardin, Juan Manuel</creator><creator>Lawrie, Theresa A</creator><general>John Wiley & Sons, Ltd</general><scope>7PX</scope><scope>RWY</scope><scope>ZYTZH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20160805</creationdate><title>Techniques for the interruption of tubal patency for female sterilisation</title><author>Lawrie, Theresa A ; Kulier, Regina ; Nardin, Juan Manuel ; Lawrie, Theresa A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5434-70dc17a4cb3dc4f44415767933e8c9da00f6fff5caba5119b122cfda5716baec3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Contraception</topic><topic>Contraception related reviews</topic><topic>Electrocoagulation</topic><topic>Electrocoagulation - methods</topic><topic>Female</topic><topic>Female sterilisation</topic><topic>Female sterilization</topic><topic>Gynaecology</topic><topic>Humans</topic><topic>Medicine General & Introductory Medical Sciences</topic><topic>Methods</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Salpingectomy</topic><topic>Salpingectomy - methods</topic><topic>Sterilization, Tubal</topic><topic>Sterilization, Tubal - adverse effects</topic><topic>Sterilization, Tubal - instrumentation</topic><topic>Sterilization, Tubal - methods</topic><topic>Surgical Instruments</topic><topic>Surgical Instruments - adverse effects</topic><topic>Techniques</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lawrie, Theresa A</creatorcontrib><creatorcontrib>Kulier, Regina</creatorcontrib><creatorcontrib>Nardin, Juan Manuel</creatorcontrib><creatorcontrib>Lawrie, Theresa A</creatorcontrib><collection>Wiley-Blackwell Cochrane Library</collection><collection>Cochrane Library</collection><collection>Cochrane Library (Open Aceess)</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Cochrane database of systematic reviews</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lawrie, Theresa A</au><au>Kulier, Regina</au><au>Nardin, Juan Manuel</au><au>Lawrie, Theresa A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Techniques for the interruption of tubal patency for female sterilisation</atitle><jtitle>Cochrane database of systematic reviews</jtitle><addtitle>Cochrane Database Syst Rev</addtitle><date>2016-08-05</date><risdate>2016</risdate><volume>2016</volume><issue>8</issue><spage>CD003034</spage><epage>CD003034</epage><pages>CD003034-CD003034</pages><issn>1465-1858</issn><eissn>1465-1858</eissn><eissn>1469-493X</eissn><abstract>Background
This is an update of a review that was first published in 2002. Female sterilisation is the most popular contraceptive method worldwide. Several techniques exist for interrupting the patency of fallopian tubes, including cutting and tying the tubes, damaging the tube using electric current, applying clips or silicone rubber rings, and blocking the tubes with chemicals or tubal inserts.
Objectives
To compare the different tubal occlusion techniques in terms of major and minor morbidity, failure rates (pregnancies), technical failures and difficulties, and women's and surgeons' satisfaction.
Search methods
For the original review published in 2002 we searched MEDLINE and the Cochrane Central Register of Controlled Trials (CENTRAL). For this 2015 update, we searched POPLINE, LILACS, PubMed and CENTRAL on 23 July 2015. We used the related articles feature of PubMed and searched reference lists of newly identified trials.
Selection criteria
All randomized controlled trials (RCTs) comparing different techniques for tubal sterilisation, irrespective of the route of fallopian tube access or the method of anaesthesia.
Data collection and analysis
For the original review, two review authors independently selected studies, extracted data and assessed risk of bias. For this update, data extraction was performed by one author (TL) and checked by another (RK). We grouped trials according to the type of comparison evaluated. Results are reported as odds ratios (OR) or mean differences (MD) using fixed‐effect methods, unless heterogeneity was high, in which case we used random‐effects methods.
Main results
We included 19 RCTs involving 13,209 women. Most studies concerned interval sterilisation; three RCTs involving 1632 women, concerned postpartum sterilisation. Comparisons included tubal rings versus clips (six RCTs, 4232 women); partial salpingectomy versus electrocoagulation (three RCTs, 2019 women); tubal rings versus electrocoagulation (two RCTs, 599 women); partial salpingectomy versus clips (four RCTs, 3627 women); clips versus electrocoagulation (two RCTs, 206 women); and Hulka versus Filshie clips (two RCTs, 2326 women). RCTs of clips versus electrocoagulation contributed no data to the review.
