Hysteroscopic Sterilization Tied to Higher Reoperation Risk
(HealthDay News) — Patients undergoing hysteroscopic sterilization have more than a 10-fold higher risk of undergoing reoperation compared with patients undergoing laparoscopic sterilization, though the risk of unintended pregnancy is similar, according to a study published online October 13 in BMJ.
Jialin Mao, MD, from Cornell University in New York, and colleagues compared the safety and efficacy of hysteroscopic sterilization with the "Essure" device (8,048 patients) with that of laparoscopic sterilization (44,278 patients). Women underwent the procedures from 2005–2013.
The researchers found that there was a significant increase in the use of hysteroscopic procedures and a decrease in the use of laparoscopic sterilization during the study period. Compared with those undergoing laparoscopic sterilization, patients undergoing hysteroscopic sterilization were older and more likely to have a history of pelvic inflammatory disease, major abdominal surgery, and cesarean section. Hysteroscopic sterilization was not associated with a higher risk of unintended pregnancy one year after surgery (odds ratio, 0.84; 95% confidence interval [CI] 0.63–1.12) but was associated with a substantially increased risk of reoperation (odds ratio, 10.16; 95% CI 7.47–13.81) compared with laparoscopic sterilization.
"Benefits and risks of both procedures should be discussed with patients for informed decision making," conclude the authors.