Analysis of causes of laparoscopic sterilization failure
Gehlot, D.; Raghav, M.
Indian Journal of Medical Sciences 41(10): 226-227
1987
ISSN/ISBN: 0019-5359 PMID: 2965107 Document Number: 364715
The high failure rate of laparoscopic sterilization in India is causing the population to lose confidence in this method. To assess the reasons for sterilization failure, 75 patients who became pregnant after undergoing laparoscopic sterilization were studied. 67% of the patients presented for pregnancy testing during the 1st trimester, and termination by modified Pomeroy's method was offered. Of the 75 patients, 26 elected to continue the pregnancy and were excluded from the study. Of the remaining 49 cases, 30 underwent pregnancy termination immediately and another 19 completed the pregnancy and then underwent repeat sterilization. Faulty application of the ring proved to be the main cause of sterilization failure. In 9 of the 49 cases investigated, the rings were only partially applied to the fallopian tubes. In another 19 cases, the ring was found on only 1 tube (in 6 of these cases the other ring could not be located, in 8 cases the other ring was on round ligament, and in 5 cases it was on the mesosalpinx). In 10 cases, both rings were on round ligaments. In 7 cases, both rings were on the mesosalpinx. In the final 4 cases, rings were broken and were hanging loosely. At present, laparoscopic sterilization rings used in India are not required to meet any quality control standards. If the high rate of failure of this technique is to be overcome, rings must be of good quality and should not be applied to edematous or fatty tube.