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Fertility and Sterility Jun 1988
The American Fertility Society classifications of adnexal adhesions, distal tubal occlusion, tubal occlusion secondary to tubal ligation, tubal pregnancies, müllerian anomalies and intrauterine adhesions.
Topics: Adnexa Uteri; Adnexal Diseases; Fallopian Tube Diseases; Female; Fertility; Humans; Mullerian Ducts; Pregnancy; Pregnancy, Tubal; Societies, Medical; Sterilization, Tubal; Tissue Adhesions; United States; Uterus
PubMed: 3371491
DOI: 10.1016/s0015-0282(16)59942-7 -
Journal of General Internal Medicine Jan 2023
Topics: Female; Humans; Sterilization, Tubal
PubMed: 36271169
DOI: 10.1007/s11606-022-07845-2 -
Journal of General Internal Medicine Jan 2023
Topics: Female; Humans; Sterilization, Tubal
PubMed: 36258154
DOI: 10.1007/s11606-022-07839-0 -
Journal of General Internal Medicine Dec 2022Tubal ligation remains common in the USA, especially among low-income patients. (Comparative Study)
Comparative Study
BACKGROUND
Tubal ligation remains common in the USA, especially among low-income patients.
OBJECTIVE
To compare the effectiveness and safety of intrauterine contraceptives (IUC) to laparoscopic tubal ligation for Medicaid clients.
DESIGN
We partnered with patient and clinician stakeholders to conduct a retrospective cohort study using California Medicaid claims for patients who had an IUC placed or laparoscopic tubal ligation performed in 2008-2014, excluding procedures performed within 42 days of a birth. We applied log-linear (Poisson) event-history regression models for clustered person-period data to adjust for sociodemographic variables and pre-procedure health status when examining associations between these contraceptive procedures and claims related to contraceptive failure, complications, and pain in the first year post-procedure.
KEY RESULTS
We identified 35,705 patients who had a levonorgestrel IUC placed, 23,628 patients who had a copper IUC placed, and 23,965 patients who underwent laparoscopic tubal ligation. In unadjusted analyses, rates of pregnancy within 1 year were similar following levonorgestrel IUC (2.40%) or copper IUC placement (2.99%) or tubal ligation (2.64%). In adjusted analyses, compared to tubal ligation, pregnancy was less common following placement of a levonorgestrel IUC (adj IRR 0.72, 95% CI 0.64-0.82) and similar with placement of a copper IUC (adj IRR 0.92, 95% CI 0.82-1.05). Procedural complications such as infection (0.35% vs. 2.91%) were significantly less common with IUC placement than tubal ligation. Claims for pelvic and abdominal pain decreased in frequency with time since all procedures; 6 to 12 months post-procedure, pelvic pain claims were less common after levonorgestrel IUC (adj IRR 0.69, 95% CI 0.65-0.73) or copper IUC placement (adj IRR 0.70, 95% CI 0.66-0.75) than tubal ligation.
CONCLUSIONS
IUC appears at least as effective as laparoscopic tubal ligation at 1-year post-procedure with lower rates of infection and pelvic pain 6 to 12 months post-procedure.
CLINICAL TRIAL REGISTRATION
NCT03438682.
Topics: Female; Humans; Pregnancy; Contraception; Copper; Levonorgestrel; Pelvic Pain; Retrospective Studies; Sterilization, Tubal; United States
PubMed: 35194746
DOI: 10.1007/s11606-022-07433-4 -
Women's Health (London, England) Nov 2015Permanent methods of contraception are used by an estimated 220 million couples worldwide, and are often selected due to convenience, ease of use and lack of side... (Review)
Review
Permanent methods of contraception are used by an estimated 220 million couples worldwide, and are often selected due to convenience, ease of use and lack of side effects. A variety of tubal occlusion techniques are available for female permanent contraception, and procedures can be performed using a transcervical or transabdominal approach. This article reviews currently available techniques for female permanent contraception and discusses considerations when helping patients choose a contraceptive method and tubal occlusion technique.
Topics: Contraception; Female; Humans; Pregnancy; Sterilization Reversal; Sterilization, Tubal
PubMed: 26626698
DOI: 10.2217/whe.15.69 -
Systematic Reviews Jun 2022Based on previous studies, it has been hypothesized that tube sterilization may be associated with a lower risk of breast cancer. This study aims to investigate the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Based on previous studies, it has been hypothesized that tube sterilization may be associated with a lower risk of breast cancer. This study aims to investigate the relationship between tubal ligation and the risk of breast cancer through a systematic review and meta-analysis.
