Clinical and psychological repercussions of videolaparoscopic tubal ligation: observational, single cohort, retrospective study

• Published in: São Paulo medical journal Vol. 132; no. 6; pp. 321 - 331
• Main Authors: Dias, Daniel Spadoto, Dias, Rogério, Nahás-Neto, Jorge, Nahás, Eliana Aguiar Petri, Leite, Nilton José, Bueloni-Dias, Flávia Neves, Modotti, Waldir Pereira
• Format: Journal Article
• Language: English; Portuguese
• Published: Brazil Associação Paulista de Medicina - APM 01.12.2014; Associação Paulista de Medicina
• Subjects: Adult; Coitus - psychology; Family planning services; Family Planning Services - methods; Female; Humans; Laparoscopy; Libido; MEDICINE, GENERAL & INTERNAL; Menstrual Cycle - physiology; Menstrual Hygiene Products; Menstruation disturbances; Menstruation Disturbances - etiology; Middle Aged; Original; Patient Satisfaction; Retrospective Studies; Sterilization, reproductive; Sterilization, tubal; Sterilization, Tubal - adverse effects; Sterilization, Tubal - methods; Sterilization, Tubal - psychology; Surveys and Questionnaires; Tertiary Care Centers; Young Adult; Esterilização reprodutiva; Distúrbios menstruais; Sterilization, reproductive; Sterilization, tubal; Esterilização tubária; Laparoscopy; Menstruation disturbances; Serviços de planejamento familiar; Family planning services; Laparoscopia
• ISSN: 1516-3180; 1806-9460; 1806-9460; 1516-3180
• DOI: 10.1590/1516-3180-2014-1326687

Tubal ligation is one of the most commonly used contraceptive methods worldwide. Since the controversy over the potential effects of tubal sterilization still continues, this study aimed to evaluate the clinical and psychological repercussions of videolaparoscopic tubal ligation. Observational, single cohort, retrospective study, conducted in a tertiary public hospital. A questionnaire was applied to 130 women aged 21-46 years who underwent videolaparoscopic tubal ligation by means of tubal ring insertion or bipolar electrocoagulation and sectioning, between January 1999 and December 2007. Menstrual cycle interval, intensity and duration of bleeding, premenstrual symptoms, dysmenorrhea, dyspareunia, noncyclic pelvic pain and degree of sexual satisfaction were assessed in this questionnaire. Each woman served as her own control, and comparisons were made between before and after the surgical procedure and between the two techniques used. The clinical and psychological repercussions were significant, with increases in bleeding (P = 0.001), premenstrual symptoms (P < 0.001), dysmenorrhea (P = 0.019) and noncyclic pelvic pain (P = 0.001); and reductions in the number of sexual intercourse occurrences per week (P = 0.001) and in libido (P = 0.001). Women aged ≤ 35 years at the time of sterilization were more likely to develop menstrual abnormalities. The bipolar electrocoagulation method showed greater clinical and psychological repercussions. Regardless of the technique used, videolaparoscopic tubal ligation had repercussions consisting of increased menstrual flow and premenstrual symptoms, especially in women aged ≤ 35 years, and also had a negative influence on sexual activity.