Transcervical sterilization with use of methyl 2-cyanoacrylate and a newer delivery system (the FEMCEPT device)
Shuber, J.
American Journal of Obstetrics and Gynecology 160(4): 887-889
1989
ISSN/ISBN: 0002-9378 PMID: 2712121 DOI: 10.1016/0002-9378(89)90305-0Document Number: 361141
Given the intraoperative complications associated with tubal sterilization, there is a need to find safer, simpler, highly effective sterilization techniques for use in both developed and developing countries. This study evaluated 1 such technique--administration of methyl 2-cyanoacrylate (0.6 ml) to the uterocornual tubal junction through use of the FEMCEPT transcervical delivery system--in 34 healthy parous women 30-44 years of age desirous of interval sterilization. The procedure, including preparation, antisepsis, insertion of the FEMCEPT device, and delivery of the methyl 2-cyanoacrylate, took less than 5 minutes in each case. Patients were followed for 22-52 months after the procedure. Complete bilateral obstruction occurred in 30 (88%) of the women who underwent hysterosalpingography. In each case, occlusion occurred in either the cornual segment with no evidence of any intramural segment or in the proximal isthmic (or fundal) segment with only a few millimeters of lumen evident. No pregnancies have occurred in these 30 women. There were no complications of insertion, procedure, or operation of the FEMCEPT device. The average length of stay in the recovery room following the procedure was under 2 hours. The absence of occlusion in 4 cases appears due to the failure of the methyl 2-cyanoacrylate to lodge in the intramural or proximal isthmic segment of the oviduct. Overall, the ease of use, lack of immediate sequelae, short procedural time, and absence of anesthetic and operative risk make this a safe alternative to present methods of female sterilization. It could be readily performed in a physician's office or clinic with no special equipment required.