[Changes in menstrual pattern following tubal ligation]. / Alteraciones del patrón menstrual, consecutivas a ligadura tubaria.

PIP: 50 women undergoing tubal sterilization by the modified Pomeroy technique at a hospital in Toluca, Mexico, were selected at random and followed for 6 months postoperative to detect changes in menstrual patterns. The women had normal menstrual histories and had not used contraceptive medications for at least 3 months prior to operation. Analgesia was provided by peridural block with 2% lidocaine. There were 45 cases of interval and 5 of immediate postpartum sterilization. The women ranged in age from 25 to 44 years and averaged 34.5.16 women, or 32%, had altered menstrual patterns. There were 12 cases of hypermenorrhea and 1 each of oligomenorrhea, polymenorrhea, amenorrhea, and proiomenorrhea. Age at menarche, parity, and obstetric history were unrelated to menstrual changes. Changes in menstrual patterns after surgical tubal occlusion have been attributed to damage in the uterine and ovarian blood vessels leading to reduced blood supply and ultimately to abnormal maturation of ovarian follicles and hormonal changes. Psychogenic factors may play a role. The extent of surgical damage after various techniques of tubal occlusion and the materials used for suturing should be assessed as possible sources of local or regional inflammation that could have repercussions in blood perfusion and nervous function.^ieng