PubMed Health⌕ Search
Home/Archive/PubMed

PubMed · 4014332

Sterilization failures and their causes.

R M Soderstrom
View original source ↗Export metadata ↓

Abstract

To say that a sterilization failure rate is expected does not answer why. Forty-seven cases of repeat sterilization have undergone such surgical and pathologic scrutiny. Resection methods failed most frequently because of spontaneous reanastomosis or fistula formation. Fimbriectomy was particularly vulnerable to reanastomosis because the fimbria ovarica was not removed. Mechanical devices failed when the device was defective, placed improperly, or placed in an improper location. Tissue damage was evident but incomplete when the bipolar electrocoagulation method failures were reviewed, and the endosalpinx remained viable. Unipolar method injuries, in contrast, were complete; they failed by fistula formation. Thus bipolar method failures may occur because of the limited range of electrical power available when using bipolar generators. Some sterilization failures are preventable, but many are not. When medicolegal questions arise, these findings may help answer the question, Why?

Explore related subjects

Contraceptive Devices, FemaleElectrosurgeryEquipment FailureFallopian Tube Patency TestsFallopian TubesFemaleHumansHysterosalpingographySterilization, TubalContraceptionContraception FailureContraceptive UsageFamily PlanningFemale SterilizationFimbriectomy--complicationsReversible SterilizationSterilization ReversalSterilization, SexualTubal Ligation--complicationsTubal OcclusionTubal ReanastomosisJournal Article

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

R M Soderstrom. 1985-06-15. Sterilization failures and their causes.. https://doi.org/10.1016/s0002-9378(85)80148-4

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed2004

New delivery systems in contraception: vaginal rings.

Vaginal rings, made of soft flexible silicone rubber, for delivery of contraceptive hormones are currently gaining clinical acceptance. This method provides extended release of hormones, which are implanted in the core of the ring and slowly disseminate into vaginal tissue. Although formulations and sizes vary, most rings are approximately 58 mm in diameter with a cross-section of 8.4 mm. Depending on the type of ring used, prolonged hormone release may occur from 3 weeks to 1 year. Advantages of the vaginal ring method are that it is user controlled, does not interfere with intercourse, does not require daily intake of a pill, and allows continuous delivery of a low dose of steroids. The Population Council has developed a progesterone-releasing ring, which is currently on the market in Chile and Peru for contraception in breastfeeding women. This ring may be effective for progesterone therapy during in vitro fertilization as well. A contraceptive ring releasing very low doses of the potent progestin Nestorone (Population Council, New York, NY) for 6 to 12 months is also under investigation. The optimal ring formulations, however, contain hormone combinations that provide excellent contraceptive efficacy with few side effects and good control of menstrual bleeding. The Food and Drug Administration has recently approved Organon's monthly ring releasing etonogestrel and ethinyl estradiol. The Population Council is developing a 1-year contraceptive ring releasing low doses of Nestorone and ethinyl estradiol. Combination rings are associated with very low pregnancy rates and side effects consistent with those of oral contraceptives.

Contraceptive Devices, Female↗
PubMed2003

In vitro release of nonoxynol-9 from silicone matrix intravaginal rings.

The controlled-release characteristics of matrix silicone intravaginal rings loaded with between 100 and 971 mg of nonoxynol-9 have been investigated with a view to developing a ring that may offer a new female-controlled method for the prevention of transmission of sexually transmitted diseases, particularly HIV. Intravaginal rings containing 253, 487 and 971 mg of nonoxynol-9 provided a daily release of 2 mg or more over the 8-day release period, the minimal amount of nonoxynol-9 considered to provide an effective vaginal concentration for the prevention of HIV. Furthermore, the maximum daily release of N9 was about 6 mg, an amount significantly smaller than that observed for other nonoxynol-9 products whose large daily doses may in fact increase the occurrence of HIV by causing epithelial damage to the vaginal tissue. The release mechanism of the liquid nonoxynol-9 from the intravaginal rings has also been investigated and compared to models describing the release of solid drugs from the rings. It has been demonstrated through release studies and surface microscopy that a drug depletion zone is not established in such liquid-loaded intravaginal ring systems, with implications for the release kinetics.

Contraceptive Devices, Female↗