Læknablaðið - 15.12.1983, Page 30

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LÆKNABLADID
þá yfirleitt til hins verra eftir ófrjósemisað-
gerðir. Flestum hefur þó reynst erfitt að
leiða fullgild rök að þessu. Til þess þarf ná-
kvæma tíðasögu fyrir og eftir aðgerð. Auk þess
þarf svo viðmiðunarhóp, t.d. eiginkonur þeirra
karla, sem farið hafa í ófrjósemisaðgerð. Af
þeim athugunum sem gerðar hafa verið, hefur
verið ályktað að í verulegum hluta þessara
tilfella verði blæðingartruflanir, einkum
auknar tíðablæðingar (menorrhagia), allt að
40-50 % (4). Við höfðum aðeins tök á að kanna
þetta lauslega með fyrirspurnum og kom þá
fram að breyting hafði orðið á blæðingum hjá
41,5 % kvennanna, í meiri hluta tilvika var um
aukningu að ræða.
SUMMARY
A survey of 1084 women undergoing sterilization
during a 4'A year period at the Department of
Obstetrics and Gynecology, National Hospital,
Reykjavík is presented. The procedures carried out
were of three types — mini-laparotomy with tubal
division (367 cases), laparoscopy with tubal fulgura-
tion (302 cases) and laparoscopy with tubal fulgura-
tion and division (276 cases).
The operation was performed during the puerpe-
rium in 140 cases, at caesarean section in 8 cases and
at legal termination of pregnancy in 223- cases.
Operative mortality was nil and morbidity low.
There were 4 serious post-operative complications.
During laparoscopy there were 2 cases of intra-
abdominal haermorrhage and one perforation of
the colon necessitating laparotomy. One patient
developed a pulmonary embolism after laparotomy.
Twelve patients have become pregnant after
sterilization, a failure rate of 1.14 %. No procedure
was superior in this respect. The mean period of
observation is 5 years and the shortest 3 years.
A questionnaire was sent to 814 women and
answered by 515 (63.3 %).
Most of the women were satisfied with the
procedure and only 16 had regrets.
Menstrual disturbance was reported by 41.5%
mainly menorrhagia, but also dysmenorrhæa and
premenstrual tension.
Questioned on the effects of the procedure on
vita sexualis, 46 % reported improvement, 5.4 %
deterioration and 48.5 % no change.
HEIMILDIR
1) Skrifstofa Landlæknis, munnlegar upplýsingar.
2) Roböl M, Stocklund KE. Sterilization of women
through a minilaparotomy. Dan Med Bull 1978;
25: 177.
3) Einarsson GV, Björnsson V, Ingólfsson Á. Ófrjó-
semisaðgerðir í gegnum kviðarholssjá. Lækna-
blaðið 1977:63:203.
4) Chamberlain G, Foulkes G. Longterm effects of
laparoscopic sterilization on menstruation. Ob-
stet Gynec Survey 1978; 33: 139.
5) Hughes G. Sterilization failure. Br Med J 1977; 2:
1337.
6) Brenner PF, Benedetti T, Mishell DR. Ectopic
pregnancy following tubal sterilization surgery.
Obstet Gynec 1977; 49: 323.
7) Petersen EP, Musich JR, Behrman SJ. Uterotubal
implantation and obstetric outcome after previo-
us sterilization. Am J Obstet Gynec 1977; 128:
662.