Gynecologic Outcomes After Hysteroscopic and Laparoscopic Sterilization Procedures

Perkins, Rebecca B.; Morgan, Jake R.; Awosogba, Temitope P.; Ramanadhan, Shaalini

doi:10.1097/ogx.0000000000000409

Cited by 3 publications

(16 citation statements)

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“…The characteristics and results of all included studies can be found in Table 1. Of the studies included for the narrative synthesis, six compared effectiveness; [24][25][26][27][28][29] sixteen assessed adverse effects; 11,24,25,[28][29][30][31][32][33][34][35][36][37][38][39][40] three compared patient recovery; 25,35,36 ve compared non-contraceptive bene ts, primarily the reduction of cancer risk; 34, 41-44 six compared tolerability; 24,25,[27][28][29]44 four compared costs to the healthcare system; 28,[45][46][47] and six compared length of procedures. 11,28,35,36,40,47 No included studies compared accessibility, eligibility, or follow-up required.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Six studies reported the rate of pregnancy, all of which were cohort studies comparing hysteroscopic tubal occlusion and laparoscopic tubal ligation. [24][25][26][27][28][29] Among the included studies, there was a wide range of follow-up time to assess effectiveness (from one year to a maximum of ten years) 24 and signi cant variance in directionality and strength of the outcome; this likely explains the considerable heterogeneity observed.…”

Section: Effectivenessmentioning

confidence: 99%

“…Patients who underwent hysteroscopic tubal occlusion were at 1.2 times higher risk of becoming pregnant compared to those who underwent laparoscopic tubal ligation [aHR = 1.20 (95% con dence interval = 1.09-1.33)]. 29 Two studies, both conducted in France, found a higher risk of pregnancy among laparoscopic tubal ligation than hysteroscopic tubal occlusion; 25,26 however for one study, this difference was only signi cant at one year [aHR = 0.70 (0.53-0.92)], but not at three years [aHR = 1.04 (0.83-1.30)]. 25…”

Section: Effectivenessmentioning

confidence: 99%

“…Sixteen studies assessed adverse effects using prospective/retrospective cohort designs. Results are organized by intervention: six compared hysteroscopic tubal occlusion and laparoscopic tubal ligation, 24,25,[28][29][30][31] three compared laparoscopic tubal ligation and a control, [32][33][34] ve compared laparoscopic tubal ligation and bilateral salpingectomy, 11,[35][36][37]40 one compared hysteroscopic tubal occlusion, laparoscopic tubal ligation with controls, and bilateral salpingectomy with controls, 38 and one compared bilateral salpingectomy with laparoscopic tubal ligation and with matched controls. 39 Hysteroscopic tubal occlusion vs. Laparoscopic tubal ligationTwo studies 24,30 found no statistically signi cant difference in rates of adverse effects including abnormal uterine bleeding, pelvic pain, or opioid managed pain between the two interventions.…”

Section: Adverse Effectsmentioning

confidence: 99%

“…31 Hysteroscopic tubal occlusion was associated with a lower risk of surgical complications than laparoscopic tubal ligation [aOR = 0.18 (0.14-0.23)] 25 and a lower risk of iatrogenic complications after surgery [OR = 0.35 (0.20, 0.61)]. 28 Two analyses found higher rates of gynecological complications with hysteroscopic tubal occlusion compared to laparoscopic tubal ligation, 25,29 with one analysis nding that menstrual dysfunction was signi cantly higher for people undergoing hysteroscopic tubal occlusion [aHR = 1.23 (1.20-1.27)]. 29 However, pelvic pain incidence was found to be signi cantly lower in hysteroscopic tubal occlusion patients compared to laparoscopic tubal ligation patients [21.0% compared with 25.6% at 2 years, aHR = 0.83 (0.80-0.85)].…”

Section: Adverse Effectsmentioning

confidence: 99%

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Comparing Female Permanent Contraception Options in High Resource Countries: A Systematic Review

Gormley

Vickers

Cheng

et al. 2020

Preprint

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Background: Multiple options for permanent or long-acting contraception are available, each with adverse effects and non-contraceptive benefits. A comprehensive comparison of methods to support decision-making for people seeking to end their fertility and their healthcare providers is needed. We aimed to understand what is known from high quality studies about the comparability of options for permanent contraception. We sought studies comparing these methods of permanent or long-acting contraception: laparoscopic tubal ligation, hysteroscopic tubal occlusion, bilateral salpingectomy, and levonorgestrel-releasing intrauterine contraception (LNG-IUC), for effectiveness, adverse events, tolerability, patient recovery, non-contraceptive benefits and healthcare system costs among females in high resource countries seeking to permanently avoid conception. Methods: We followed PRISMA guidelines, searched EMBASE, Pubmed (Medline), Web of Science, and screened retrieved articles to identify additional relevant studies. We extracted data on population, interventions, outcomes, follow-up, health system costs, and study funding source. We assessed risk of bias using the Newcastle-Ottawa Scale, excluding studies with high risk of bias. Due to considerable heterogeneity, we performed a narrative synthesis. Results: Our search identified 6,612 articles. We reviewed the full text of 154 studies, yielding 35 studies which met inclusion criteria. We excluded 10 studies with high risk of bias, retaining 25 at low or medium risk for bias in our synthesis. Most studies assessed hysteroscopic tubal occlusion and/or laparoscopic tubal ligation. Most comparisons reported on effectiveness and adverse events, with fewer reporting tolerability, patient recovery, non-contraceptive benefits, and healthcare system costs. No comparisons reported accessibility, eligibility, or follow-ups required. We found inconclusive evidence comparing the effectiveness of hysteroscopic tubal occlusion to laparoscopic tubal ligation. All studies reported adverse events. All forms of tubal interruption reported a protective effect against cancers. Tolerability appeared greater among tubal ligation patients compared to hysteroscopic tubal occlusion patients. No medium or high-quality studies compared LNG-IUC to other methods.Conclusions: High-quality studies comparing outcomes relevant for those seeking female permanent contraception are needed to support informed decision-making. Research is needed to directly compare surgical forms of permanent contraception, such as tubal ligation or removal, with alternative options, such as intrauterine contraception.Systematic review registration: PROSPERO [CRD42016038254].

