Development of a Novel Method of Female Sterilization: II. Retention of Tubal Screws in Patients Undergoing Simultaneous Laparoscopic Sterilization

Abstract

Background and Objectives:

This study was a long-term follow-up of patients in whom hysteroscopic tubal screws had been applied at the time of laparoscopic sterilization.

Methods:

Tubal screw application was performed before laparoscopic Filshie clip application. Follow-up ultrasonography was arranged 3, 6, and 9 months postoperatively to confirm retention. The tubal screws were removed hysteroscopically between 12 and 20 months after sterilization under local or light general anesthesia.

Results:

Thirty-five women agreed to take part in the study. For the purpose of analysis, these patients were divided into an initial group (cases 1–20, group A) and a later group (cases 21–35, group B). Twenty-three patients had 41 tubal screws inserted (18 women had bilateral screw application). Twenty tubal screws were removed from 13 patients between 9 and 20 months after insertion, one screw remained in situ, and 20 screws had previously been extruded. Life table analysis plots demonstrated a marked but nonsignificant difference (P = .163) in the duration of tubal screw retention between the initial patients (group A) and the later patients (group B): 46.7% versus 76.9% at 6 months and 33% versus 61.5% at 12 months (P = .09 and P = .11, respectively).

Conclusions:

Our experience demonstrated improved application and retention with experience and refinement of the equipment; however, retention of the tubal screws, even in the later stages of development, was poor. A relatively noninvasive method of female sterilization remains the ideal, and further refinements are required.