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  • Title: Female sterilization in current clinical practice.
    Author: Porter CW, Hulka JF.
    Journal: Fam Plann Perspect; 1974; 6(1):30-8. PubMed ID: 4282075.
    Abstract:
    The sterilization procedures most widely employed in the U.S. and newer methods which hold promise are reviewed. Abdominal Pomeroy tubal ligation, the most commonly used method, is usually done within 48 hours after delivery. A small incision ate. A knuckle of each fallopian tube is ligated and then resected. The cut ends of the tubes retract from each other when the suture absorbs and become sealed by a peritoneal covering. Local or general anesthesia may be used. nimally prolonged. Postoperative morbidity is 2-4% and a reported failure rate of less than 1%. Following Caesarean section, the Irving procedure is used most often. In this method the tubes are double ligated and bedded in the uterine musculature and the distal ends are buried beneath the broad ligament. As an interval procedure, the Pomeroy method or fimbriectomy may be done using the vaginal approach. Pelvic erus prevent this method from being used. igation is combined with first trimester abortion the morbidity is increased. Laparoscopy, culdoscopy, and hysteroscopy are recent advances. To use these methods, special training is needed and the required equipment is 2-puncture method and general anesthesia are preferred. An alternative to coagulation of the tubes is the application of clips. The new spring-loaded clips appear to be most promising. With culdoscopy each tube ligated, cut, and returned to its normal position. Tantalum clips may be used to occlude the tubes. This operation requires a good deal of time to learn but can be done as an outpatient procedure. Pelvic cult. Postoperative infection may follow in 2-10% of cases. In using the hysteroscopic technique, after dilatation of the cervix the hysteroscopic sleeve is introduced and the uterine cavity A cautery probe is introduced into each uterotubal junction and electrocoagulation done. Scar tissue later blocks the tubes. The equipment is expensive and special training is re are numerous contraindications to this method. Hysterectomy for sterilization is a drastic measure. Quinacrine hydrochloride instilled into the uterine cavity is 90% effective in preventing pregnancy. Other sclerosing agents cements, as gelatin-resorcinol-formilin have been used to promote tissue ingrowth to seal fallopian tubes. The choice of procedure for each woman varies according to her life situation and specific needs. seem to offer any advantages over the postpartum Pomeroy tubal ligation. Hysterotomy and tubal ligation are a combination which sometimes seems favorable. Counseling for sterilization is important and complications. problems.
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