Female sterilization using Filshie clip in private practice.

This article presents the results of a trial Filshie cliip sterilization program in private practice in Malaysia. The Filshie clip is designed to accomodate thick Fallopian tubes better than the widely used Hulka clip. The Filshie applicator is also simpler to use. In addition, the Filshie clip causes minimal destruction of the Fallopian tube, facilitating reconstruction, if desired. Between 1980 and 1982, a total of 385 female sterilization procedures were performed in a private clinic in Klang, Malaysia. 49.6% of the owmen had 5 or more children, while 22.6% had 3 children or fewer. Complications were minimal: stitch abscess was seen in 3 patients, infection of the tube in 1, and endometriosis was detected in 1 subject. Only 1 subject became pregnant; it was later discovered that the tubal lumen was not completely occluded by the clip. No ectopic pregnancies occurred. The overall success rate was 99.74%. The metal of the Filshie clip may not be acceptable to certain religious groups, since it constitutes a foreign body. This study supports the view that private practitioners can play an important role in the delivery of family planning services in developing countries.