Nationwide salpingectomy rates for an indication of permanent contraception before and after published practice guidelines

Polen-De, Clarissa; Meganathan, Karthikeyan; Lang, P; Hohmann, Samuel F.; Jackson, Amanda; Whiteside, James L.

doi:10.1016/j.contraception.2019.03.054

Cited by 6 publications

(10 citation statements)

References 16 publications

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“…According to the Kazakhstani national guidelines for female surgical sterilization, the procedure is currently performed via tubal ligation, rather than salpingectomy. However, in developed countries that have accepted an opportunistic salpingectomy as a preventative measure for ovarian cancer, rates of salpingectomies for permanent contraception are steadily increasing [ 47 , 48 ]. 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 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, in developed countries that have accepted an opportunistic salpingectomy as a preventative measure for ovarian cancer, rates of salpingectomies for permanent contraception are steadily increasing [ 47 , 48 ]. 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 ].…”

Section: Discussionmentioning

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%

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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“…For example, physicians practicing in academic hospitals appear to be more likely to respond to emerging evidence. 6,10 This has been argued to be due to increased patient volume and consistent exposure to learners. Our results demonstrate the CH decline following the 2011 AUA CPG was greater in teaching hospitals relative to nonteaching hospitals.…”

Section: Discussionmentioning

confidence: 99%

The Practice of Cystoscopy with Hydrodistention Since the 2011 American Urological Association Clinical Guideline on Interstitial Cystitis/Bladder Pain Syndrome

et al. 2021

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Introduction:We determined the rate of cystoscopy with hydrodistention (CH) before and after the 2011 American Urological Association (AUA) amended clinical guideline, "Diagnosis and Treatment of Interstitial Cystitis/Bladder Pain Syndrome."Methods: Clinical encounters with a diagnosis of interstitial cystitis/bladder pain syndrome (IC/ BPS) where cystoscopy with and without hydrodistention was performed were identified in the VizientÒ Clinical Data Base between January 2009 and February 2020. Demographic and clinical information such as patient age, gender, race, treating physician specialty, insurance type and type of hospital (teaching vs nonteaching) was recorded. Descriptive statistics, Wilcoxon 2-sample test and chi-square test were used to compare variables. An interrupted time series analysis was used to assess the change in CH rate following the June 2011 AUA guideline.Results: From January 2009 to February 2020, 69,983 encounters were identified to have an IC/BPS diagnosis and to have undergone outpatient cystoscopy, of which 7,502 (10.7%) were CH. Compared to those not undergoing CH, subjects with IC/BPS undergoing CH were younger, predominantly female, Caucasian and had commercial insurance. Before the guideline, across all medical specialties, the base rate of CH was rising from 16.6% at a rate of 0.12% per month. Following guideline release, the CH rate dropped by 6.8%, declining 0.07% per month until February 2020. This pattern was most pronounced in urology relative to all other medical specialties. Conclusions:The monthly average rate of CH among individuals with IC/BPS undergoing an outpatient CH dropped from nearly 17% before the 2011 AUA guideline to less than 10% in early 2020.

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“…However, the embracement of this strategy at the time of cesarean delivery for pregnant women who desire permanent sterilization has not been widely adopted, probably due to a lack of available data including the surgical and psychological data in this setting ( 14 ) . By 2017, the overall proportion of salpingectomies in patients who underwent a permanent contraception procedure was reported to be as high as 61.5%, in a nationwide data analysis ( 15 ) . In a large retrospective cohort study of seven years, almost half of the women preferred OBS as the mode of contraception at either elective or unscheduled cesarean section, which implies that OBS has a high acceptable rate for its higher contraceptive efficacy and risk-reduction benefit for ovarian cancer ( 16 ) .…”

Section: Discussionmentioning

confidence: 99%

Patients’ perceptions toward and the driving factors of decision-making for opportunistic bilateral salpingectomy at the time of cesarean section

Yassa¹,

Pulatoğlu

2020

tjod

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Objective: Enough data can be found in the literature regarding the protective effect of tubal ligation on gynecological cancers. In addition, a large body of evidence revealed that prophylactic bilateral salpingectomy had no significant negative effect on the ovarian function, quality of life, sexuality, surgery duration, and cost-effectivity. This study was aimed at exploring the underlying factors that motivate women for either opportunistic bilateral salpingectomy (OBS) or tubal ligation, particularly focusing on their preferences, knowledge, and beliefs toward female sterilization, satisfaction from counseling, and body image following the salpingectomy. Materials and Methods: A total of 54 patients who had undergone surgical sterilization with either OBS or tubal ligation were included in this prospective cohort study. The acceptance rate of the OBS at the time of cesarean section among pregnant women seeking surgical sterilization was calculated. The underlying reasons for women’s acceptance or refusal for salpingectomy were assessed by a non-validated data collection tool that had 14 open-ended questions focusing on the women’s preferences, knowledge, beliefs toward female sterilization, satisfaction from counseling, and body image following the salpingectomy. Results: The acceptance rate of OBS at the time of cesarean section among pregnant women and electively among non-pregnant women were 93.5% (n=43/46) and 75% (6/8), respectively. The main driving factors influencing the decision of preferring OBS over tubal ligation were the risk-reducing effect for ovarian cancer and superior pregnancy prevention. Conclusion: The acceptance rate of OBS at the time of cesarean section was found to be very high, and it should therefore be offered at the time of cesarean section to women who desire permanent contraception.

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Nationwide salpingectomy rates for an indication of permanent contraception before and after published practice guidelines

Cited by 6 publications

References 16 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)

The Practice of Cystoscopy with Hydrodistention Since the 2011 American Urological Association Clinical Guideline on Interstitial Cystitis/Bladder Pain Syndrome

Patients’ perceptions toward and the driving factors of decision-making for opportunistic bilateral salpingectomy at the time of cesarean section

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