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Syst Rev 2019 Mar 26;8(1):74. Epub 2019 Mar 26.

Contraception and Abortion Research Team-Groupe - de recherche sur l'avortement et la contraception (CART-GRAC), BC Women's Hospital, Vancouver, Canada.

Background: For women seeking permanent contraception, there are a variety of options available including surgical techniques such as tubal ligation or bilateral salpingectomy, in-clinic procedures such as hysteroscopic techniques using micro-inserts, or the levonorgestrel-releasing intrauterine contraceptive. Despite the various methods available for women who are seeking permanent contraception, there is not a review or decision-making tool that systematically brings together outcomes related to effectiveness, tolerability, adverse effects, non-contraceptive benefits, recovery, or accessibility: all of which are important for shared decision-making between patients and health care providers.

Methods: We registered our protocol [on Prospero: CRD42016038254] following PRISMA guidelines. Read More

Obstet Gynecol 2019 Apr;133(4):e279-e284

Opportunistic salpingectomy may offer obstetrician-gynecologists and other health care providers the opportunity to decrease the risk of ovarian cancer in their patients who are already undergoing pelvic surgery for benign disease. By performing salpingectomy when patients undergo an operation during which the fallopian tubes could be removed in addition to the primary surgical procedure (eg, hysterectomy), the risk of ovarian cancer is reduced. Although opportunistic salpingectomy offers the opportunity to significantly decrease the risk of ovarian cancer, it does not eliminate the risk of ovarian cancer entirely. Read More

Obstet Gynecol 2019 Apr;133(4):842-843

Opportunistic salpingectomy may offer obstetrician-gynecologists and other health care providers the opportunity to decrease the risk of ovarian cancer in their patients who are already undergoing pelvic surgery for benign disease. By performing salpingectomy when patients undergo an operation during which the fallopian tubes could be removed in addition to the primary surgical procedure (eg, hysterectomy), the risk of ovarian cancer is reduced. Although opportunistic salpingectomy offers the opportunity to significantly decrease the risk of ovarian cancer, it does not eliminate the risk of ovarian cancer entirely. Read More

JSLS 2019 Jan-Mar;23(1)

Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Massachusetts, USA.

Background And Objectives: An increasing number of women are seeking removal of the Essure sterilization device due to symptoms including pelvic pain, abnormal bleeding, and allergic reaction. A fraction of these women also desire a future pregnancy and request sterilization reversal at the time of device removal. We present a novel technique for Essure reversal in addition to our experience with three cases. Read More

Obstet Gynecol 2019 Mar;133(3):592-594

Female and male sterilization are both safe and effective methods of permanent contraception used by more than 220 million couples worldwide (1). Approximately 600,000 tubal occlusions and 200,000 vasectomies are performed in the United States annually (2-4). For women seeking permanent contraception, sterilization obviates the need for user-dependent contraception throughout their reproductive years and provides an excellent alternative for those with medical contraindications to reversible methods. Read More

J Minim Invasive Gynecol 2019 Feb 13. Epub 2019 Feb 13.

Department of Obstetrics and Gynecology, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, Texas (Drs. Kim, Berens, Chen, Gants, Swilinski, and Chang-Jackson).

Study Objective: To assess the change in the rate of laparoscopic salpingectomy for sterilization after the release of the November 2013 Society of Gynecologic Oncology Clinical Practice Statement and the January 2015 American College of Obstetricians and Gynecologists Committee Opinion: Salpingectomy for Ovarian Cancer Prevention. We hypothesized there would be an increase in salpingectomy as a percentage of total laparoscopic sterilizations performed without an increase in complications when compared with conventional bilateral tubal ligation (BTL).

Design: A retrospective cohort study. Read More

Cuad Bioet 2019 Jan-Apr;30(98):67-76

Academia Alphonsiana Roma. Italia.

The article presents a rare case of uterine rupture at the 19th week of gestation, in the presence of a scar after a caesarean section practiced two years earlier. The fetus was pulled out alive, but given the gestational age, died within a few minutes. The uterus was preserved, but the woman was advised to proceed with tubal ligation and, in any case, to absolutely avoid a new pregnancy. Read More

Cochrane Database Syst Rev 2019 02 1;2:CD011807. Epub 2019 Feb 1.

Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.

Background: Postpartum mini-laparotomy tubal ligation (PPTL) is a contraceptive method that works by interrupting the patency of the fallopian tubes. Several methods are used for intraoperative pain relief, such as systemic administration of opioids or intraperitoneal instillation of lidocaine.

Objectives: To evaluate the effectiveness of and adverse effects associated with interventions for pain relief in women undergoing PPTL. Read More

Front Surg 2018 9;5:79. Epub 2019 Jan 9.

Department of Obstetrics and Gynecology, St-Vincent Clinic, Rocourt, Belgium.

