Female sterilization failure: Review over a decade and its clinicopathological correlation

Abstract

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.

Female Sterilization Failure reported during 5 Years at a Tertiary Care Teaching Hospital: A Retrospective Survey

“…Peterson et al 3 observed that 62% women reporting with failures were less than 28 years old and another study also quoted that 65% were below 30 years. 4 In our study, 69% women were below 30 years. Date et al 4 reported that 24.29% women presented after 20 weeks gestation and continued pregnancy, 5.71% underwent LSCS.…”

Female sterilization failure, consequences and further contraception: a review of cases over ten years

“…As compared to similar study where <1 year interval was seen in 15% of cases and the maximal interval was 20 years. 9 In our study 29.7% patient continued their pregnancy without any future sterilization. This could be explained via the fact that that tubal occlusion could be associated with either the feeling of regret post sterilization or lack of faith in invasive permanent method after failure.…”

Placenta accreta after postpartum tubal sterilisation and Novasure® endometrial ablation

“…Patients should be counseled regarding failure rates depending on the timing of the procedure and the method used. The following are some of the documented reasons for tubal sterilization failure: Spontaneous recanalization Formation of tuboperitoneal fistula Selection of wrong anatomical structure (eg, round ligament, peritoneal folds)—This is an example of an operator's error Incomplete occlusion of the tube Slippage of occlusive device Pre‐existing gynecological diseases 4,6 …”