Sterilisation Flashcards

1
Q

What are the methods of sterilisation?

A
  • Hysteroscopic sterilisation - expanding springs inserted into tubal ostia via hysteroscope
  • Tubal occlusion (laparoscopic) - occlude fallopian tubes with Filshie clips
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2
Q

What advice should be given to women considering sterilisation?

A
  • Irreversible/reversal requires high skilled and is difficult
    • Vasectomy = safer, quicker and associated with less morbidity
  • High proportion of women regret sterilisation
  • Does not protect against STIs
  • Requires thorough counselling about risks, SE, irreversibility, alternative contraception
  • Prior to the procedure = abstain from UPSI for 3 weeks and have a pregnancy test
    • Protected sex is ok
  • Effective contraception is required until:
    • Laparoscopic procedure: the next menstrual period
    • Hysteroscopic procedure: 3 months
  • Pregnancy following female sterilisation
    • Increased risk of ectopic pregnancy
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3
Q

What are the indications for sterilisation?

A
  • Desire for permanent contraception (>99% effective)
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4
Q

What are the complications of female sterilisation?

A
  • Generic
    • Bleeding
    • Infection
    • Damage to local structures
    • Procedural failure (1 per 200, 1% peripartum)
    • Anaesthetic complications
  • Increased risk of future ectopic pregnancy
  • VTE damage to other organs
  • Risk of conversion to open procedure
  • Reversal is only successful in 30-70%
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