Doppler colour flow analysis of uterine and ovarian arteries prior to and after surgery for tubal sterilization: a prospective study

Abstract

Female sterilization by tubal ligation is a very common method of birth control. A relationship between tubal sterilization and subsequent development of menstrual disorders has been described in the literature but a biological mechanism explaining such an association has not yet been demonstrated. The aim of this study was to evaluate the influence of tubal ligation by the Pomeroy technique on ovarian and uterine artery blood flow using pre- and post-surgical Doppler assessments. We studied prospectively 20 patients undergoing laparotomy for tubal ligation. All patients had a Doppler blood flow assessment before and after surgery, conducted in the mid-follicular phase of their cycle. The pulsatility index (PI) of the right uterine artery ranged from 1.44 to 3.86 (mean 2. 23) when measured prior to surgery and from 1.36 to 2.85 (mean 2.13) when measured after surgery. In the left uterine artery, the PI ranged from 1.67 to 3.17 (mean 2.17) and from 1.69 to 2.88 (mean 2. 22) before and after surgery respectively. The difference was not statistically significant. The PI of the right ovarian artery ranged from 1.38 to 3.48 (mean 2.41) prior to surgery and from 1.48 to 3.23 (mean 2.29) after surgery. In the left ovarian artery, the PI ranged from 1.36 to 3.62 (mean 2.54) and from 1.85 to 4.00 (mean 2.61) before and after surgery respectively. Again, the difference was not statistically significant. Our results suggest that tubal sterilization performed by Pomeroy's technique does not induce immediate alterations in the vascular flow of either ovarian or uterine arteries.