Voluntary Surgical Contraception Research Articles

Family Planning Policies in Peru (1995-2023): Ontological Problems on Fertility and Infertility in Andean and Amazonian Culture

The research proposes a historical analysis of family planning policies in force from 1995 to 2023, with the objective of understanding the problems derived from the Voluntary Surgical Contraception (VSC) program implemented between 1995 and 2000, as well as the current decline of the health system in relation to sexual health and family planning. It addresses the influence of conservative-oriented governments and policies, as well as the interaction with Andean, Amazonian and urban cultural conceptions of fertility and infertility. The methodology employed is historical in nature, with an anthropological and qualitative approach. The findings highlight that policies related to sexuality and family planning in the historical context of the country did not take into account the cultural values and perspectives of local communities, which has contributed to a social gap in the field of public health. It is evident that the mass sterilization policies implemented in Peru during the 1990s suffered from lack of informed consent, pressure and coercion on individuals, having a disproportionate impact on the most vulnerable communities. Therefore, this study seeks to provide guidance and recommendations to address the current problem identified.

Tubal Ligation under Local Anesthesia in a Country with Limited Resources: 56 Cases of Wife and Husband’s Experience in the Gynecology-Obstetrics Department of Ignace Deen National Teaching Hospital, Conakry, Guinea

Tubal ligation is a surgical sterilization procedure that provides permanent and reliable contraception to women. Tubal obstruction is a method of permanent birth control that can be performed after mini-laparotomy under local anesthesia. Objective: To determine the outcome of tubal sterilizations by mini-laparotomy under local anesthesia performed in clients who underwent the surgical operation in the Maternity Ward of Ignace Deen National Hospital. Patients and Methods: The Gynecology and Obstetrics Department of Ignace Deen National Hospital was used as the place for the study. The study involved all the women seeking voluntary surgical contraception. This was a retrospective study of a descriptive type carried out from January 1, 2017 to December 31, 2018. A consent form was filled out and signed by spouses after an interview and a systematically carried out pre-operative clinical and para-clinical assessment. Results: During the study period, 56 tubal ligations were performed i.e. 4.72 percent of all family planning methods. The recruiting for the surgical contraception involved clients whose typical profile is that of women with an average age of 35, mostly housewives (35.71%), major multiparous (69.63%) with 6 living children on average. Married women made up the bulk of the recruiting i.e. 96.44%. Unmarried women made much more use of other methods. Indications of personal convenience were the most frequently encountered common reason. Among medical causes, high blood pressure concerned the majority of cases: 38% of the indications. Surgical contraception in between was more practiced than the post-partum one. The recorded complication was the parietal hematoma due to a lack of hemostasis and it accounted for 1.79% of cases. The progress was uncomplicated in 98.68% of cases. Forty couples (71.42%) expressed their feelings of satisfaction against only 6 cases of regret (10.71%). Conclusion: The surgical contraception has become a requirement for modern couples. Tubal ligation by mini-laparotomy is a simple operation and a harmless method of contraception that allows clients to use permanent contraception. Carried out on an outpatient basis, incidents and accidents are rare and may have psychological repercussions that are difficult to assess. The technical mastery of the gesture helps to minimize these incidents.

Anticoncepción quirúrgica voluntaria como alternativa a los métodos anticonceptivos reversibles de larga acción-LARC

La anticoncepción quirúrgica voluntaria (AQV), ya sea en su modalidad de ligadura tubárica en la mujer o vasectomía en el hombre, es un método anticonceptivo considerado definitivo. La reversibilidad de ambos métodos solo es posible con microcirugía y con un éxito no mayor al 30%1. Ambos son bien tolerados y la mayoría puede ser realizada con sedo-analgesia y anestesia local. Su eficacia alcanza a un 99,5%2, y es usada a nivel mundial por 200 millones de personas3. La indicación principal es el no deseo de más hijos en la persona o la pareja.

Eficacia del nylon de pescar en esterilización tubaria

OBJETIVO: Eficacia del nylon de pescar en esterilizaciones tubarias. MATERIAL Y MÉTODOS: En 208 pacientes se practicó minilaparatomía más Pomeroy con nylon de pescar, se hizo seguimiento 2 años postoperatorio. RESULTADOS: Tasa de embarazos 0%. CONCLUSIÓN: Sutura adecuada para AQV.

