Results of the insertion of hysteroscopic sterilization devices in a brazilian public hospital / Resultados da inserção de dispositivos de esterilização histeroscópica em um hospital público brasileiro

Abstract Objective To evaluate the insertion of the hysteroscopic intratubal sterilization device for female sterilization concerning the technique and the feasibility. Methods Retrospective study with data collection of medical records of 904 patients who underwent device insertion between January and September 2016 in a public hospital in Rio de Janeiro (Brazil) with data analysis and descriptive statistics. Results In 85.8% of the cases, the uterine cavity was normal, and themost commonlydescribed findings upon hysteroscopy were synechiae (9.5%). The procedure lasted an average of 3.56minutes (range: 1 to 10minutes), and the pain was considered inexistent or mild in 58,6% of the cases, mild or moderate in 32,8%, and severe or agonizing in less than 1% (0.8%) of the cases, based on a verbal scale ranging from 0 to 10. The rate of successful insertions was of 85.0%, and successful tubal placement was achieved in 99.5% of the cases. There were no severe complications related to the procedure, but transient vasovagal reactions occurred in 5 women (0.6%). Conclusion Female sterilization performed by hysteroscopy is a safe, feasible, fast, and well-tolerated procedure. The rates of successful insertions and tubal placements were high. There were few and mild adverse effects during the procedure, and there were no severe complications on the short term.

Resumo Objetivo Avaliar a inserção de dispositivo intratubário de esterilização histeroscópica com relação à viabilidade e à técnica. Métodos Estudo retrospectivo com coleta de dados de prontuários das pacientes submetidas à inserção do dispositivo entre janeiro e setembro de 2016 emumhospital público do Rio de Janeiro, comanálise dos dados e realização de estatísticas descritivas. Resultados Foram incluídos 904 casos no estudo. Em 85,8% dos casos, a cavidade uterina estava normal, e os achados mais comumente descritos à histeroscopia foram as sinequias (9,5%). O tempomédio do procedimento foi de 3,56minutos (gama: de 1 a 10 minutos); a dor foi considerada de ausente a leve em 58,6% dos casos, de leve a moderada em32,8% dos casos, e de forte à pior dor possível emmenos de 1% dos casos (0,8%). A taxa de inserções bem-sucedidas foi de 85,0%, e a colocação tubária foi bemsucedida em 99,5% dos casos. Não foram identificadas complicações graves, mas reações vasovagais transitórias ocorreram em 5 mulheres (0,6%). Conclusão A esterilização feminina por histeroscopia é um procedimento seguro, viável, rápido, e bem tolerado. As taxas de inserção bem-sucedida e de colocação tubária foram altas. Houve poucos e leves efeitos colaterais durante o procedimento, e não foram observadas complicações graves no curto prazo.

A comparative study of psychosexual problems in women who have undergone sterilization versus hysterectomy

Background: Female sterilization a popular contraceptive procedure that results in loss of reproductive function whereas hysterectomy, the surgical removal of uterus results in loss of both reproductive and menstrual function. These are important events in women that are found to be contributing for psychological problems as these are related with feminine identity. Though the usual age at operation is different for both the groups, the concerns are same like feminine identity and sexual life. Aim: To compare and study the psychological problems in terms of depression and anxiety and sexual problems in women who have undergone female sterilization and hysterectomy and also to find out whether these procedures affect quality of life; and, also to study whether better information education communication (IEC) activities, round the clock medical services and careful selection of cases have impact on outcome of these procedures. Methods: A cross sectional epidemiological Study conducted in urban slums by administering semi structured questionnaire and instruments like Hospital Anxiety and Depression scale(HADS), World Health Organization Quality of Life-BREF scale (WHOQOL-BREF) Results: Though the hysterectomy group showed slightly higher mean scores in terms of anxiety and depression but they are not statistically significant. Quality of life was good in all domains in both groups where as sexual problems are slightly more in hysterectomy group. Conclusion: Thus the knowledge about procedure, round the clock medical facility, careful selection, pre procedural distress has impact on outcome Key message: We can minimise psychosexual problems by careful selection and regular follow up counselling

Factors affecting sterilization operation among couples of a rural area in Ahmedabad: A record-based study.

Introduction: Various socio demographic factors play role in sterilization operation. Materials and Methods: A record-based study was conducted in Jetalpur, rural area of Ahmedabad District. Records of all sterilization operation done between April 2010 to March 2011 were studied. Results: A total of 180 sterilization operations were performed, of which 179 (99.4%) were female sterilization and one (0.6%) was vasectomy. The mean age of females was 28.27 years and that of their husbands was 31.72 years. Total 45% of females in the study population were illiterate, whereas 17% of their husbands were illiterate and their average family size was 2.8 members. Majority of females underwent sterilization operation when the age of last living child was between 1-5 years. In 67% cases, female health worker was the motivator. Only two couples had no living male child, whereas all other couples had at least one male child in the family. There was no significant relationship between the education of the mother and the age of the last living child, but education of mother was significantly related to the total number of living children in the family. Education of the father was significantly related with the age of last living child and the total number of living children in the family. Conclusion: The study reveals that education of both parents is an important driving factor in deciding the size of family. Majority of couple decide for permanent sterilization after having at least one male child. Thus, there is a strong preference for at least one male child in the family.

Avaliação das concentrações de zinco no aparelho reprodutor feminino por ativação neutrônica instrumental / Assessment of zinc concentration in the female reproductive system by instrumental neutron activation

A esterilização feminina não cirúrgica por meio da aplicação intracervical de pastilhas de cloridrato de quinacrina foi considerada um método contraceptivo definitivo de baixo custo, seguro e eficaz. O zinco, presente no útero e nas tubas uterinas, inibe a ação da quinacrina. A adição de cobre aumenta a eficácia da quinacrina, reduzindo o risco de gravidez devido às falhas de obstrução das tubas uterinas. O cobre neutraliza o efeito deletério do zinco, aumentando a eficácia do método. Para obter o mapeamento da concentração de zinco no aparelho reprodutor feminino, amostras de útero e de tubas uterinas foram analisadas por ativação neutrônica instrumental. Os resultados obtidos são apresentados neste trabalho.

Nonsurgical female sterilization through the transcervical insertion of quinacrine pellets was considered a definitive, low-cost, safe and effective contraceptive method. The zinc, present in both uterus and Fallopian tubes, inhibit the action of quinacrine. The addition of copper increases the efficacy of quinacrine, thus reducing the risk of pregnancy due to the failure to obstruct the Fallopian tubes. The copper neutralized the deleterious effect of the zinc and so the treatment efficacy is increased. In order to obtain a mapping to study the zinc concentration in the female reproductive system, samples of both uterus and Fallopian tubes were analyzed by neutron activation. The results are here reported.