Long-term follow-up of laparoscopic sterilizations by electrocoagulation, the Hulka clip and the tubal ring.

A follow-up study of 499 women who underwent sterilization between August 1973 and May 1976 at the Siriraj Hospital in Bangkok, Thailand, and had long-term (4-12 years post-surgery) follow-up is described. Women were sterilized through participation in one of three studies conducted at this hospital. In the first study, 124 underwent sterilization using the Hulka clip via laparoscopy; 67.7% of these women returned for a long-term follow-up visit. In the second study, 300 women were randomly allocated to the Hulka clip or to unipolar electrocoagulation (cautery) via laparoscopy; 70.7% of the women from this study returned for a long-term follow-up visit. The final study was a randomized trial comparing the tubal ring and unipolar electrocoagulation occlusion techniques in 300 cases. Long-term follow-up visits were recorded for 207 women (69.0%) from this study. Five technical failures (procedures not performed or completed as planned) and six non-interval cases were excluded from follow-up analyses. A total of 713 interval patients were eligible for follow-up. Long-term follow-up was initiated in 1978 and continued through 1986. Late sequelae of sterilization, including pregnancies and pelvic surgery, are discussed with regard to type and time of tubal occlusion. One intrauterine and two ectopic pregnancies were reported among women who were sterilized with cautery; one ectopic pregnancy was reported by a woman sterilized with the Hulka clip. Pelvic or abdominal surgeries were reported in 27 cases. Most (greater than 98%) women indicated that they were satisfied with their sterilization procedure.