METHODS
In this systematic review and meta-analysis, PubMed/Medline, Web of Science, Scopus, and Google Scholar were searched for relevant non randomized studies published up to November 2020. Then, we screened the papers to include the eligible papers in the meta-analysis. Finally, we pooled the extracted results of individual studies to estimate the summary effect size. All analyses were done using Stata software version 13 (Stata Corp, College Station, TX).
RESULTS
Four hundred sixty-four papers were retrieved from PubMed/Medline (160), Scopus (165), and Web of Science (139), and 21 papers from Google Scholar and manual search of references in selected full texts. After the removal of duplicates and screening of the papers, 11 articles (6 cohort and 5 case-control study) were included in the final analysis. The results of cohort (RR = 0.99, 95% CI = 0.97-1.0, I = 21.1%) and case control studies (OR = 0.87, 95% CI = 0.62-1.12, I = 88.9%) revealed that tubal ligation was not significantly associated with breast cancer risk.
CONCLUSION
According to our findings, tubal ligation cannot be considered as a risk factor associated with breast cancer risk.
Topics: Breast Neoplasms; Case-Control Studies; Cohort Studies; Female; Humans; Risk Factors; Sterilization, Tubal
PubMed: 35718766
DOI: 10.1186/s13643-022-02000-8 -
Menopause (New York, N.Y.) Dec 2021Oral contraceptives (OCs) and tubal ligation are commonly used methods of contraception that may impact ovarian function. Few studies have examined the association of...
OBJECTIVE
Oral contraceptives (OCs) and tubal ligation are commonly used methods of contraception that may impact ovarian function. Few studies have examined the association of these factors with antimüllerian hormone (AMH), a marker of ovarian aging.
METHODS
We examined the association of OC use and tubal ligation with AMH in the Nurses' Health Study II prospective cohort among a subset of 1,420 premenopausal participants who provided a blood sample in 1996-1999. History of OC use and tubal ligation were reported in 1989 and updated every 2 years until blood collection. We utilized generalized linear models to assess whether mean AMH levels varied by duration of and age at first use of OCs and history, age, and type of tubal ligation.
RESULTS
In multivariable models adjusted for smoking, reproductive events, and other lifestyle factors, we observed a significant, inverse association between duration of OC use and mean AMH levels (P for trend = 0.036). Compared to women without a tubal ligation, AMH levels were significantly lower when the procedure included a clip, ring, or band (1.04 ng/ml vs 1.72 ng/ml, P < 0.01). AMH levels were not associated with age at first use of OCs or age at tubal ligation.
CONCLUSIONS
Our analysis found an association between duration of OC use and certain types of tubal ligation with mean AMH levels. Further research is warranted to confirm the long-term association of these widely used contraceptive methods with AMH.
Topics: Anti-Mullerian Hormone; Contraception; Contraceptives, Oral; Female; Humans; Prospective Studies; Sterilization, Tubal
PubMed: 34873106
DOI: 10.1097/GME.0000000000001905 -
Obstetrics and Gynecology Jun 2019To determine the effect of tubal ligation on age at natural menopause, as a marker of long-term ovarian function.
OBJECTIVE
To determine the effect of tubal ligation on age at natural menopause, as a marker of long-term ovarian function.
METHODS
Three preexisting population-based cohorts were included in this cross-sectional study. Data from each cohort was analyzed separately. The cohorts were restricted to women who never smoked and had reached natural menopause, without prior hysterectomy or oophorectomy. The following variables were collected: race, age at menarche, age at menopause, history of hysterectomy or oophorectomy, gravidity and parity, tobacco use, and ever use of hormonal contraception. The type of tubal ligation and age at tubal ligation were manually abstracted in cohort 1. For cohorts 2 and 3, history of tubal ligation was obtained from an institutional form, completed by patient report. The primary outcome, age at natural menopause, was compared between the two groups (those with and without a history of tubal ligation).
RESULTS
Inclusion criteria was met by 555 women from cohort 1, 1,816 women from cohort 2, and 1,534 women from cohort 3. Baseline characteristics did not differ between cohorts. The percentage with tubal ligation was the same in all cohorts: 26.0%, 25.5%, and 25.0%, respectively. Women with a tubal ligation were more likely to have had at least one pregnancy and to have used hormonal contraception compared with women without a tubal ligation. There was no significant difference in age at natural menopause in women who underwent tubal ligation (50.1, 49.9, 50.0 years, respectively) compared with those who did not (50.7, 49.6, 50.0 years, respectively). The type of tubal ligation (cohort 1 only) had no effect on age at menopause.
CONCLUSIONS
Tubal ligation did not affect age at natural menopause in the three large cohorts included in this study.
