Evaluation of contemporary female sterilization methods.

Different methods of sterilization were evaluated. Laparoscopic techniques were the most satisfactory because they had lower pelvic and incision infection rates and shorter hospitalization and convalescent times than laparotomy lower pelvic infection rates than culdoscopy and culpotomy. Via laparoscopy, sterilization by coagulation and cutting, spring-loaded clips and bands was an effective, safe method. Mechanical problems with the applicator and optics and decreased visibility resulted in more technical failures and difficulties and more misapplication with the clip applicator. Although the total complication rates were similar with all methods, bleeding from the tubes and wound and pelvic infections were more frequent with silastic-band technique. Long-term complications, such as dysmenorrhea and menometrorrhagia and especially those resulting in hysterectomy after laparoscopy, are infrequent. Pregnancy rates are low after laparoscopic sterilization with coagulation and silastic bands as compared to the clip. Rates of complications with sterilization combined with abortion or delivery are only slightly higher than after abortion without sterilization and much less than the combined complications that would be anticipated from abortion and interval sterilization. To make colpotomy, culdoscopy and minilaparotomy easier and potentially safer, mechanical techniques using the spring-loaded clip and silastic band are being evaluated. Simplified techniques that can be administered via the cervix, such as Quinacrine, may be practical in the future.