Objectives:The primary objective of the following study is to determine the demographic patterns of women presenting as sterilization-failure and secondary is to evaluate possible etiological factors for failure and lay standard guidelines to reduce failure rate.Materials and Methods:The present study is retrospective study conducted in Department of Obstetrics and Gynecology, Government Medical College and Hospital-based on the case records maintained in our institution over a decade (April 2002-March 2012).Results:Over a decade, 140 cases of sterilization-failure with longest interval of 20 years have been documented out of 80 (57.14%) cases were of minilaparotomy (minilap), 53 (37.86%) laparoscopic tubal ligation and 5 (3.57%) were lower segment cesarean section. In 84 cases (60%) sterilization were performed in Primary Health Centre (PHC). Only 58 (41.43%) patients reported failure in 1st trimester (<12 weeks). 14 cases (10%) were of ectopic pregnancy. There were 25 cases (17.86%) of spontaneous recanalization. In 27 cases (19.29%) failure was due to improper surgical procedure and rest 54 (38.57%) have conceived due to tuboperitoneal fistula.Conclusion:Female sterilization even though considered as permanent method of contraception, recanalization is possible even 20 years after procedure. Maximum cases of failure were with minilap and those were performed at PHC. The most common cause of failure was tuboperitoneal fistula. Ectopic pregnancies were seen in 10% of cases. Proper counseling of patient is must. There is a need to stick to standards of sterilization procedure to prevent future failure.
Background: Female sterilization is the most requested permanent contraceptive method worldwide and one of the most frequently performed elective, intra-abdominal surgical procedure in reproductive-age women. Even though considered as simple and safe procedure, complications do occur including death. Methods: The primary objective of the following study is to determine the demographic patterns of women presenting as sterilization complications and secondary is to evaluate possible etiological factors leading to complications and lay standard guidelines to reduce complication rate. Results: Over a decade, 103 cases of female sterilization related complications were documented, out of 14 cases (13.6%) were of laparoscopic tubal ligation and rest 89 were minilaparotomy (86.4%). In 3 cases tubal ligation was not performed as surgeon was not able to either open peritoneal cavity or find fallopian tubes due to adhesions (2.91%). In 70 cases (67.96%) sterilization were performed in primary health centre (PHC). Four patients (3.88%) required hospital stay of more than a month with longest stay being 43 days. Exploratory laparotomy with surgical intervention was done in 34 cases (33%). Two patients (1.94%) died due to tubectomy complications due to septicemia and encephalitis. Conclusions: Female sterilization is very popular and commonly performed permanent method of sterilization but complications can happen and many of them are preventable with proper screening and selection of cases with proper evaluation before surgery. There is a need to have proper training in sterilization and to stick to standards of sterilization procedure to minimize chances of complications.
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