Female sterilization using tubal coagulation.

Area of Science:

• Gynecology
• Minimally Invasive Surgery
• Reproductive Health

Background:

• Laparoscopic sterilization is a common method for permanent contraception.
• Tubal coagulation techniques, including unipolar electrocoagulation (UPE), bipolar electrocautery (BPE), and endothermic coagulation (EC), are used.
• Evaluating the long-term efficacy and safety of these techniques is crucial.

Purpose of the Study:

• To evaluate the 3-year follow-up experience with three different laparoscopic tubal coagulation sterilization techniques.
• To compare the efficacy and failure rates of UPE, BPE, and EC.
• To assess the reliability of hysterosalpingography (HSG) for post-sterilization follow-up.

Main Methods:

• Retrospective analysis of 3-year follow-up data for patients undergoing laparoscopic tubal coagulation.
• Categorization of patients based on the technique used: UPE (17 cases), BPE (94 cases), and EC (166 cases).
• Post-sterilization follow-up included clinical pregnancy rates and, in 200 patients, hysterosalpingography (HSG).

Main Results:

• Unipolar electrocoagulation (UPE) had a 5.88% ectopic pregnancy rate.
• Bipolar electrocautery (BPE) demonstrated 0% pregnancy rate.
• Endothermic coagulation (EC) resulted in a 5.42% pregnancy rate.
• Hysterosalpingography (HSG) showed tubal patency in 2% of cases, with half of clinical pregnancies having a negative HSG.

Conclusions:

• Bipolar electrocautery (BPE) is the preferred method for tubal coagulation due to its high efficacy.
• Endothermic coagulation (EC) exhibits a high failure rate and should be used cautiously.
• Unipolar electrocoagulation (UPE) should be abandoned; hysterosalpingography (HSG) is not a reliable method for assessing sterilization success.