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  • Title: Aftermaths of surgical sterilisation with special reference to menstrual disturbances.
    Author: Purkayastha S, Bhattacharyya PK.
    Journal: J Indian Med Assoc; 1992 Feb; 90(2):29-30. PubMed ID: 1534107.
    Abstract:
    With the increasing use of a variety of surgical methods for sterilisation, certain pitfalls of these surgical decisions are emerging. In the present study 216 cases who underwent sterilisation at least 2 years prior to coming for consultation with various problems have been analysed. Menstrual disturbances like menorrhagia (59.2%), dysmenorrhoea (29.6%) and metrorrhagia (5.56%) are the leading symptoms ascribable to a large extent to the operation if not the fullest extent in some cases. The physical and psychological disturbances that have evolved from sterilisation include pain abdomen (25%), vague abdominal discomfort and backache (14.8%), leucorrhoea (12.03%), obesity (8.34%), insomnia (4.17%), irritability (2.78%), depression (2.78%) and regret (1.39%). Physicians examined 216 women who presented at Chittaranjan Seva Sadan College of Obstetrics, Gynaecology, and Child Health in Calcutta, India, and had undergone surgical sterilization at least 2 years earlier. Endometrial biopsies during the late secretory phase in the 32 cases with excessive bleeding during the late menstrual period found proliferative changes: dilated glands in 28 cases and poor secretory phase in 4 cases. The 12 ovarian biopsies revealed cortical stromal hyperplasia in 1 case. None of the control cases (i.e., those with no menorrhagia) had any ovarian changes. Observed pelvic pathologies included in the order of frequency: cystic ovaries, hydrosalpinx, uterine fibroids, pelvic endometriosis, uterine prolapse, chronic cervicitis, and scar endometriosis. Most of the 216 women were 25 to 35 years old and the youngest was 22 years old. Menorrhagia was the most common complaint (59.2%) and 30 to 35 year old women suffered from it the most. Among women who had no pelvic pathology, dysfunctional uterine bleeding was responsible for menorrhagia. Dysmenorrhea was the next most frequent complaint (29.6%). Intermenstrual bleeding, abnormally infrequent menstruation, and secondary amenorrhea were other menstrual disturbances (5.56%, 4.17%, and 1.39%, respectively). Other relatively common symptoms associated with surgical sterilization were abdominal pain (25%), abdominal discomfort and backache (14.8%), and whitish, viscid vaginal or uterine discharge (12.03%). Less frequent symptoms were obesity, painful scar, insomnia, irritability, depression, and regret. Proper preoperative and postoperative counseling would have prevented many of the complications.
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