One year after sterilisation, failure rates were low (< 5/1000) for all methods.There were no deaths reported with any method, and major morbidity related to the occlusion technique was rare.
Minor morbidity was higher with the tubal ring than the clip (Peto OR 2.15, 95% CI 1.22 to 3.78; participants = 842; studies = 2; I² = 0%; high‐quality evidence), as were technical failures (Peto OR 3.93, 95% CI 2.43 to 6.35; participants = 3476; studies = 3; I² = 0%; high‐quality evidence).
Major morbidity was significantly higher with the modified Pomeroy technique than electrocoagulation (Peto OR 2.87, 95% CI 1.13 to 7.25; participants = 1905; studies = 2; I² = 0%; low‐quality evidence), as was postoperative pain (Peto OR 3.85, 95% CI 2.91 to 5.10; participants = 1905; studies = 2; I² = 0%; moderate‐quality evidence).
When tubal rings were compared with electrocoagulation, postoperative pain was reported significantly more frequently for tubal rings (OR 3.40, 95% CI 1.17 to 9.84; participants = 596; studies = 2; I² = 87%; low‐quality evidence).
When partial salpingectomy was compared with clips, there were no major morbidity events in either group (participants = 2198, studies = 1). The frequency of minor morbidity was low and not significantly different between groups (Peto OR 7.39, 95% CI 0.46 to 119.01; participants = 193; studies = 1, low‐quality evidence). Although technical failure occurred more frequently with clips (Peto OR 0.18, 95% CI 0.08 to 0.40; participants = 2198; studies = 1; moderate‐quality evidence); operative time was shorter with clips than partial salpingectomy (MD 4.26 minutes, 95% CI 3.65 to 4.86; participants = 2223; studies = 2; I² = 0%; high‐quality evidence).
We found little evidence concerning women's or surgeon's satisfaction. No RCTs compared tubal microinserts (hysteroscopic sterilisation) or chemical inserts (quinacrine) to other methods.
Authors' conclusions
Tubal sterilisation by partial salpingectomy, electrocoagulation, or using clips or rings, is a safe and effective method of contraception. Failure rates at 12 months post‐sterilisation and major morbidity are rare outcomes with any of these techniques. Minor complications and technical failures appear to be more common with rings than clips. Electrocoagulation may be associated with less postoperative pain than the modified Pomeroy or tubal ring methods. Further research should include RCTs (for effectiveness) and controlled observational studies (for adverse effects) on sterilisation by minimally‐invasive methods, i.e. tubal inserts and quinacrine.</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>27494193</pmid><doi>10.1002/14651858.CD003034.pub4</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1465-1858 |
| ispartof | Cochrane database of systematic reviews, 2016-08, Vol.2016 (8), p.CD003034-CD003034 |
| issn | 1465-1858 1465-1858 1469-493X |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7004248 |
| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Cochrane Library; Alma/SFX Local Collection |
| subjects | Contraception Contraception related reviews Electrocoagulation Electrocoagulation - methods Female Female sterilisation Female sterilization Gynaecology Humans Medicine General & Introductory Medical Sciences Methods Randomized Controlled Trials as Topic Salpingectomy Salpingectomy - methods Sterilization, Tubal Sterilization, Tubal - adverse effects Sterilization, Tubal - instrumentation Sterilization, Tubal - methods Surgical Instruments Surgical Instruments - adverse effects Techniques |
| title | Techniques for the interruption of tubal patency for female sterilisation |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-08T06%3A11%3A17IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Techniques%20for%20the%20interruption%20of%20tubal%20patency%20for%20female%20sterilisation&rft.jtitle=Cochrane%20database%20of%20systematic%20reviews&rft.au=Lawrie,%20Theresa%20A&rft.date=2016-08-05&rft.volume=2016&rft.issue=8&rft.spage=CD003034&rft.epage=CD003034&rft.pages=CD003034-CD003034&rft.issn=1465-1858&rft.eissn=1465-1858&rft_id=info:doi/10.1002/14651858.CD003034.pub4&rft_dat=%3Cproquest_pubme%3E1816638457%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1816638457&rft_id=info:pmid/27494193&rfr_iscdi=true |