Complications after abdominal and vaginal sterilization operation.

A comparative study was made regarding the complications of abdominal and vaginal sterilization operations in order to evaluate the efficacy and safety of the 2 procedures. The cases were selected from outpatient departments and family planning clinics of the Patna Medical College (Patna India) over the 1974-79 period. A preoperative assessment and investigation were performed in all cases. The operations were performed by modified Pomeroys technique in 300 cases (Group A) by abdominal route and in 300 cases (Group B) by vaginal route. General anesthesia was administered in all cases. Subsequent follow-up was done at intervals of 6 weeks 3 months 6 months 1 year and up to 5 years. Follow-up attendance was unsatisfactory but a comparative evaluation of the complications was done in both groups among patients who came for follow-up. Puerperal sterilization cases were excluded from the series. In Group A 149 sterilizations were done with medical termination of pregnancy (MTP) and the remaining were interval sterilizations. In Group B 148 were sterilizations with MTP and the remaining were interval sterilizations. The age varied between 28-42 years. The majority of the patients were more than 4 para in both groups. Pelvic sepsis was more common with vaginal sterilization operations. Complications were as follows in Group A: pyrexia 30 cases; pain in abdomen 75; urinary tract infection 30; sore throat cough 60; stitch induration 90; and wound disruption 3. For Group B complications were as follows: pyrexia 90; pain in abdomen 30; urinary tract infection 75; sore throat cough 60; tuboovarian mass 12; wound infection 45; and persistent temperature rise 12. The nature of complaints at follow-up for Group A were: leukorrhea 30; menorrhagia 60; irregular bleeding 30; dysmenorrhea 12; dyspareunia 9; loss of libido 9; and incisional hernia 1. Complaints at follow-up were as follows for Group B: leukorrhea 45; menorrhagia 21; irregular bleeding 60; dysmenorrhea 75; dyspareunia 60; loss of libido 12; abdominal pain 12; and stress incontinence 3. In sum the sterilization operation by abdominal route was much safer compared to the vaginal route.