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Maturitas. 2010 Apr;65(4):372-7. doi: 10.1016/j.maturitas.2010.01.005. Epub 2010 Jan 27.

A prospective cohort study of menstrual symptoms and morbidity over 15 years following laparoscopic Filshie clip sterilisation.

Author information

1
Elliot Smith Clinic, Churchill Hospital, Oxford OX3 7LJ, United Kingdom. ian.mackenzie@obs-gyn.ox.ac.uk

Abstract

OBJECTIVE:

To observe the incidence of menstrual symptoms and relevant surgery after sterilisation.

STUDY DESIGN:

1101 women sterilised with Filshie clips between 1983 and 2002 were assessed prospectively comparing menstrual symptomatology documented immediately before surgery and 5-14 years later by questionnaire.

MAIN OUTCOME MEASURES:

Prevalence of menstrual dysfunction and subsequent surgery related to pre-operative menstrual symptoms and contraception.

RESULTS:

After excluding 232 (24%) of the 968 eligible women sent questionnaires whose address had changed, 573 of the remaining 735 women (78%) completed the questionnaire, 223 5-6 years after sterilisation, 175 after 7-9 years and 175 after 10-15 years; the respondents were demographically representative of the total population. Heavy periods increased from 9% before to 35% (P<0.0001) after sterilisation, painful periods from 2% to 21% (P<0.0001) and 6% had undergone hysterectomy or endometrial ablation. These findings were not influenced by the pre-sterilisation method of contraception but were inversely related to advancing age (P<0.0002). The lowest rates of menstrual symptoms were reported 10-15 years after sterilisation.

CONCLUSION:

Menstrual symptoms increased following Filshie clip sterilisation irrespective of pre-sterilisation symptoms and contraception. Whatever the causative mechanism, the progestogen-loaded intrauterine system (IUS), with similar efficacy but with improved menstrual symptoms, should be considered before sterilisation.

PMID:
20106612
DOI:
10.1016/j.maturitas.2010.01.005
[Indexed for MEDLINE]

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