CONOCIMIENTOS Y ACTITUDES EN RELACIÓN A LA AQV EN LAS MUJERES EN EDAD FÉRTIL DE LA LOCALIDAD DE NUEVA CAJAMARCA-REGIÓN SAN MARTÍN

OBJETIVO: Determinar conocimientos y actitudes acerca de la anticoncepción quirúrgica voluntaria (AQV) y los medios de información a través de los cuales se informan sobre este tema, en la localidad de Nueva Cajamarca, provincia de Rioja. DISEÑO: Estudio prospectivo, descriptivo. RESULTADOS: Se tomó una muestra poblacional de mujeres en edad fértil, en quienes se utilizó un cuestionario de preguntas para el recojo de información. El 98,5% contestó que no sabía lo que es el AQV y el 85% no conocía los riesgos del AQV El 53,5% respondió que no se debe de imponer el AQV en un 34,5% respondieron que desearían ser usuarias de AQV y el 40,5% respondió que no les gustaría que otras personas se enterasen de ser usuaria de este método. Mencionaron al personal de salud como los principales informadores del AQV y el 1% mencionó a la Iglesia. Las personas encuestadas refieren que desearían informarse del tema a través de la radio y televisión principalmente. CONCLUSIONES: En la población encuestada el conocimiento sobre el AQV es mínimo y la actitud hacia este método fue positiva. La población estudiada considera el rol del establecimiento de Salud en la difusión de este tema.

Conocimientos y actitudes sobre anticoncepción quirúrgica voluntaria en pacientes en el C.S. Colcabamba Tayacaja Huancavelica

El objetivo del presente estudio fue evaluar los conocimientos de actitudes en una población rural que adopta como método anticonceptivo la anticoncepción quirúrgica voluntaria con la finalidad de mejorar las coberturas del programa de planificación familiar.

VOLUNTARY SURGICAL CONTRACEPTION OF WOMEN OF LATE REPRODUCTIVE AGE SUFFERING FROM PELVIC ORGAN PROLAPSE – FEATURES AND BENEFITS

In recent years there has been a noticeable "rejuvenation" of pelvic organ prolapse. Inconsistency of the pelvic floor muscles, including the omission of sexual organs, is extremely common pathology, observed almost a third of women of reproductive age. The search for effective, convenient methods of contraception for this category of patients is an important problem of modern gynecology.We proposed a method of transvaginal voluntary surgical contraception, produced in conjunction with surgical treatment of descent and prolapse of the vaginal walls. Studied the nearest and long-term results of surgery in 50 women to which, during the surgical treatment of genital prolapse at the same time was performed transvaginal occlusion of the fallopian tubes. Control groups consisted of 30 women to which in the first step before surgical correction of pelvic organ prolapse have been performed minilaparotomy and voluntary surgical sterilization (VSS). Our method consists in penetrating into the abdominal cavity through the anterior vaginal vault, downgrading the fallopian tubes with a hook of Ramathibodi and tubal sterilization by Pomeroy method. Intra - and postoperative complications were not observed. In the late postoperative periods - the effectiveness of the method was 100%. Marked tendency to improve the quality of sexual life tells about the positive impact of elimination of genital prolapse with simultaneous DCA on the quality of life of women.

Voluntary surgical contraception women of late reproductive age suffering from pelvic organ prolapse – features and benefits

Voluntary surgical contraception women of late reproductive age suffering from pelvic organ prolapse – features and benefits

A Review of Family Planning Methods Used in Kano, Nigeria

Objective To review the acceptance pattern and the influence of age and parity on the choice of Family Planning Methods at the Family Planning Clinic, Aminu Kano Teaching Hospital (AKTH), Kano, Nigeria. Method All records of the clients that attended the Family Planning Clinic from January 2003 to December 2007 were analyzed Results New clients were 22% while revisits were 78%, with a steady increase in the number of new clients from 4% in 2003 to 26% in 2007. Injectable contraceptives were the most commonly used (40.63%), followed by the intrauterine contraceptive device (IUCD) (34.53%). Most women of low parity used the injectable contraceptive method (36.2%) and oral contraceptive pills (30.7%), while those in the early reproductive age group (37.1%) used oral contraceptive pills and injectable contraceptive method (32.5%) than any other method. Women of high parity (47.1%) and those in the late reproductive age group (51.2%) used injectable contraceptives more, followed by IUCD (43.0% and 46.1% respectively). There was very low acceptance of Implants (0.54%) and voluntary surgical contraception (0.36%). Majority of the clients (67.5%) were informed about voluntary family planning by Health workers. Conclusion There is an increasing trend in the yearly number of new clients in our centre. Contraceptive methods that do involve surgery or the exposure of the women were preferred, and these should be promoted in a conservative society like ours. The influence of husbands, community and religious leaders and female education are important, if the acceptance of voluntary family planning is to increase in societies like ours, where women marry early and are not socioeconomically empowered. Efforts should be made to step up campaign for voluntary surgical contraception, especially among women who have completed their families, as its utilization is very low in our community. Keywords: Voluntary family planning methods, age, parity, acceptance, Kano.

