Salpingectomy vs tubal ligation for sterilization: a systematic review and meta-analysis

Mills, Kerry; Marchand, Greg; Sainz, Katelyn; Azadi, Ali; Ware, Kelly; Vallejo, Janelle; Anderson, Sienna; King, Alexa; Osborn, Asya; Ruther, Stacy; Brazil, Giovanna; Cieminski, Kaitlynne; Hopewell, Sophia; Rials, Lisa; Klipp, Angela

doi:10.1016/j.ajog.2020.09.011

Cited by 20 publications

(15 citation statements)

References 27 publications

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“…As reported by researchers, in the USA, 14.8% of subjects underwent a salpingectomy for permanent contraception within a 5-year period (2013–2017) [ 47 ]. According to these studies, laparoscopic bilateral salpingectomy is found to be a safe method for sterilization [ 23 , 48 ]. It does not increase perioperative risk compared with conventional tubal ligation [ 48 ], and may be preferred, where appropriate, to reduce the risk of ovarian cancer [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

“…According to these studies, laparoscopic bilateral salpingectomy is found to be a safe method for sterilization [ 23 , 48 ]. It does not increase perioperative risk compared with conventional tubal ligation [ 48 ], and may be preferred, where appropriate, to reduce the risk of ovarian cancer [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

“…It is indicated in cases of confirmed tubal ectopic pregnancy, tubo-ovarian abscess, and sactosalpinx as a preparation step for assisted reproductive technology (ART) treatment in patients with infertility. With new evidence about the tubal origin of ovarian cancer cells [ 18 , 19 ], many developed countries adopted an opportunistic salpingectomy as an intervention to prevent ovarian cancer [ 7 , 20 , 21 , 22 , 23 , 24 , 25 ].…”

Section: Introductionmentioning

confidence: 99%

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The Prevalence, Indications, Outcomes of the Most Common Major Gynecological Surgeries in Kazakhstan and Recommendations for Potential Improvements into Public Health and Clinical Practice: Analysis of the National Electronic Healthcare System (2014–2019)

Sakko

Aimagambetova

Terzić

et al. 2022

IJERPH

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Objectives: Major gynecological surgeries are indicated for the treatment of female genital pathologies. It is key to examine trends in gynecologic surgical procedures and updated recommendations by international gynecological societies to find opportunities for improvement of local guidelines. To date, a very limited number of reports have been published on the epidemiology of gynecological surgeries in Kazakhstan. Moreover, some local guidelines for gynecological conditions do not comply with the international recommendations. Thus, this study aims to investigate the prevalence, indications, and outcomes of the most common major gynecological surgeries by analyzing large-scale Kazakhstani healthcare data, and identifying possible opportunities for improvement of the local public health and clinical practice. Methods: A descriptive, population-based study among women who underwent a gynecological surgery in healthcare settings across the Republic of Kazakhstan during the period of 2014–2019 was performed. Data were collected from the Unified Nationwide Electronic Health System (UNEHS). Results: In total, 80,401 surgery cases were identified and analyzed in the UNEHS database for a period of 6 years (2014–2019). The median age of the participants was 40 years old, with 61.1% in reproductive age. The most prevalent intervention was a unilateral salpingectomy—29.4%, with 72.6% patients aged between 18–34 years. The proportion of different types of hysterectomies was 49.4%. In 20% of cases, subtotal abdominal hysterectomy was performed due to uterine leiomyoma. The proportion of laparoscopic procedures in Kazakhstani gynecological practice is as low—11.59%. Conclusions: The Kazakhstani public health and gynecological care sector should reinforce implementation of contemporary treatment methods and up-to-date policies and guidelines. The overall trends in surgical procedures performed for gynecological pathologies, including uterine leiomyoma and ectopic pregnancy treatment, should be changed in favor of the minimally invasive methods in order to adopt a fertility-sparing approach.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Prevalence, Indications, Outcomes of the Most Common Major Gynecological Surgeries in Kazakhstan and Recommendations for Potential Improvements into Public Health and Clinical Practice: Analysis of the National Electronic Healthcare System (2014–2019)

Sakko

Aimagambetova

Terzić

et al. 2022

IJERPH

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“…More serious complications, such as uterine perforation, are found to occur rarely (estimated 2.6 per 1000 insertions) [ 24 ]. A systematic review comparing complication rates between laparoscopic tubal ligation and bilateral salpingectomy for sterilization found no significant differences in blood loss, perioperative complications, or rehospitalizations [ 60 ]. Upcoming research comparing salpingectomy and tubal ligation found no difference in time to first physician visit related to menopause between patients [ 61 ].…”

Section: Discussionmentioning

confidence: 99%

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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“…[10][11][12] Although OS has not been associated with complications, there might be subtle long-term consequences. [13,14] Removing the shared blood supply between the fallopian tubes and ovaries could theoretically decrease oocyte quality and may cause earlier onset of menopause. [14] Given that premature menopause is associated with a higher risk of cardiovascular diseases, cognitive impairment and osteoporosis, this potential risk of OS might outweigh its preventive benefits.…”

Section: Introductionmentioning

confidence: 99%

The effect of opportunistic salpingectomy for primary prevention of ovarian cancer on ovarian reserve: a systematic review and meta-analysis

Gelderblom¹,

Beerendonk²,

Dagovic³

et al. 2022

Maturitas

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Salpingectomy vs tubal ligation for sterilization: a systematic review and meta-analysis

Cited by 20 publications

References 27 publications

The Prevalence, Indications, Outcomes of the Most Common Major Gynecological Surgeries in Kazakhstan and Recommendations for Potential Improvements into Public Health and Clinical Practice: Analysis of the National Electronic Healthcare System (2014–2019)

The Prevalence, Indications, Outcomes of the Most Common Major Gynecological Surgeries in Kazakhstan and Recommendations for Potential Improvements into Public Health and Clinical Practice: Analysis of the National Electronic Healthcare System (2014–2019)

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

The effect of opportunistic salpingectomy for primary prevention of ovarian cancer on ovarian reserve: a systematic review and meta-analysis

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