Long-term outcomes after elective sterilization procedures — a comparative retrospective cohort study of Medicaid patients

Steward, Rachel; Carney, Patricia I.; Law, Amy; Xie, Lin; Wang, Yuexi; Yüce, Hüseyin

doi:10.1016/j.contraception.2017.12.015

Cited by 4 publications

(12 citation statements)

References 9 publications

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“…Based on our inclusion/exclusion criteria, through full-text screening, we identified 61 studies for inclusion. 1 , 3 , 6 – 8 , 11 , 13 – 15 , 21 , 22 , 24 – 31 , 34 – 41 , 44 – 46 , 49 – 61 , 63 – 67 , 69 – 73 , 75 , 78 – 80 , 82 – 84 , 87 We included no additional studies through reference search and 4 additional studies solicited from coauthors that were not otherwise included, 19 , 23 , 43 , 81 resulting in a total sample of 65 studies, all of which were published in the English language; hence, no studies were excluded based on language.…”

Section: Resultsmentioning

confidence: 99%

Real-world data and evidence in pain research: a qualitative systematic review of methods in current practice

Vollert

Kleykamp

Farrar

et al. 2023

PR9

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The use of routinely collected health data (real-world data, RWD) to generate real-world evidence (RWE) for research purposes is a growing field. Computerized search methods, large electronic databases, and the development of novel statistical methods allow for valid analysis of data outside its primary clinical purpose. Here, we systematically reviewed the methodology used for RWE studies in pain research. We searched 3 databases (PubMed, EMBASE, and Web of Science) for studies using retrospective data sources comparing multiple groups or treatments. The protocol was registered under the DOI:10.17605/OSF.IO/KGVRM. A total of 65 studies were included. Of those, only 4 compared pharmacological interventions, whereas 49 investigated differences in surgical procedures, with the remaining studying alternative or psychological interventions or epidemiological factors. Most 39 studies reported significant results in their primary comparison, and an additional 12 reported comparable effectiveness. Fifty-eight studies used propensity scores to account for group differences, 38 of them using 1:1 case:control matching. Only 17 of 65 studies provided sensitivity analyses to show robustness of their findings, and only 4 studies provided links to publicly accessible protocols. RWE is a relevant construct that can provide evidence complementary to randomized controlled trials (RCTs), especially in scenarios where RCTs are difficult to conduct. The high proportion of studies reporting significant differences between groups or comparable effectiveness could imply a relevant degree of publication bias. RWD provides a potentially important resource to expand high-quality evidence beyond clinical trials, but rigorous quality standards need to be set to maximize the validity of RWE studies.

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Section: Resultsmentioning

confidence: 99%

Real-world data and evidence in pain research: a qualitative systematic review of methods in current practice

Vollert

Kleykamp

Farrar

et al. 2023

PR9

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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%

“…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%

“…One study found no difference between chronic pelvic pain, risk of hysterectomy, or abnormal uterine bleeding at 6 or 12 months post-procedure among women who underwent hysteroscopic tubal occlusion compared to laparoscopic tubal ligation, nding only a signi cantly lower risk of chronic pelvic pain and risk of hysterectomy among women undergoing hysteroscopic tubal occlusion at 24 months post-procedure. 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)].…”

Section: Adverse Effectsmentioning

confidence: 99%

“…Notably no studies comparing pain included patients selecting the LNG-IUC. One study found that hysteroscopic tubal occlusion patients had a lower risk of post-procedure hysterectomy 24-months post-procedure, 31 but the strength of the evidence is diminished with potential bias in funding from Bayer, the company that created the Essure™ device. Multiple studies have found an association between an increased risk of anal cancer and a history of laparoscopic tubal ligation.…”

Section: Summary Of Evidencementioning

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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Chronic Pain After Gynecological Surgery

Reinert¹,

Hibner²

2021

Management of Chronic Pelvic Pain

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Long-term outcomes after elective sterilization procedures — a comparative retrospective cohort study of Medicaid patients

Cited by 4 publications

References 9 publications

Real-world data and evidence in pain research: a qualitative systematic review of methods in current practice

Real-world data and evidence in pain research: a qualitative systematic review of methods in current practice

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

Chronic Pain After Gynecological Surgery

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