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Sterilisation by implants associated with high risk of further operations

Women who undergo implant-based sterilisation have an increased risk of reoperation after complications, the results of a new study show.

US researchers compared the performance, safety and outcomes of two widely used forms of female sterilisation: laparoscopic involving the clipping, stitching or burning of the fallopian tubes to prevent pregnancy, and hysteroscopic which uses the Essure implant to block the fallopian tubes.

The researchers analysed data from 44,278 patients who underwent laparoscopic sterilisation between 2005 and 2013, and 8,048 patients who underwent hysteroscopic sterilisation. They looked at complications within 30 days of initial procedures, and unintended pregnancies and reoperation up to three years after initial sterilisation.

One year after surgery, they found that although hysteroscopic sterilisation was not associated with a higher risk of unintended pregnancy, it was associated with a substantially increased reoperation risk.

Patients undergoing hysteroscopic sterilisation had more than a ten-fold increased risk of reoperation compared with those undergoing laparoscopic procedures. Following initial sterilisation, these women were eight times more likely to

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US researchers compared the performance, safety and outcomes of two widely used forms of female sterilisation: laparoscopic – involving the clipping, stitching or burning of the fallopian tubes to prevent pregnancy, and hysteroscopic – which uses the Essure implant to block the fallopian tubes.

The researchers analysed data from 44,278 patients who underwent laparoscopic sterilisation between 2005 and 2013, and 8,048 patients who underwent hysteroscopic sterilisation. They looked at complications within 30 days of initial procedures, and unintended pregnancies and reoperation up to three years after initial sterilisation.

One year after surgery, they found that although hysteroscopic sterilisation was not associated with a higher risk of unintended pregnancy, it was associated with a substantially increased reoperation risk.

Patients undergoing hysteroscopic sterilisation had more than a ten-fold increased risk of reoperation compared with those undergoing laparoscopic procedures. Following initial sterilisation, these women were eight times more likely to undergo a reoperation at two years, and six times more likely at three years.

‘With an estimated 600,000 sterilisation procedures performed in the US every year, the device-based hysteroscopic sterilisation has a major public health impact,’ the study authors said.

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