Comments on the Medical Tribune series on sterilization.

It is thought that the Medical Tribune series on sterilization and elective hysterectomy took a caustic approach and drew conclusions more from ideology than from "observed fact." It is noted that physicians disagree, but it is felt that the matter must be presented completely so the patient can make an educated decision. In support of elective sterilization as a means to eliminate further gynecological surgery, several studies are cited. Muldoon's 10-year follow-up study found 43% of 474 tubal ligations needed further gynecological treatment and 25% needed major gynecological surgery as support for hysterectomies for sterilization. Laufe and Kreutner found vaginal hysterectomies to be an effective and safe procedure in 77 patients requiring therapeutic abortion and sterilization with or without correction of benign gynecologic pathology. Nagell and Roddick concluded that vaginal hysterectomies may be the procedure of choice for the indigent, multiparous patient who is most susceptible to development of benign and malignant disease, and is unlikely to return for adequate follow-up postoperatively. Bunker, using a computer analysis to estimate the benefits vs. risks of complete hysterectomies in women 40-50 years old, postmenopausal, and in good general health found elective hysterectomy and oophorectomy might increase life expectancy 14 days. Child, comparing potential years lost from hysterectomies in women 40 years of age and older found that 233,917 years were lost by cancer victims as compared with 77,381 years lost by a potential 2058 hysterectomy deaths, a savings of 156,536 woman-years each year. Elective hysterectomies are considered of value in light of women's increasing knowledge of uterine cancers. The Medical Tribune's call for a permanent ban on federal funding for sterilization of all under 21 years of age and the mentally retarded is opposed.