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Effects of female sterilization: one year follow-up in a prospective controlled study of psychological and psychiatric outcome.

A prospective controlled study of the psychological effects of elective interval and postpartum tubal sterilization was carried out on a selected sample of women. Subjects were interviewed pre-operatively (n = 138) and one year post-operatively (n = 116; 83%), using standardized instruments and procedures, including the Present State Examination. No differences within or between sterilization and control groups were found over the follow-up year in the prevalence of psychiatric morbidity, which was no higher than would be expected in a general population sample. Beneficial effects of sterilization were reported on a number of psychosexual variables. Adverse effects such as regret or deterioration in marital relationship were rare, but were more likely to occur in postpartum subjects, among whom abdominal pain was also reported more commonly at one year follow-up than pre-operatively. The relevance of "normal" postnatal events and of the role of pre-operative counselling are considered in relation to these findings. Less favourable outcome at one year follow-up was commonly associated with higher PSE scores pre-operatively.

Abdomen↗

The safety and efficacy of tubal sterilization: an international overview.

This article presents a synthesis of some of the major published studies on the efficacy and safety of tubal sterilization. The conclusions of this overview are that tubal sterilization is a safe operation, long-term sequelae of tubal sterilization have not been well documented, and the risk of pregnancy following tubal sterilization is less than 1 in 100. Continued study is needed to determine how to make a safe and effective procedure even safer and more effective.

Female↗

Psychological long-term effects of sterilization on anxiety and depression.

Two-thousand cases (500 women and 500 men with sterilization; 500 women and 500 men without sterilization) in two counties and two cities in Sichuan, China, were investigated between 15 September 1992 and 30 April 1993. Information was obtained about their age, parity, marriage, contraceptives, social behavior, and present psychological characteristics. CES-D, SAS, and E.P.Q. scales were used to assess the depressive symptomatology, anxiety, and personality of the subjects. The results revealed that sterilization psychologically affected the depressive symptoms and anxiety under the neutral personality. In addition, depressive symptoms and anxiety were related to the subjects' age, educational level, income, operative doctors' attitudes to sterilization acceptors, and subjects' understanding of the sterilization.

Adult↗

Streptococcal toxic shock-like syndrome as an unusual complication of laparoscopic tubal ligation. A case report.

Toxic shock-like syndrome due to Streptococcus pyogenes is an unusual occurrence. Previously reported cases have been the result of focal infections with S pyogenes. We present a case in which manipulation of a colonized mucosal surface during laparoscopic tubal ligation was the presumed cause of the sepsis syndrome. Whereas other reports of this syndrome have all noted concurrent infections with S pyogenes, in this instance it was unclear if toxin-mediated disease was initiated by mild endometritis or iatrogenic manipulation of a colonized mucosal surface.

Adult↗

Menstrual patterns after female sterilization: variables predicting change.

Previous studies of the changes in menstrual pattern characteristics following sterilization have been flawed by methodologic errors. As a result, contradictory findings have been reported. Appropriate methodologic approaches to the study of poststerilization menstrual patterns are presented, and a new methodologic approach-an index of menstrual pattern change-is offered, which evaluates four menstrual parameters simultaneously. A carefully controlled study using this index indicates that most women report no change in menstrual pattern at 12 months poststerilization, and among those who do experience change, changes in one direction are balanced by changes in the other direction. The changes reported include improvements as well as changes for the worse. The best predictor of whether a woman would experience menstrual pattern change after sterilization is whether her pattern had any abnormal characteristics during the three months prior to the procedure. Surgical variables and special subgroups of women are also evaluated.

Adult↗

Effect of uterine artery ligation on ovulation in the rat.

Female rats were divided into six groups: (1) control, (2) one uterine artery (a.) ligated near the utero-tubal (U-T) junction, (3) one uterine a. ligated at the level of the cervix, (4) both uterine aa. ligated separately at the U-T junction, (5) both uterine aa. ligated separately at the cervix and (6) both uterine aa. tied with one ligature at the cervix. Segmental aa. were disrupted in all experimental groups except group 6. Animals were allowed to recover for ten days and killed the first metestrus thereafter. Number of eggs ovulated was determined by flushing the oviduct with saline solution and counting the ova. Control rats ovulated 5.0 +/- 0.4 eggs per ovary. Groups 2 and 3 had an increase in the number of eggs shed from the ovary on the non-ligated side. In contrast, a decrease in the number of ova shed occurred on the ligated side. When both aa. were ligated separately (groups 4 and 5), irrespective of location, a decrease in the number of eggs shed by both ovaries was evident. No effect was found when only one ligature was placed near the cervix (group 6). The data demonstrate that blood supply to the ovary via the uterine artery is essential for the full complement of eggs to be shed.

Animals↗