Post-ablation tubal sterilization syndrome: Does route of sterilization matter?

Katherine F. Chaves, Amanda L. Merriman, Jenine Hassoun, Laura E. Cedó Cintrón, Zhiguo Zhao, Amanda C Yunker, Amanda Yunker
Contraception · 2021 · vol. 107 , pp. 17–22 · doi:10.1016/j.contraception.2021.10.015 · PMID:34752776 · W3214560231
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This study investigates whether the method used for tubal sterilization affects the occurrence of post-ablation tubal sterilization syndrome.

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Abstract

OBJECTIVE: To compare the prevalence of clinical post-ablation tubal sterilization syndrome among women who underwent abdominal (i.e., peripartum or laparoscopic) vs hysteroscopic permanent contraception in addition to endometrial ablation. STUDY DESIGN: This study was a retrospective cohort study conducted at an academic medical center. We included women (N = 188) who successfully underwent both endometrial ablation and permanent contraception between 2005 and 2017. Forty-one women underwent hysteroscopic permanent contraception and 147 underwent abdominal (i.e., peripartum or laparoscopic) permanent contraception. The primary outcome was the prevalence of clinical post-ablation tubal sterilization syndrome, as defined by new or worsening cyclic pelvic pain after completion of both procedures. RESULTS: The overall prevalence of the syndrome was 19.1% (34 of 178 women who followed up), with no detected difference between those who underwent hysteroscopic (6 of 38, 15.8%) vs abdominal permanent contraception (28 of 140, 20.0%, p = 0.55). In multivariate regression modeling, when adjusted for race, parity, gynecologic pathologies, hormonal medication use, and the presence of baseline pain (both pelvic and non-pelvic) only younger patient age was marginally associated with increased odds of the syndrome (aOR 1.85, 95% CI 1.01- 3.45, p = 0.05), while abdominal as compared to hysteroscopic permanent contraception was not (aOR 1.29, 95% CI 0.59-2.84, p = 0.53). Of the 28 patients with clinical post-ablation tubal sterilization syndrome who underwent hysterectomy and/or salpingectomy as treatment for their pain, none showed signs of hematosalpinx or hematometra at the time of surgery or on final pathology. CONCLUSION: We did not find evidence that route of permanent contraception affects the risk of post-ablation tubal sterilization syndrome development. Younger patients may be at higher risk of this syndrome.

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MeSH descriptors

Sterilization, Tubal Sterilization, Tubal Sterilization, Tubal Female Humans Hysterectomy Hysterectomy Male Pelvic Pain Pelvic Pain Pelvic Pain Pregnancy Retrospective Studies Sterilization

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