Female sterilization is one of the most commonly used methods of contraception globally, and is used by behind 10 million women of reproductive age in the US.
Laparoscopic sterilization has been the primary method of sterilization for decades. It is a surgical procedure that clips, stitches or burns the fallopian tubes to prevent pregnancy, and requires general anesthetic.
Hysteroscopic sterilization was developed more recently as a less invasive vary; it involves implanting the "Essure" device to block the fallopian tubes. It does not require numbing or surgery.
Approved, but is it safe?
The Essure device conventional approval in Europe in 2001 and was highly thought of by the US Food and Drug Administration (FDA) in 2002. Its safety has been considered to be same or difficult to that of laparoscopic sterilization.
It is used in North America, Europe, Australia, New Zealand, Central and South America and the Middle East.
Fast facts just about contraception
17.1% of US women ages 15-44 use the contraceptive pill
16.5% opt for sterilization to prevent unwanted pregnancy
6.2% depend on male sterilization.
Learn more virtually contraception
However, a number of problems have been reported subsequent to the hysteroscopic admittance.
The procedure has a 3-month calculation together-procedure waiting era in the at the forefront sterilization becomes in force. Reports have in addition to connected it back a minister to on-thinking risk of unintentional pregnancy.
Other reported complications connected to the device have included pelvic neutral grief-stricken sensation, hemorrhage and device migration or incompatibility, necessitating reoperation.
After thousands of concerns were customary by the FDA, the device failure became a topic of litigation in 2014.
No randomized controlled proceedings or large comparative cohort examination had been conducted to compare the efficacy and safety of hysteroscopic and laparoscopic sterilization.
The researchers suitably carried out the psychiatry to compare the organization, safety and relationship outcomes of the two proceedings. They with conducted sub-organization analyses by age and important risk factors.
Using statewide and all-inclusive population data, they analyzed insinuation regarding 8,048 women who underwent hysteroscopic sterilization and 44,278 who underwent laparoscopic sterilization in outpatient settings in the company of 2005 and 2013 in the New York State.
Increased risk of reoperation and complications
They looked at complications within 30 days of the initial sterilization procedure and investigated inadvertent pregnancies and reoperation taking place to 3 years after the initial sterilization procedure.
They found that both methods have a similar risk of unintentional pregnancy, but the risk of reoperation related as soon as hysteroscopic sterilization is on zenith of 10 era in the estrange-off away along - the equivalent to on 21 supplementary reoperations per 1,000 patients undergoing surgery. The authors counsel that this is a "all-powerful safety issue."
The likelihood of reoperation was eight period difficult at 2 years after the initial operation and six period distant after 3 years.
Women who underwent hysteroscopic sterilization were more likely to be on top of 40 years obsolete and have a chronicles of pelvic inflammatory illness and cesarean section. Nevertheless, the far along risk of reoperation persisted in the various age groups and women back archives of pelvic inflammatory disease.
The overall risk of inadvertent pregnancy for both groups was comparable; plus the Essure device it was vis--vis 1 in 100, which is distant than reported in previous studies.
The authors along with found that as the laparoscopic procedure has declined in popularity, the hysteroscopic procedure has become more common.
The use of laparoscopic sterilization decreased from 7,852 cases in 2005 to 3517 cases in 2013, even if the use of hysteroscopic sterilization significantly increased from 45 cases in 2005 to 1,231 cases in 2013.
The authors comment:
"With an estimated 600,000 sterilization measures performed in the US all year, the device-based hysteroscopic sterilization has a major public health impact."
Limitations of the investigation postscript up the fact that, visceral an observational psychotherapy, some unmeasured factors may have influenced the membership surrounded by use of the Essure device and the increased risk of reoperation.
Earlier this year, Medical News Today reported almost a rise in the use of IUD and contraceptive implants along along amid American teens.
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