Evaluation of women seeking sterilisation reversal.

ABSTRACT

A total of 1120 women attending at Regional Centre of Excellence (RCOE), RG Kar Medical College and Hospital, Calcutta from October, 1989 to July, 1998 with the request for sterilisation reversal (SR) were evaluated step by step for fitness of SR operation on the basis of history, clinical examination, pre-operative investigations, fertility status and laparoscopic findings. One thousand and sixty couples completed their evaluation. Majority of the SR seekers were young (< 30 years) and significant number (8.9%) of women came in late age (> 40 years). Most (85.8%) of the women had one or no child. The main reason for requesting reversal was death of children (91.8%). Only 43.3% were ultimately found fit for SR operation and rest (56.7%) were refused. Presence of 2 or more children in not remarried couple (13.8%), gross pelvic pathology (2.35%), advanced age (8.7%), seminopathy (4.05%), and some medical diseases (3.2%) were important reasons before pre-operative investigations for refusal. Faulty sterilisation technique (11%) was responsible for refusal at laparoscopic evaluation. The need of critical evaluation of all women seeking reversal has been emphasised in this study. Various aspects related with demand for SR and preventive measures to improve the success of this procedure have been critically discussed.