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Tubal LigationAka: Tubal Sterilization

Indications
1. Permanent Contraception
Advantages
1. Highly effective permanent Contraception
2. Decreased risk of Pelvic Inflammatory Disease
3. Decreased risk of Ovarian Cancer
Disadvantages
1. Surgical risk
2. Ectopic Pregnancy risk (one third of pregnancies)
3. No protection against Sexually Transmitted Disease
4. Regret following sterilization (<10% undergo reversal)
  1. Reversal success rate : 47-90%
5. Functional Ovarian Cyst risk increases (odds ratio 1.7)
  1. Holt (2003) Obstet Gynecol 102:252
Efficacy: Failure rate
1. First year failure rate: 0.5%
2. Overall cummulative 10 year failure rate: 1.85%
  1. Peterson (1996) Am J Obstet Gynecol 174:1161
3. Minilaparotomy 10 year cummulative failure rate: 2.01%
4. Filshie clip 10 year cummulative failure rate: 0.5%
  1. Small study (n=200)
  2. Filshie (1998) ISGE 7th annual meeting, South Africa
Complications: Acute short-term
1. Overall rates
  1. Mortality: 1-2 per 100,000
  2. Major complications: <0.5% of procedures
2. Trauma to contiguous organs (e.g. bladder, bowel)
3. Hemorrhage
4. Anesthesia complications
References
1. Baill (2003) Am Fam Physician 67(6):1287
2. Pati (2000) Obstet Gynecol Clin North Am 27:859

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This page was written by Scott Moses, MD. This page was last revised before 5/10/08, prior to consistent tracking of revision date. This page was last published on 5/10/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.