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  • Title: Some aspects of the sterilization program in Malaysia.
    Author: Arshat H, Ali J, Noor Laily Abu Bakar.
    Journal: Malays J Reprod Health; 1984 Jun; 2(1):1-13. PubMed ID: 12267515.
    Abstract:
    Sterilization is most often indicated when the desired family size is reached and no more children are desired. Because of technical advances and societal changes surgical sterilization is increasingly becoming the most utilized method of contraception. Since female sterilization is more common, several methods have been devised to make it safe and reliable. The traditional large abdominal incision (laparotomy) is now replaced by minilaparotomy, which is a small abdominal incision. Other techniques, such as transvaginal and trancervical approaches require no incision at all. These method permit occlusion of any part of the fallopian tube. Minilapatomy is the recommended method of female sterilization for 3rd world countries. Laparoscopic sterilization appears to be more psychologically acceptable to 3rd world women who have an inherent dread of surgery. A higher incidence of hematoma formation has been reported in puerperal laparoscopic sterilizations and the failure rate is also higher than in other methods. Other complications associated with laparoscopic sterilization include wound sepsis, surgical emphysema of the parieties and uterine perforation. Laparoscopic sterilizations can be performed under local, general, spinal or epidural anesthesia. Local and general anesthesia is the commonest. Both tubal ligations and vasectomies have been available in Malaysia since the 1960s. Laparoscopy was 1st introduced in Malaysia in the early 1970s. Several laparoscopy centers have been established in Malaysia to provide specialized family planning services. Outpatient laparoscopic sterilization is a feature of the Kuala Lumpur Specialist Center. Traditonally doctors and specialists in Malaysia received their practical training in sterilization techniques during their internship or residency. Since 1980, however, a formal training program was initiated. Because laparoscopy provides interval sterilization without major abdominal surgery, this procedure has played a major role in promoting acceptance of female sterilization. The use of mass media to promote sterilization has not been fully utilized because of religious and political sensitivities.
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