A novel tubal sterilization technique to prevent recanalization- a preliminary study

Abstract

Background: Spontaneous luminal recanalisation, and peritoneal fistula formation connecting the lumens of cut ends, are common causes for tubectomy failure. Failures rates are high with Pomeroy and Madlener methods. Uchida or Irvin techniques have lower failure rates. However, these techniques are not commonly practised because of technical complexity and long surgical time. We developed a novel surgical technique, which leaves the cut ends far away and peritonised.Methods: In our hospital, modified Pomeroy method, and Parkland method were used during 2000- 09, and our new method was used during 2010-19. In the new method, 0.5cm of the cut end of the tube was turned inside and tied to the stump in such a way that the stumps get peritonised. The failure rates were compared between the groups.Results: In the first group, 997 tubectomies were performed. Modified Pomeroy method was used in 360 women. Among them, one woman had a tubal ectopic pregnancy, and one woman had intrauterine pregnancy with a failure rate of 0.55%. Parkland method was used in 637 women. Among them, two women had tubal ectopic pregnancies with a failure rate of 0.31%. During the second 10 years, 637 tubectomies were performed using the new technique. None of the women had failure, with a failure rate of 0.0%. This difference is statistically significant with P<001.Conclusions: New tubectomy method is simple, and more effective in preventing recanalization than Modified Pomeroy and Parklands methods.