Bilateral Tubal Ligation Versus Vasectomy: which Method of Surgical Contraception is More Prevalent?

Objective: To determine whether female or male method of voluntary surgical contraception is more prevalent? Study Design: Observational study. Place and Duration of Study: This study was carried out in Population Welfare department, Faisalabad from July 2007 to June 2008. Patients and Methods : During this study, the total number and CYP (couple yearly protected) of bilateral tubal ligation and vasectomy performed in all family planning centers / Reproductive health centers of Government/private sectors and Non government organizations of District FSD, performed in one year from July 2007 to June 2008 was recorded on a printed proforma. The data was shifted to computer for analysis. The software used for analysis was SPSS version 10, and descrip-tive statistics used for analysis .Chi-square test was chose as test of significance. Results: A total of 6938 bilateral tubal ligations with CYP of 86725 were performed as compared to 1602 vasectomies with CYP of 20025 in one year. The difference is significant statistically (p - value > 0.05) as well as therapeutically in terms of CYP. Conclusion: Bilateral tubal ligation / female voluntary surgical contraception is a more prevalent method of surgical contra-ception as compared to male voluntary surgical contraception. Key Words: Bilateral tubal ligation, vasectomy.

Tubal Ligation under Local Anesthesia and Conscious Sedation by Microlaparoscopy

Study Objective: Definitive Voluntary Surgical Contraception (DVSC) is the most common contraception method in Brazil and throughout the world.

Fifteen Years Evaluation Of Haematocrit Values In Clients Accepting Minilaparotomy Sterilization In Jos, Nigeria

The study retrospectively evaluated the haematocrit values of clients accepting female sterilization over a 15year period in Jos University Teaching Hospital, Jos, Plateau State, Nigeria. Between January 1985 and December 1999, 2986 female sterilizations, through minilaparotomy, were performed. The mean (± SD) age and parity of the patients were 36.4 ± 4.2 years and 8 ± 2.0 respectively. 93.4% were between the ages 30-44years and 89.5% of them had delivered more than 5children. Interval sterilization was performed in 93.7% while 85% of the cases were done under local anesthesia. General anesthesia was used in 1.8% of the clients. The mean range of packed cell volume was 35.4%-39.6% with a mean (± SD) of 38.1 ± 2.9%. There was no anaemia related morbidity or mortality associated with the clients. The authors concluded that quality guidelines in voluntary surgical contraception ensured safety and continuity of services. Keywords: Haematocrit, Minilaparotomy, female sterilization.Journal of Mining and Geology Vol. 5 (1&2) 2006: pp. 5-12

Improving the range of contraceptive choices in rural Ethiopia

Background: Despite the reality of a high unmet need, the utilization of family planning services in Ethiopia could be described as very low. Besides this, the knowledge and practice of family planning is limited merely to the usage of shorter-term contraceptive methods. Therefore, there is a need to expand access to family planning services in rural Ethiopia by making available more choices to family planning clients. Objective: The aim of this study is to examine the pattern of family planning method mix overtime and to assess the impact of combining strategies, such as community and facility based approaches, in improving access to family planning services and choices. Methods: A cross-sectional, descriptive study was conducted in September 2000 in Tehuledere woreda, in South Wollo zone, Amhara Regional State. A census was done on all clients who live in 15 kebeles in the woreda and who used long-term and permanent family planning methods which included IUD, Norplant and male and female sterilization methods and were interviewed. Results: Among the 218 family planning clients interviewed, 11 (5%) were males who had undergone vasectomy. Almost 81% of the clients using long-term and permanent methods were in the age group of 25-44 years. The mean age was 34.2 years with a range of 18-70 years and the mean number of children ever born to the study subjects was 5.6 with a range of 0-14 children. Knowledge of modern family planning methods was found to be over 90%, the majority (73.9%) of the respondents getting information on family planning from the community based reproductive health (CBRH) program. Fifty two percent have undergone voluntary surgical contraception, followed by Norplant (39.0%) and IUD (8.7%). Among the major reasons mentioned for the use of the current family planning methods were limiting family size (45.9%), spacing (27.5%), and side effects of the previous method (12.4%). For most clients (90.8%) the source of information for their current use is the CBRH program. Conclusions: Improving the usage of wide range of contraceptive method mix improves the quality of family planning services rendered to the community and ensures sustainability of the services. A coordinated effort among facility based and community based providers can assist in ensuring client choices and improving the method mix. The Ethiopian Journal of Health Development Vol. 20 (2) 2006: 74-78

