Complications of interval laparoscopic tubal sterilization: Findings from the United States collaborative review of sterilization

Objective: To estimate the risk of intraoperative or postoperative complica tions for interval laparoscopic tubal sterilizations. Methods: We used a prospective, multicenter cohort study of 9475 women who had interval laparoscopic tubal sterilization to calculate the rates of int raoperative or postoperative complications. The relative safety of various methods was assessed by calculating overall complication rates for each maj or method of tubal occlusion. Method-related complication rates also were c alculated and included only complications attributable to a method of occlu sion. We used logistic regression to identify independent predictors of one or more complications. Results: When we used a more restrictive definition of unintended major sur gery, the overall rate of complications went from 1.6 to 0.9 per 100 proced ures. There was one life-threatening event and there were no deaths. Compli cations rates for each of the four major methods of tubal occlusion ranged from 1.17 to 1.95, with no significant differences between them. When compl ication rates were calculated, the spring clip method had the lowest method -related complication rate (0.47 per 100 procedures), although it was not s ignificantly different from the others. In adjusted analysis, diabetes mell itus (adjusted odds ratio [OR] 4.5; 95% confidence interval [CI] 2.3, 8.8), general anesthesia (OR 3.2; CI 1.6, 6.6), previous abdominal or pelvic sur gery (OR 2.0; CI 1.4, 2.9), and obesity (OR 1.7; CI 1.2, 2.6) were independ ent predictors of one or more complications. Conclusion: Interval laparoscopic sterilization generally is a safe procedu re; serious morbidity is rare. (Obstet Gynecol 2000;96:997-1002. (C) 2000 b y The American College of Obstetricians and Gynecologists.).