What happens after tubal sterilization : a jordanian experience

الملخص EN

Objective: To study the menstrual and hormonal changes in Jordanian women who underwent tubal sterilization, and compare these with international studies. Methods: A systematic review of international literature identified around 190 articles related to tubal sterilization using the pub med site from year 1972 to 2004.

In our study we reviewed the files of 300 cases that underwent tubal sterilization in Prince Rashid Ben Al-Hassan Hospital in the period between 1990 and 2000 and another control group of 440 cases with no history of tubal ligation matching same age and parity.

Two hundred and twenty patients filled a questionnaire and completed the study.

We compared the incidence of hysterectomy, changes in menstrual cycle pattern, hormonal and endometrial tissue biopsy results.

Patients were followed up in the clinic for a period for one year to 12 years.

We compared our results to those published in the literature. Results: Out of the 220 patients who participated in the study 14 patients who underwent sterilization had hysterectomy later giving incidence 6.3%.

Of these 120 patients had previously used oral contraceptives or an intrauterine contraceptive device prior to tubal ligation.

Women, who had used oral contraceptives before, showed worsening in dysmenorrhea and dysfunctional uterine bleeding as well as an increased amount of blood loss as compared to those who had not used this method.

Patients who used intrauterine contraceptive devices showed improvement in these symptoms.

No significant hormonal or endometrial tissue changes after sterilization where recorded in our study. Conclusion: Tubal sterilization is not associated with an increased risk of menstrual dysfunction, dysmenorrhea, or increased premenstrual distress in women who underwent the procedure after the age of 30 years.

There may be some increased risk for younger women, although they do not appear to have significant hormonal or endometrial tissue changes after tubal ligation.