Rioux J E
Int J Gynaecol Obstet. 1978;16(6):488-92. doi: 10.1002/j.1879-3479.1979.tb00955.x.
Voluntary sterilization is the birth control method most widely practiced throughout the world. The last ten years have witnessed great improvements in techniques and perfection of innovations, explaining the important role that it now plays in the regulation of fertility. Different methods are examined and it is concluded that hysterectomy is the best, if medically indicated; conventional laparotomy is not justified unless required by concomitant intraabdominal pathology; minilaparotomy is mostly suitable postpartum; colpotomy is better left to specialists; laparoscopy is ideal for nonpregnant patients; culdoscopy is a relic of the past; and hysteroscopy, although still experimental, may be the way of the future. The advantages of voluntary sterilization lie in its remarkable and immediate efficiency, freedom from ongoing motivation, the convenience of a one-time operation, the absence of side effects and the reduction of total costs. Its disadvantages are the complexity of any surgical intervention for a woman, its indisputable finality, its uncertain legality and the risks inherent in any operation. Hysterectomy and tubal ligation are practically never fatal, so this argument does not influence the choice of either method. However, incidence of morbidity is higher following hysterectomies, which must therefore be justified. The balance is clearly in favor of voluntary sterilization for the woman who is convinced that the size of her family is complete.
自愿绝育是全世界应用最广泛的节育方法。在过去十年中，该技术有了很大改进，创新也日臻完善，这解释了它如今在生育调节中所起的重要作用。文中对不同方法进行了研究，并得出结论：如果有医学指征，子宫切除术是最佳选择；除非伴有腹腔内病变需要，否则传统剖腹手术并不合理；迷你剖腹手术最适合产后；阴道切开术最好留给专家处理；腹腔镜检查对未怀孕的患者来说是理想选择；后穹窿镜检查已是过去式；宫腔镜检查虽然仍处于试验阶段，但可能是未来的发展方向。自愿绝育的优点在于其显著且立竿见影的效果、无需持续的动机、一次性手术的便利性、无副作用以及总成本的降低。其缺点在于对女性而言任何手术干预都很复杂、其不可争议的终结性、其合法性不确定以及任何手术都存在固有风险。子宫切除术和输卵管结扎术实际上几乎不会致命，所以这一因素并不影响对任何一种方法的选择。然而，子宫切除术后的发病率较高，因此必须有合理的理由。对于确信自己的家庭规模已完整的女性来说，权衡之下显然有利于自愿绝育。
