Yassa Murat, Pulatoğlu Çiğdem
Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey.
İstinye University, Medical Park Gaziosmanpaşa Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey.
Turk J Obstet Gynecol. 2020 Jun;17(2):115-122. doi: 10.4274/tjod.galenos.2020.12129. Epub 2020 Jul 29.
Enough data can be found in the literature regarding the protective effect of tubal ligation on gynecological cancers. In addition, a large body of evidence revealed that prophylactic bilateral salpingectomy had no significant negative effect on the ovarian function, quality of life, sexuality, surgery duration, and cost-effectivity. This study was aimed at exploring the underlying factors that motivate women for either opportunistic bilateral salpingectomy (OBS) or tubal ligation, particularly focusing on their preferences, knowledge, and beliefs toward female sterilization, satisfaction from counseling, and body image following the salpingectomy.
A total of 54 patients who had undergone surgical sterilization with either OBS or tubal ligation were included in this prospective cohort study. The acceptance rate of the OBS at the time of cesarean section among pregnant women seeking surgical sterilization was calculated. The underlying reasons for women's acceptance or refusal for salpingectomy were assessed by a non-validated data collection tool that had 14 open-ended questions focusing on the women's preferences, knowledge, beliefs toward female sterilization, satisfaction from counseling, and body image following the salpingectomy.
The acceptance rate of OBS at the time of cesarean section among pregnant women and electively among non-pregnant women were 93.5% (n=43/46) and 75% (6/8), respectively. The main driving factors influencing the decision of preferring OBS over tubal ligation were the risk-reducing effect for ovarian cancer and superior pregnancy prevention.
The acceptance rate of OBS at the time of cesarean section was found to be very high, and it should therefore be offered at the time of cesarean section to women who desire permanent contraception.
关于输卵管结扎对妇科癌症的保护作用，文献中已有足够的数据。此外，大量证据表明，预防性双侧输卵管切除术对卵巢功能、生活质量、性功能、手术时长和成本效益均无显著负面影响。本研究旨在探讨促使女性选择机会性双侧输卵管切除术（OBS）或输卵管结扎的潜在因素，尤其关注她们对女性绝育的偏好、知识和信念、咨询满意度以及输卵管切除术后的身体形象。
本前瞻性队列研究纳入了54例行OBS或输卵管结扎绝育手术的患者。计算了寻求手术绝育的孕妇剖宫产时OBS的接受率。通过一个未经验证的数据收集工具评估女性接受或拒绝输卵管切除术的潜在原因，该工具包含14个开放式问题，聚焦于女性对女性绝育的偏好、知识、信念、咨询满意度以及输卵管切除术后的身体形象。
孕妇剖宫产时以及非孕妇择期手术时OBS的接受率分别为93.5%（n = 43/46）和75%（6/8）。影响女性选择OBS而非输卵管结扎的主要驱动因素是对卵巢癌的风险降低作用以及更好的避孕效果。
剖宫产时OBS的接受率非常高，因此对于有永久避孕需求的女性，应在剖宫产时提供OBS。
