Five Methods of Tubal Sterilization

We prospectively compared five methods of interval tubal sterilization: minilaparotomy Pomeroy (ML), laparoscopic coagulation (C), laparoscopic Falope ring (FR), laparoscopic Pomeroy with endoloops (E), and laparoscopic Hulka clip (H). The 114 women undergoing interval sterilization were interviewed by nurses using a structured data-abstraction instrument immediately postoperatively, and 24 hours and 2 weeks postoperatively to compare pain, vomiting episodes, overall satisfaction with the surgical experience, and time to resuming activities. Operating time, time in the recovery room, and cost of medical supplies also were compared. The measured variables were evaluated for significance by analysis of variance and Bonferroni's correction for multiple comparisons. Significant differences were found for postoperative pain (p = 0.01) between FR (6.96 ± 2.91) and C (4.36 ± 3.51); time in the recovery room (p <0.001) between ML (271.87 ± 57.95) and H (162.78 ± 48.79), FR (161.80 ± 47.78), and C (138.06 ± 41.77); and cost of surgical supplies (p <0.001) between E ($352.73 ± 42.76) and H ($133.28 ± 82.90), C ($131.09 ± 59.06), FR ($125.00 ± 72.98), and ML ($64.79 ± 14.07). It may be concluded that the cost of medical equipment used in laparoscopic Pomeroy ligation (and other variations of so-called pelviscopic sterilization) with endoloops is significantly greater than that of the other four methods, and that immediate postoperative pain is greater with the Falope ring than with tubal coagulation.