Abstract
CONTEXT AND OBJECTIVE: Tubal ligation is one of the most commonly used contraceptive methods worldwide. Since the controversy over the potential effects of tubal sterilization still continues, this study aimed to evaluate the clinical and psychological repercussions of videolaparoscopic tubal ligation.DESIGN AND SETTING: Observational, single cohort, retrospective study, conducted in a tertiary public hospital.METHODS: A questionnaire was applied to 130 women aged 21-46 years who underwent videolaparoscopic tubal ligation by means of tubal ring insertion or bipolar electrocoagulation and sectioning, between January 1999 and December 2007. Menstrual cycle interval, intensity and duration of bleeding, premenstrual symptoms, dysmenorrhea, dyspareunia, noncyclic pelvic pain and degree of sexual satisfaction were assessed in this questionnaire. Each woman served as her own control, and comparisons were made between before and after the surgical procedure and between the two techniques used.RESULTS: The clinical and psychological repercussions were significant, with increases in bleeding (P = 0.001), premenstrual symptoms (P < 0.001), dysmenorrhea (P = 0.019) and noncyclic pelvic pain (P = 0.001); and reductions in the number of sexual intercourse occurrences per week (P = 0.001) and in libido (P = 0.001). Women aged ≤ 35 years at the time of sterilization were more likely to develop menstrual abnormalities. The bipolar electrocoagulation method showed greater clinical and psychological repercussions.CONCLUSION: Regardless of the technique used, videolaparoscopic tubal ligation had repercussions consisting of increased menstrual flow and premenstrual symptoms, especially in women aged ≤ 35 years, and also had a negative influence on sexual activity.
Highlights
Maternal mortality is one of the great worldwide challenges in medicine
An interval of at least 60 days was observed between manifestation of the desire for sterilization and implementation of tubal ligation, so that counseling and detailed information could be provided to the patients
Occurrences of premenstrual symptoms such as headache, edema, mastalgia, dizziness and irritability before sterilization, which were reported by 55.4% of the patients, increased significantly to 74.6% after the procedure (P < 0.001)
Summary
Maternal mortality is one of the great worldwide challenges in medicine. Family planning has become highly important in preventing maternal and infant morbidity and mortality, among women at high reproductive risk.[1]. Tubal ligation is one of the most commonly used contraceptive methods all over the world. The number of women currently practicing contraception in Brazil is extremely high, reaching up to 80% of those in stable unions. According to the last Brazilian National Survey on Demography and Health (PNDS), conducted in 2006, most respondents controlling their fertility were using modern contraceptive methods and 29% of the women living in a relationship were sterilized. It was noteworthy that 10.9% of the respondents who had not committed themselves to a stable union had chosen tubal ligation as a birth control method.[2]
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