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  • Title: Non-endoscopic surgical contraception (vaginal tubectomy).
    Author: Bashir A.
    Journal: Adv Contracept Deliv Syst; 1993; 9(1):33-6. PubMed ID: 12344833.
    Abstract:
    Pakistan and other countries with high population growth rates are in need of an acceptable procedure to prevent fertilization and lower birth rates and reduce maternal mortality. Vaginal tubectomy and nonsurgical tubectomy are discussed as forms of female sterilization which may be suitable to women and countries with limited finances. 15,000 cases of vaginal tubectomy have been performed in Pakistan during 1972-92 with a failure rate of 1/1000 and no ectopic pregnancies. Quinacrine nonsurgical procedures have been used on about 4000 case during 1990-93 with no serious complications or side effects; the failure rate is 4% and no ectopic pregnancies have resulted. Vaginal tubectomy is suitable for Pakistani patients who have fatty abdomens and are reluctant to have an abdominal operation. Women also find the absence of an abdominal scar desirable because of the fear of abdominal rupture. Laparoscopic tubectomy is compared to vaginal tubectomy. In laparoscopic sterilization ectopic pregnancy is high for patients who have coagulation and division. Laparoscopic tubectomy case also have more complications than vaginal tubectomy cases requiring laparotomy. Vaginal tubectomy procedures are simple and economical, require short hospitalizations, have short recovery periods, have minimal postoperative discomfort and lower minor morbidity and major complications, and can be combined with other vaginal procedures. Endoscopic procedures may require general anesthesia which carries its own risks, requires sophisticated equipment and operative skill, and is not suitable for obesity; endoscopes are expensive in cost and maintenance. Other types of interval sterilization are not as accepted by women. Culdoscopic tubal ligation and hysteroscopic tubal occlusion are feasible and acceptable alternatives to vaginal tubectomy. Many gynecologists acquired skills in one method, which is used continuously; this makes it difficult to compare methods. Both vaginal tubectomy and quinacrine introduction into the uterine cavity are described as medical procedures.
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