Pelvic surgery and hospitalization among Chilean women after nonsurgical sterilization with quinacrine pellets between 1977 and 1989

Contraception. 2012 Aug;86(2):106-9. doi: 10.1016/j.contraception.2011.11.072. Epub 2012 Jan 10.

Abstract

Background: Concern about quinacrine lingers because of its carcinogenic effects in rats. We describe results of long-term follow-up of women who underwent quinacrine pellet sterilization in Chile between 1977 and 1989 (N=1492).

Methods: We interviewed the women or relatives in five rounds of data collection between 1991-1993 and 2006-2007, and reviewed hospital records. Median follow-up was 18.5 years; total person-time was 23,894 woman-years. This analysis focuses on pelvic and abdominal surgeries and conditions. We used survival analysis to estimate the 15-year cumulative probability of hysterectomy, other pelvic surgical procedures and relevant adverse events.

Results: Uterine fibroids were by far the most common gynecologic condition, reported by 11% of the cohort. Surgical procedures were recorded for 15% of the cohort; hysterectomy was the most frequent procedure (10%), followed by salpingectomy (2%). The 15-year probability of any pelvic or abdominal procedure was 14.7 per 100 women (95% confidence interval 12.4-16.9). The probability of hysterectomy was 9.3 per 100 women (95% confidence interval 7.4-11.1). Number of quinacrine insertions had little impact on the probabilities.

Conclusion: During long-term follow-up of women who received quinacrine pellets for nonsurgical sterilization, the incidence of noncancer adverse outcomes was not unusually high, and no alarming patterns emerged.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Carcinogens / toxicity
  • Chile / epidemiology
  • Cohort Studies
  • Dose-Response Relationship, Drug
  • Drug Implants
  • Family
  • Female
  • Follow-Up Studies
  • Genital Neoplasms, Female / chemically induced
  • Genital Neoplasms, Female / epidemiology*
  • Genital Neoplasms, Female / surgery
  • Humans
  • Incidence
  • Kaplan-Meier Estimate
  • Leiomyoma / chemically induced
  • Leiomyoma / epidemiology
  • Leiomyoma / surgery
  • Medical Records
  • Middle Aged
  • Pelvis / surgery*
  • Quinacrine / administration & dosage
  • Quinacrine / adverse effects*
  • Reproductive Control Agents / administration & dosage
  • Reproductive Control Agents / adverse effects*
  • Sterilization, Reproductive / adverse effects*
  • Uterus

Substances

  • Carcinogens
  • Drug Implants
  • Reproductive Control Agents
  • Quinacrine