Topics: Adult; Age Factors; Aged; Aged, 80 and over; Cohort Studies; Contraception; Cross-Sectional Studies; Female; Humans; Menopause; Middle Aged; Pregnancy; Risk Factors; Sterilization, Tubal
PubMed: 31135741
DOI: 10.1097/AOG.0000000000003266 -
Medicina (Kaunas, Lithuania) Dec 2023To investigate histopathological changes and serous carcinoma precursors such as secretory cell outgrowths (SCOUTs) and p53 signature in the bilateral tubal ligation...
To investigate histopathological changes and serous carcinoma precursors such as secretory cell outgrowths (SCOUTs) and p53 signature in the bilateral tubal ligation (BTL) materials used during cesarean section (S/C). : In total, 138 patients underwent S/C and tubal sterilization (TS) between October 2020 and May 2021 at Konya City Hospital. Patients' data were obtained from the hospital's system. All data and findings were investigated and statistically evaluated. The mean age was 34.62 years (22-44), the mean gravity was 4.89 (2-15) and the mean parity was 3.46 (1-10). In total, 5.79% SCOUT, 7.24% atypia and 9.42% p53 signatures were observed. Significant correlations were shown between the epithelial cell lineage and age between Ki-67, SCOUT, and gravity; between the Ki-67 results and gravity and parity; and between the p53 score and age. : TS is a common, safe, and effective method worldwide. Today, BTL is increasing along with increasing S/C ratios. In addition to the reduced risk of ovarian cancers with ligation alone, precursor lesions such as hyperplasia, SCOUT, p53 signature, and STIL/Serous tubal intraepithelial carcinoma (STIC) are encountered in the ampulla materials obtained. Considering the low rates of re-anastomosis, tubal excision may be recommended instead of ligation in women of relatively higher gravity and age.
Topics: Pregnancy; Humans; Female; Adult; Sterilization, Tubal; Ki-67 Antigen; Tumor Suppressor Protein p53; Cesarean Section; Fallopian Tube Neoplasms; Cystadenocarcinoma, Serous
PubMed: 38138220
DOI: 10.3390/medicina59122117 -
BMC Cancer Oct 2019Studies on relationship between tubal ligation and endometrial cancer have led to contradictory findings. In several studies, however, a reduced endometrial cancer risk... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Studies on relationship between tubal ligation and endometrial cancer have led to contradictory findings. In several studies, however, a reduced endometrial cancer risk was suggested following tubal ligation. Therefore, a systematic review and meta-analysis was conducted to examine the relationship between tubal ligation and endometrial cancer risk.
METHODS
In this systematic review and meta-analysis, PubMed/Medline, Web of Science, Scopus, Embase, and Google Scholar were searched for relevant studies published up to May 30th, 2018. We compared endometrial cancer risk in women with and without tubal ligation in retrieved studies.
RESULTS
Two hundred nine studies were initially retrieved from the data bases. After exclusion of duplicates and studies which did not meet inclusion criteria, ten cohort and case-control studies, including 6,773,066 cases, were entered into the quantitative meta-analysis. There was 0.90% agreement between two researchers who searched and retrieved the studies. The summary OR (SOR) was reported using a random effect model. Begg's test suggested that there was no publication bias, but a considerable heterogeneity was observed (I = 95.4%, P = 0.001). We pooled the raw number of tables cells (i.e. a, b, c, and d) of eight studies. The SOR suggested that tubal ligation was significantly associated with a lower risk of endometrial cancer (SOR = 0.577, 95% CI = 0.420-0.792). Also, given the rare nature of endometrial cancer (< 5%), different effect sizes were considered as comparable measures of risk. Therefore we pooled ten studies and SOR of these studies revealed that tubal ligation was significantly associated with a lower risk of endometrial cancer (SOR = 0.696, 95% CI = 0.425-0.966). Besides that, we pooled eight studies in which adjusted effect sizes were reported and a subsequent analysis revealed that the summary estimate of adjusted odds ratio (SAOR) was significant (SAOR = 0.862, 95% CI = 0.698-1.026).
CONCLUSIONS
This study revealed a protective effect of tubal ligation on endometrial cancer risk (approximately 42% lower risk of cancer). It is recommended that studies should be designed to reveal mechanisms of this relationship.
Topics: Adolescent; Adult; Aged; Chi-Square Distribution; Endometrial Neoplasms; Female; Humans; Incidence; Middle Aged; Odds Ratio; Risk; Sterilization, Tubal; Young Adult
PubMed: 31604465
DOI: 10.1186/s12885-019-6174-3