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Gynecologic Complications Up With Hysteroscopic Sterilization

TUESDAY, Jan. 23, 2018 -- Hysteroscopic sterilization is associated with an increased risk of gynecologic complications compared with laparoscopic sterilization, according to a study published in the Jan. 23/30 issue of the Journal of the American Medical Association.

Kim Bouillon, M.D., Ph.D., from the French National Agency for Medicines and Health Products Safety in Saint-Denis, and colleagues compared the risk of reported adverse events between hysteroscopic and laparoscopic sterilization in a nationwide cohort study. Data were included for 105,357 women aged 30 to 54 years who underwent a first hysteroscopic sterilization (67.7 percent) or laparoscopic sterilization (32.3 percent) between 2010 and 2014.

The researchers found that the risk of surgical complications was lower for hysteroscopic sterilization during the hospitalization for sterilization (0.13 versus 0.78 percent; adjusted risk difference, −0.64); the risk for medical complications was also lower for hysteroscopic sterilization during hospitalization (0.06 versus 0.11 percent; adjusted risk difference, −0.05). During the first year after sterilization, 4.83 and 0.69 percent of women who underwent hysteroscopic and laparoscopic sterilization had sterilization failure (adjusted hazard ratio, 7.11; adjusted risk difference, 4.23 per 100 person-years). Overall, gynecologic reoperation was required for 5.65 and 1.76 percent of women who underwent hysteroscopic and laparoscopic sterilization, respectively (adjusted hazard ratio, 3.26; adjusted risk difference, 4.63 per 100 person-years); these differences were attenuated after three years but persisted. Hysteroscopic sterilization was not associated with significantly increased risks of medical outcomes.

"These findings do not support increased medical risks associated with hysteroscopic sterilization," the authors write.

One author disclosed financial ties to Boston Scientific.

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Posted: January 2018