Marques Cecília Maria Ventuzelo, Magalhães Magda Maria do Vale Pinto, Carvalho Maria João Leal da Silva, Carvalho Giselda Marisa Costa, Fonseca Francisco Augusto Falcão Santos, Torgal Isabel
Gynecology A Service, Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, Coimbra, Portugal.
Department of Medicine, Universidade de Coimbra, Coimbra, Portugal.
Rev Bras Ginecol Obstet. 2017 Jul;39(7):344-349. doi: 10.1055/s-0037-1602706. Epub 2017 May 4.
To evaluate the trends in definitive contraception in a ten-year interval comprising the years 2002 and 2012. Retrospective analysis of the tubal sterilization performed in our service in 2002 and 2012, analyzing the demographic characteristics, personal history, previous contraceptive method, definite contraception technique, effectiveness and complications. Definitive contraception was performed in 112 women in 2002 (group 1) and in 60 women in 2012 (group 2). The groups were homogeneous regarding age, parity, educational level and personal history. The number of women older than 40 years choosing a definitive method was more frequent in group 1, 49.1% ( = 55); for group 2, the rate was 34.8% ( = 23) ( = 0.04). The time between the last delivery and the procedure was 11.6 ± 6.2 and 7.9 ± 6.4 years ( = 0.014) in 2002 against 2012 respectively. In 2002, all patients performed tubal ligation by laparoscopic inpatient regime. In 2012, the bilateral placement of the Essure (Bayer Corporation, Whippany, NJ, US) device was suggested to 56.1% ( = 37) of the patients, while laparoscopy was suggested to 43.9% ( = 29) of them. All women who underwent laparoscopic sterilization had the procedure successfully completed using silastic rings. The overall bilateral device placement rate for the Essure was 91.6%, with only one complication reported. All Essure procedures were performed in an outpatient setting; for the laparoscopy, this rate was 79% ( = 15). No intentional pregnancies occurred until this date. There is a trend in the decrease in definitive contraception over the years in our institution, maybe as a result of the development of long-acting reversible contraceptives. The hysteroscopic procedure has become a frequent option, as it is performed in an office setting without anesthesia, being a well-tolerated, minimal invasive method.
评估2002年至2012年这十年间永久性避孕的趋势。对我们科室2002年和2012年进行的输卵管绝育术进行回顾性分析，分析人口统计学特征、个人史、既往避孕方法、永久性避孕技术、有效性和并发症。2002年有112名女性进行了永久性避孕（第1组），2012年有60名女性进行了永久性避孕（第2组）。两组在年龄、产次、教育水平和个人史方面具有同质性。选择永久性避孕方法的40岁以上女性在第1组中更为常见，占49.1%（n = 55）；第2组的比例为34.8%（n = 23）（p = 0.04）。2002年与2012年相比，最后一次分娩与手术之间的时间分别为11.6±6.2年和7.9±6.4年（p = 0.014）。2002年，所有患者均通过腹腔镜住院治疗进行输卵管结扎。2012年，56.1%（n = 37）的患者被建议使用美国新泽西州惠普宁市拜耳公司生产的埃苏瑞（Essure）装置进行双侧放置，而43.9%（n = 29）的患者被建议进行腹腔镜检查。所有接受腹腔镜绝育术的女性均使用硅橡胶环成功完成手术。埃苏瑞装置的总体双侧放置率为91.6%，仅报告了一例并发症。所有埃苏瑞手术均在门诊进行；腹腔镜检查的这一比例为79%（n = 15）。截至目前，未发生意外妊娠。在我们机构中，多年来永久性避孕呈下降趋势，这可能是长效可逆避孕方法发展的结果。宫腔镜手术已成为一种常见选择，因为它在门诊进行，无需麻醉，是一种耐受性良好、微创的方法。
