GYN: Post - Tubal Ligation Syndrome?
From: art fougner, md (evsono@pipeline.com)
Thu Dec 7 06:24:33 2000
this in today's New England Journal -
The Risk of Menstrual Abnormalities after Tubal Sterilization
Herbert B. Peterson, Gary Jeng, Suzanne G. Folger, Susan A. Hillis,
Polly A. Marchbanks, Lynne S. Wilcox, for the U.S. Collaborative
Review of Sterilization Working Group
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Abstract
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Background. The existence of a post-tubal-ligation syndrome of
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menstrual abnormalities has been debated for decades. We used data from
the U.S. Collaborative Review of Sterilization to determine whether the
likelihood of persistent menstrual abnormalities was greater among women
who had undergone tubal sterilization than among women who had not.
Methods. A total of 9514 women who underwent tubal sterilization and
573 women whose partners underwent vasectomy were followed in a
multicenter, prospective cohort study for up to five years by means of
annual telephone interviews. All women were asked the same questions
about six characteristics of their menstrual cycles in the
presterilization and follow-up interviews. Multiple logistic-regression
analysis was used to assess the risk of persistent menstrual changes.
Results. The women who had undergone sterilization were no more likely
than those who had not undergone the procedure to report persistent
changes in intermenstrual bleeding or the length of the menstrual cycle.
They were more likely to have decreases in the number of days of
bleeding (odds ratio, 2.4; 95 percent confidence interval, 1.1 to 5.2),
the amount of bleeding (odds ratio, 1.5; 95 percent confidence interval,
1.1 to 2.0), and menstrual pain (odds ratio, 1.3; 95 percent confidence
interval, 1.0 to 1.8) and to have an increase in cycle irregularity
(odds ratio, 1.6; 95 percent confidence interval, 1.1 to 2.3). Among
women who had had very heavy bleeding at base line, women who had
undergone sterilization were more likely than women who had not
undergone the procedure to report decreased bleeding (45 percent vs. 33
percent, P=0.03).
Conclusions. Women who have undergone tubal sterilization are no more
likely than other women to have menstrual abnormalities. (N Engl J Med
2000;343:1681-7.)
Source Information
>From the Division of Reproductive Health, National Center for Chronic
Disease Prevention and Health Promotion, Centers for Disease Control and
Prevention, Atlanta. Address reprint requests to Dr. Peterson at the
Division of Reproductive Health, National Center for Chronic Disease
Prevention and Health Promotion, Centers for Disease Control and
Prevention, Mailstop K-34, 4770 Buford Hwy., NE, Atlanta, GA 30341-3724.
The members of the U.S. Collaborative Review of Sterilization Working
Group are listed in the Appendix.
Appendix
The members of the U.S. Collaborative Review of Sterilization Working
Group are as follows: Design, coordination, and analysis center,
Division of Reproductive Health, National Center for Chronic Disease
Prevention and Health Promotion, Centers for Disease Control and
Prevention, Atlanta -- H.B. Peterson (principal investigator), J.M.
Hughes, Z. Xia, L.S. Wilcox, L.R. Tylor, J. Trussell; Data
Collection Centers -- N.G. Courey, State University of New York at
Buffalo, Erie County Medical Center, Buffalo, N.Y.; P.D. Darney,
University of California, San Francisco; E.R. Friedrich, Washington
University School of Medicine, St. Louis; R.W. Hale and R.T. Nakayama,
Kapiolani Medical Center, Honolulu; J.F. Hulka, University of North
Carolina School of Medicine, Chapel Hill; A.N. Poindexter, Baylor
College of Medicine, Houston; G.M. Ryan and E.M. Thorpe, University of
Tennessee School of Medicine, Memphis; G.K. Stewart (deceased), Planned
Parenthood of Sacramento, Sacramento, Calif.; H.A. Zacur and L. Blanco,
Johns Hopkins University School of Medicine, Baltimore.
have a happy!
art
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art fougner, md
A series of 1000 cases begins with but a single anecdote.
