RESUMO
Because female sterilization is being used extensively as a method of limiting family size, its early complications as well as long-term sequelae should be carefully documented. This analysis of a two-year controlled prospective study of 3,466 sterilized women shows that the incidence of poststerilization gynecologic abnormalities was not significantly higher than what might be expected in the general population and declined markedly over time. Poststerilization surgery rates were also low. The incidence of weight gain among sterilized women was significantly higher than that of weight loss. Analysis of menstrual patterns showed no change in menstrual cycle parameters after sterilization for the majority of the cases. Both favorable and unfavorable changes in menstrual cycle parameters were reported. The two-year pregnancy rate was 0.4%. One ectopic pregnancy was reported.
PIP: The India Fertility Research Program has conducted a wide range of studies for the purpose of evaluating the safety and effectiveness of female sterilization techniques. This is a report of a 2 year follow-up analysis of women who underwent sterilization for family size limitation. The data were examined to evaluate the incidence of gynecologic abnormalities, subsequent gynecologic surgery, weight gain, changes in menstrual patterns, and pregnancies following sterilization. Follow-up data were reported for 3466 women who underwent sterilization over the 1973 to 1979 period at 8 institutions participating in 15 studies utilizing the standard protocols of the India Fertility Research. Data on patient characteristics, medical and menstrual history and clinical aspects of the procedure were reported at the time of sterilization. Early complications and complaints were reported at the 1st follow-up visit, 1-3 weeks after surgery. The reported incidence of gynecologic conditions decreased from 10.1% at the 6 month follow-up visit to 8.8% and 6.2% at the 12 and 24 month follow-up visits. There was a decrease, over time, in the incidence of acute (1.0% to 0.7%) and chronic (6.1% and 2.8%) pelvic infection as well as incision related complications (1.5% to 0.3%). At the 6 month follow-up visit, 16.2% of the women reported complaints. At the 12 and 24 month follow-up visits, only 9.8% and 5.4% of the women reported any complaints. The incidence of pelvic pain, the most frequently reported complaint, decreased from 13.0% at the 6 month visit to 7.1% and 5.0% at the 12 and 24 month follow-up visits. The incidence of wounded pain decreased from 2.2% at the 6 month follow-up visit to 1.0% at the 12 month and 0.2% at the 24 month follow-up visits. Poststerilization gynecologic surgery was reported for 11 women at 6 months, 14 at 12 months and 92 at 24 months. No change in body weight was reported for 57.2% to 63.3% of the women at the various follow-up visits. Significantly more women reported an increase rather than a decrease in body weight at each follow-up visit. Over 80% of the women reported no change in the amount of menstrual flow after sterilization. 37 pregnancies were reported for this series. There was 1 ectopic pregnancy. Results of this prospective study show that the incidence of gynecologic pathology for women undergoing sterilization was not significantly higher than what might be expected in the general population and that there was a significant decline, over time, in the rates of gynecologic abnormalities reported after sterilization.
