Tubal Sterilization and the Long-term Risk of Hysterectomy

Abstract

To assess the effect of tubal sterilization on the risk of hysterectomy, we studied 7414 women aged 20 to 49 years who had had a tubal sterilization at a health maintenance organization between January 1, 1968, and December 31, 1983. Compared with a population-based cohort of nonsterilized women, women sterilized while 20 to 29 years old were 3.4 times more likely to have had a subsequent hysterectomy (95% confidence interval, 2.4 to 4.7). Adjustment for the effects of potential confounders with a subset of 276 women did not appreciably alter this association. For multivariate comparisons with 5323 wives of vasectomized men, there was no significant elevation in the risk of hysterectomy following sterilization among women sterilized while 20 to 29 years old. Tubal sterilization was not associated with hysterectomy for married women who underwent tubal sterilization at age 30 or older. These results do not support a biological basis for the relationship between tubal sterilization and hysterectomy.

Biosocial determinants of hysterectomy in New Zealand

“…11,[24][25][26][27][28][29] However, in our study there was no difference in the risk of undergoing hysterectomy between those women who had had tubal sterilization and those who had not-a finding confirmed by a more recent US study. 30 Prior pill and IUD use was associated with a lower likelihood of hysterectomy, but the relation was not statistically significant. However, the likelihood of hysterectomy was increased among those who experienced side effects and stopped using the IUD, probably because of complications arising from IUD use as well as inherent physiologic conditions.…”

Is tubal sterilization associated with an increased risk of subsequent hysterectomy but a decreased risk of ovarian cancer? A review of recent literature

“…Stergachis et al [10], using data from the Group Health Cooperative (GHC) of Puget Sound, USA, found that women who had had a TS between ages 20 and 29 years (n = 7414) as well as wives with vasectomized husbands (n = 5323) were both 3.4 times (95% CLs: 2.4-4.7) more likely to have had a subsequent hysterectomy than was the population-based cohort of unsterilized women (n = 25 736). However, TS was not associated with hysterectomy among women who underwent TS at age 30 or older.…”

“…Thus, the need for hysterectomy for women in the comparison (unsterilized) group who use OCs may be decreased [7,9,10]. In contrast, by discontinuing OCs after TS, the sterilized women may experience more menstrual disturbances than before TS.…”

“…20-24 years) but not in women sterilized at an older age (e.g. 35 years and over) [8,10,12]. Cohen [9] speculated that this may be due to the fact that women who undergo TS at a younger age probably married earlier, are likely to be of higher parity, and may have been sexually active at a younger age -factors which make younger women a 'poor gynecological risk'.…”

Tubal Ligation, Hysterectomy and D&C: Evidence from the Melbourne Women’s Midlife Health Project

“…Stergachis et al [6] used the records of a health maintenance organization (HMO) to compare 7,414 sterilized women with 25,736 nonsterilized women and with another group of 5,323 wives of vasectomized men. Using crude relative risks (RRs), after matching on age and duration of membership of the HMO, they found a significant overall excess (RR = 1.6) of hysterectomies among sterilized women relative to the larger 'population-based' control group, and also (RR = 1.4) relative to the wives of vasectomized men.…”