MECHANICAL DEVICES FOR INTERVAL LAPAROSCOPIC TUBAL-STERILIZATION IN PREVIOUS IUD USERS

This retrospective analysis was conducted to determine whether IUD use rs are good candidates for laparoscopic sterilization using the tubal ring and the Filshie clip. The data set used for the analysis came fro m international multicenter clinical trials involving 1235 women who w ere sterilized by the tubal ring and 1892 women sterilized by the Fils hie clip. Results indicate that former IUD use is not associated with an increased risk of surgical injuries, including uterine perforation, major complications, or postoperative infections, for either of these tubal occlusion techniques. The risk of a sterilization procedure end ing in technical failure (defined as switching to laparotomy and/or a tubal occlusion technique not originally planned) among tubal ring cas es was greater for former IUD users than for non-IUD users. However, t his may be related to a center effect. Nine of the 10 ring cases with technical difficulties were successfully switched to electrocoagulatio n, and the operator did not have to resort to an unintended laparotomy . The incidence of surgical difficulties among the Filshie clip cases was also higher in former IUD users, but all of these difficulties wer e safely overcome without changing the tubal occlusion method. These f indings lead us to believe that, in general, a woman's IUD use should not generally be a reason for an experienced service provider to hesit ate in performing an interval laparoscopic sterilization using a mecha nical tubal occlusion technique.