Knowledge, attitude and concerns about voluntary surgical conception among healthcare workers in Ibadan, Nigeria

SummaryA multicentre study was conducted among healthcare workers in three major hospitals in Ibadan, south-west Nigeria. Structured questionnaires were self-administered to different cadres of healthcare workers in these hospitals with the objective of evaluating their knowledge, attitude and concerns about voluntary surgical contraception. The study revealed that though they had a generally good knowledge of voluntary surgical contraception, their attitude and concerns about the procedure was not encouraging and were largely biased. Such beliefs among healthcare workers tend to negatively influence the uptake of the procedure in the general population, further depleting the low contraceptive use in Nigeria, which has only recently attained a percentage in double figures. Strategies and means to improve on this are discussed to encourage better uptake and acceptability of the procedure among the general population.

Changes in menstrual pattern and ovarian function following bipolar electrocauterization of the fallopian tubes for voluntary surgical contraception

Objective Our aim was to investigate the changes in menstrual pattern, ovarian reserve and presence of dysmenorrhea and ovulation after tubal ligation via bipolar electrocautery. Methods Sixty patients requesting voluntary tubal ligation were recruited in the study. Laparoscopic tubal sterilization via bipolar electrocoagulation was performed in all patients in the early follicular phase. Blood samples were collected on day 3, one cycle before the procedure, in the same cycle when the procedure was carried out and on the third cycle following the procedure for determination of follicle-stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E 2), and on day 21 for progesterone (P) levels. All patients were followed for 3 months, and changes in menstrual pattern, presence or absence of dysmenorrhea and ovulation were noted. Results Menstrual changes occurred in six patients (10%), although only one patient had mild dysmenorrhea (1.6%) after the procedure. The incidence of ovulation was 33% preoperatively, rising to 40% in the cycle when surgery was performed and maintained a constant level at 40% 3 months after tubal ligation. There was no statistically significant difference in the serum FSH, LH and estradiol levels in preoperative and postoperative assessments (p>.05). Conclusion Tubal ligation has been blamed for causing luteal phase defect as a result of an effect on ovarian circulation. In our study, the rate of ovulation was slightly improved after the procedure, and ovarian reserve was not negatively affected. Bipolar electrocoagulation of the fallopian tubes did not alter the ovarian reserve and function.

Female sterilisation through mini-laparotomy at Gondar College of Medical Sciences.

To describe the socio-demographic characteristics and clinical course and follow up of clients who have undergone voluntary surgical contraception (VSC) through minilaparotomy (mini-lap) under local anaesthesia (LA). Also, to evaluate the safety and method satisfaction, so as to forward recommendations for method utilisation in the Ethiopian context. A case series design where pre- and post-operative conditions of clients coming for voluntary surgical contraception via mini-laparotomy were systematically analysed. Department of Obstetrics and Gynaecology, Gondar College of Medical Sciences, Gondar, Ethiopia. Eighty two clients (median age of 33 years, range 25-40) who decided to use tubal sterilisation method of contraception from April 1993 to May 1995 were included in the study. A format prepared and distributed to VSC providing sites in Ethiopia by the Family Guidance Association of Ethiopia (FGAE) was used in collecting the necessary information, including informed consent of every client. Previous knowledge of contraceptive methods, decision making for tubal sterilisation, size of incision, advantages of use of local anaesthesia in the local setting, duration of hospital stay, conditions on follow up. Eighty two (55.4%) women underwent tubal sterilisation through mini-lap. The mean number of the live children per client was 6.2 +/- 1.7, with parity ranging from two to eleven children. Mothers with five or more children were 70 (85.4%). Among 69 mothers (84.1%), the last pregnancy outcome were live births. The average length of the time since making a decision not to have any more children was 2.5 +/- 2 years (median of one year). The rationales given were economic, ill health and completed family size. Regarding the pattern of decision making, in 77 (91.9%) clients both the couples were involved in decision making. All except two underwent the procedure under LA and no complication was encountered during surgery. Follow-up attendance was 100% in one-year period and nothing serious was reported. All reported to be satisfied with the method. The study showed that early decision making by involving both couples other than proper case selection minimises regrets. The authors believe that tubal sterilisation through mini-lap under LA is an ideal method in developing countries where access to family planning and other reproductive health services are not widely available and where there is population explosion, less than 10% contraceptive prevalence rate and high maternal mortality.