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Section: Study Characteristicsmentioning

confidence: 99%

Section: Effectivenessmentioning

confidence: 99%

Section: Effectivenessmentioning

confidence: 99%

Section: Adverse Effectsmentioning

confidence: 99%

Section: Adverse Effectsmentioning

confidence: 99%

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Comparing Female Permanent Contraception Options in High Resource Countries: A Systematic Review

Gormley

Vickers

Cheng

et al. 2020

Preprint

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Comparing options for females seeking permanent contraception in high resource countries: a systematic review

et al. 2021

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Background Multiple options for permanent or long-acting contraception are available, each with adverse effects and benefits. People seeking to end their fertility, and their healthcare providers, need a comprehensive comparison of methods to support their decision-making. Permanent contraceptive methods should be compared with long-acting methods that have similar effectiveness and lower anticipated adverse effects, such as the levonorgestrel-releasing intrauterine contraception (LNG-IUC). We aimed to understand the comparability of options for people seeking to end their fertility, using high-quality studies. We sought studies comparing laparoscopic tubal ligation, hysteroscopic tubal occlusion, bilateral salpingectomy, and insertion of the LNG-IUC, for effectiveness, adverse events, tolerability, patient recovery, non-contraceptive benefits, and healthcare system costs among females in high resource countries seeking to permanently avoid conception. Methods We followed PRISMA guidelines, searched EMBASE, Pubmed (Medline), Web of Science, and screened retrieved articles to identify additional studies. We extracted data on population, interventions, outcomes, follow-up, health system costs, and study funding source. We used the Newcastle–Ottawa Scale to assess risk of bias and excluded studies with medium–high risk of bias (NOS < 7). Due to considerable heterogeneity, we performed a narrative synthesis. Results Our search identified 6,612 articles. RG, BV, BC independently reviewed titles and abstracts for relevance. We reviewed the full text of 154 studies, yielding 34 studies which met inclusion criteria. We excluded 10 studies with medium–high risk of bias, retaining 24 in our synthesis. Most studies compared hysteroscopic tubal occlusion and/or laparoscopic tubal ligation. Most comparisons reported on effectiveness and adverse events; fewer reported tolerability, patient recovery, non-contraceptive benefits, and/or healthcare system costs. No comparisons reported accessibility, eligibility, or follow-up required. We found inconclusive evidence comparing the effectiveness of hysteroscopic tubal occlusion to laparoscopic tubal ligation. All studies reported adverse events. All forms of tubal interruption reported a protective effect against cancers. Tolerability appeared greater among tubal ligation patients compared to hysteroscopic tubal occlusion patients. No high-quality studies included the LNG-IUC. Conclusions Studies are needed to directly compare surgical forms of permanent contraception, such as tubal ligation or removal, with alternative options, such as intrauterine contraception to support decision-making. Systematic review registration PROSPERO [CRD42016038254].

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Resolution of Chronic Pelvic Pain and Abnormal Uterine Bleeding After Essure® Surgical Removal and Laparoscopic Sterilization: A Case Report

Gentile¹,

Costanza²,

Zinna³

2020

IJCR

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Hysteroscopic sterilization with Essure ® microinsert is a method of female permanent contraception. Complications of the procedure are malpositioning, unintended pregnancy, abnormal uterine bleeding, and chronic pelvic pain. We report the case of a 44-year-old patient presented to our hospital for chronic pelvic pain and abnormal uterine bleeding. She had 5 years before a hysteroscopic placement of an Essure ® device. At hysteroscopy, both devices were removed and a laparoscopic bilateral salpingectomy was performed. The patient reported resolution of chronic pelvic pain and of abnormal uterine bleeding following surgical procedures. Pelvic pain is the main symptom described after Essure ® insertion with an incidence of 4.2% regarding persistent pain. The patients should be informed about the risks and benefits of hysteroscopic and laparoscopic sterilization procedures.

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Gynecologic Outcomes After Hysteroscopic and Laparoscopic Sterilization Procedures

Abstract: (Abstracted from Obstet Gynecol 2016;128:843–852) The contraceptive method chosen by nearly 10 million US women is female tubal sterilization. This procedure can be performed either laparoscopically or hysteroscopically.

Cited by 3 publications

References 0 publications

Comparing Female Permanent Contraception Options in High Resource Countries: A Systematic Review

Comparing Female Permanent Contraception Options in High Resource Countries: A Systematic Review

Comparing options for females seeking permanent contraception in high resource countries: a systematic review

Resolution of Chronic Pelvic Pain and Abnormal Uterine Bleeding After Essure® Surgical Removal and Laparoscopic Sterilization: A Case Report

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