Female sterilization: update on clinical efficacy, side effects and contraindications

Area of Science:

• Gynecology
• Reproductive Health
• Minimally Invasive Surgery

Background:

• Female sterilization is a permanent method of contraception.
• Various surgical approaches exist, each with distinct advantages and disadvantages.

Purpose of the Study:

• To compare female sterilization methods.
• To identify the optimal approach and device for individual patients.
• To evaluate timing, safety, cost-effectiveness, failure rates, complication rates, and patient satisfaction.

Main Methods:

• Systematic literature search of MEDLINE, EMBASE, Sciencedirect, and Cochrane Library (2000-2012).
• Inclusion of original descriptions, case reports, retrospective studies, and review articles on tubal sterilization.
• Outcome measures included effectiveness, tolerability, complications, and patient satisfaction.

Main Results:

• The ideal female sterilization method is simple, safe, highly effective, inexpensive, and requires a one-time procedure without side effects.
• Trans-cervical hysteroscopic approach offers minimal postoperative pain, short hospitalization, and rapid return to daily activities.
• Laparoscopic and laparotomic methods are considered secondary options, with transcervical hysteroscopic methods expected to increase in gynecological practice, especially in developing countries.

Conclusions:

• Safety, hospital stay, costs, and surgeon experience influence the choice of female sterilization method.
• Hysteroscopic devices are preferred when feasible.
• Thorough patient counseling is crucial for informed decision-making.
• Method selection depends on the clinical setting, surgeon expertise, economic development, and patient preference.