An Eleven Year Review of Failed Female Sterilisation in Ile-Ife, Nigeria

Context: Female sterilisation is the most widely used method of fertility control in the world. Pregnancy following the procedure is often associated with significant morbidity due to delay diagnosis and management. Objective: The aim of this study is to examine the peculiarities and factors leading to failed female sterilisation in Ile-Ife Nigeria. Study Design, Setting And Subjects: A descriptive study of all cases of pregnancy following bilateral tubal ligation encountered at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria from October 1 1987 to September 30 1998. Main Outcome Measures: Incidence and crude failure rate of female sterilisation, types and methods of sterilisation, types of pregnancy and sterilisation-pregnancy interval. Results: During the period of study, there were 16,847 births, 533 cases of voluntary surgical contraception and 4 patients with pregnancy following bilateral tubal ligation. The incidence of female sterilisation was 31.5 per 1000 births while the crude failure rate was 7.5/1000. Postpartum and interval voluntary surgical contraception were done in 91.4% and 8.6% respectively. In all the cases of failed female sterilisation, Pomeroy method of female sterilisation was employed and they were all done in the post partum period, with the sterilisation-pregnancy interval ranging from 14 to 42 months. Conclusion: This study advocates the postponement of tubal sterilisation till 6 weeks postpartum in order to reduce the failure rate.and the use of techniques that involve burying the outer ends of the fallopian tubes in the broad ligament if sterilisation is done in the immediate puerperium. (Tropical Journal of Obstetrics and Gynaecology, 2001, 18(1): 8-11)

Fourteen years’ experience in voluntary female sterilization through minilaparotomy in Jos, Nigeria

Between January 1985 and December 1998, 2913 female sterilizations through minilaparotomy were performed. The mean (±SD) age was 36.4 ± 4.2 years and 68% of the women were between the ages of 30 and 39 years. The mean (±SD) parity distribution was 8.0 ± 2.0; 59.5% of the patients were para ≥8, and the mean (±SD) number of living children was 6.8 ± 1.6. Only 32.9% had the equivalent ≥8 number of living children at the time of the procedure. Completed desired family size was the indication for the tubal occlusion in 95% of the patients. The predominant surgical technique was Pomeroy’s method in 97%. Tubal ligation as an interval procedure was performed in 93.6% and local anesthesia was used in 83.7%. The study showed a yearly increase in the growth of voluntary surgical contraception at the institution, made possible by trained personnel.

Defect formation and densification mechanisms in injection moulded cemented carbide : M.J. Yang, R.M. German (Pennsylvania State University, Pennsylvania, USA)

Physicians understand that family planning and reliable contraception are among today's critical health issues. To meet individual and family contraceptive needs, an office-based procedure such as vasectomy widely is accepted as a safe, permanent, and inexpensive method for men. It can be performed safely in the office setting with a low failure rate and a low rate of significant short-term and long-term complications,27 resulting in high rates of patient satisfaction with this sterilization procedure. A new approach to exposing the vas deferens, called no-scalpel vasectomy (NSV), was developed by Li15 at the Chongquing Family Planning Scientific Institute in the Sichuan Province of China in 1974. This innovative method results in fewer complications than the traditional incisional technique and has been used increasingly in the United States since its introduction in 1986. The Association for Voluntary Surgical Contraception (now AVSC International) was instrumental in the original promotion of this technique and has continued to make training available to physicians in the United States and abroad. A list of trainers and trained physicians is available from AVSC by writing them at 79 Madison Avenue, New York, NY 10016.

Wear resistance of a compositionally graded tool steel : R.A. Queeney, S.F. Gradess (University of Pennsylvania, USA)

Physicians understand that family planning and reliable contraception are among today's critical health issues. To meet individual and family contraceptive needs, an office-based procedure such as vasectomy widely is accepted as a safe, permanent, and inexpensive method for men. It can be performed safely in the office setting with a low failure rate and a low rate of significant short-term and long-term complications,27 resulting in high rates of patient satisfaction with this sterilization procedure. A new approach to exposing the vas deferens, called no-scalpel vasectomy (NSV), was developed by Li15 at the Chongquing Family Planning Scientific Institute in the Sichuan Province of China in 1974. This innovative method results in fewer complications than the traditional incisional technique and has been used increasingly in the United States since its introduction in 1986. The Association for Voluntary Surgical Contraception (now AVSC International) was instrumental in the original promotion of this technique and has continued to make training available to physicians in the United States and abroad. A list of trainers and trained physicians is available from AVSC by writing them at 79 Madison Avenue, New York, NY 10016.