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Hysteroscopic vs Laparoscopic Sterilization Outcomes

Obstet Gynecol; ePub 2016 Sep 5; Perkins, Morgan, et al

When compared to laparoscopic sterilization, hysteroscopic sterilization may be associated with a higher rate of pregnancy, more menstrual dysfunction, more hysteroscopic surgeries, less pelvic pain, and fewer intra-abdominal gynecologic surgeries, while pregnancy rates appear to be similar, a recent retrospective cohort study found. The study included 42,391 women who underwent laparoscopic and 27,724 who underwent hysteroscopic sterilization. Researchers found:

  • Pregnancy rate was higher after hysteroscopic than laparoscopic sterilization (adjusted HR, 1.20; 2.4% compared with 2.0% risk of pregnancy at 2 years).
  • Only 66.1% of women who underwent hysteroscopic sterilization received a hysterosalpingogram; this group had similar pregnancy rates as those who underwent laparoscopic sterilization (aHR, 0.90; 1.8% vs 2.0% at 2 years).
  • After undergoing hysteroscopic sterilization, more women were diagnosed with menstrual dysfunction (aHR, 1.23; 26.8% compared with 22.3% at 2 years), and more underwent hysteroscopic surgeries (aHR, 2.05; 13.8% vs 6.4% at 2 years).
  • However, fewer were diagnosed with pelvic pain (aHR, 0.83; 21.0% vs 25.6% at 2 years).

Citation:

Perkins RB, Morgan JR, Awosogba TP, Ramanadhan S, Paasche-Orlow MK. Gynecologic outcomes after hysteroscopic and laparoscopic sterilization procedures. [Published online ahead of print September 5, 2016]. Obstet Gynecol. doi:10.1097/AOG.0000000000001615.