To evaluate the pregnancy and delivery rates of laparoscopic tubal reanastomosis. From 2003 to 2013, 135 laparoscopic tubal reversals were performed according to the four stitch technique. The parameters studied, included positive pregnancy test, miscarriage, ectopic pregnancy, termination of pregnancy, term delivery, post-operative time to conception, post-operative hysterosalpingography, and spermogram. Read More

Contraception 2019 Apr 24;99(4):205-211. Epub 2019 Jan 24.

Department of Pediatrics and Child Health, College of Medicine, University of Nigeria, Nsukka, Enugu, Nigeria; HealthySunrise Foundation, Las Vegas, NV, USA.

Objective: Uptake of permanent contraception among women remains low in sub-Saharan Africa compared to other regions. We aimed to synthesize available evidence on barriers to, and facilitators of permanent contraception with regards to tubal ligation among women in sub-Saharan Africa.

Study Design: We reviewed literature on tubal ligation among African women published between January 1, 2000 and October 30, 2017. Read More

Medicine (Baltimore) 2019 Jan;98(4):e14193

Department of Obstetrics and Gynecology, Chia-Yi Chang Gung Memorial Hospital.

Rationale: Tubal sterilization as a contraception method has a high success rate; however, it also carries a low risk of incidental pregnancy. A majority of these pregnancies are ectopic. In this study, we report a rare case of spontaneous right distal tubal pregnancy after bilateral laparoscopic tubal sterilization. Read More

Obstet Gynecol 2019 Mar;133(3):e194-e207

Female and male sterilization are both safe and effective methods of permanent contraception used by more than 220 million couples worldwide (). Approximately 600,000 tubal occlusions and 200,000 vasectomies are performed in the United States annually (2-4). For women seeking permanent contraception, sterilization obviates the need for user-dependent contraception throughout their reproductive years and provides an excellent alternative for those with medical contraindications to reversible methods. Read More

Obstet Gynecol 2019 Feb;133(2):323-331

Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, New York; the Department of Obstetrics and Gynecology, Division of Family Planning, University of Colorado Anschutz Medical Campus, Aurora, Colorado; the Department of Obstetrics and Gynecology, Stamford Hospital, Stamford, Connecticut; and the Departments of Urology and Obstetrics and Gynecology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, New York.

Objective: To evaluate 7-year outcomes after hysteroscopic and laparoscopic sterilizations, including subsequent tubal interventions and hysterectomies.

Methods: This observational cohort study included women undergoing hysteroscopic and laparoscopic sterilizations in outpatient and ambulatory surgical settings in New York State during 2005-2016. We examined subsequent procedures (tubal ligation or resection, and hysterectomy not related to uterine leiomyomas or gynecologic tumors) after the index procedures. Read More

F1000Res 2018 26;7:1557. Epub 2018 Sep 26.

Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, Seattle, Washington, 98195, USA.

Use of an epidural catheter has been suggested to be efficient to provide anesthesia for postpartum tubal ligation (PPTL). Reported epidural reactivation success rates vary from 74% to 92%. Predictors for reactivation failure include poor patient satisfaction with labor analgesia, increased delivery-to-reactivation time and the need for top-ups during labor. Read More

Issues Ment Health Nurs 2019 Jan 3:1-8. Epub 2019 Jan 3.

b Public Health Nursing , Selcuk University , Konya , Turkey.

Aim: This study was conducted to evaluate Turkish nurses' attitudes, awareness and practices regarding reproductive health needs of individuals with schizophrenia.

Method: The sample of this descriptive study consisted of 96 psychiatric nurses and 90 nurses and midwives working in family health centers who agreed to participate. The data were presented as numbers and percentages, and chi-square analyses were used to compare the groups. Read More

J Affect Disord 2019 03 18;246:174-181. Epub 2018 Dec 18.

Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China. Electronic address:

Background: Although there are potential mechanisms of female hormones in depression, conflicting results still exist in epidemiological studies. This study aimed to determine whether reproductive history, an important indicator of estrogen exposure across the lifetime, is associated with risk of depressive symptoms in postmenopausal women.

Methods: We analyzed the baseline data from Zhejiang Ageing and Health Cohort Study including 5537 postmenopausal women. Read More

Maedica (Buchar) 2018 Sep;13(3):235-237

Filantropia Clinical Hospital, Bucharest, Romania.

Background: Encountered between methods of contraception, tubal sterilization is not a priority in Romania. Moreover, many women regret their decision a few years later. The aim of this study is to present the reproductive outcome reported in Filantropia Clinical Hospital after laparoscopic tubal reanastomosis. Read More

Fertil Steril 2018 12;110(7):1328-1337

Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.

Objective: To evaluate the relationship between demographic, lifestyle, and reproductive factors and the risk of ectopic pregnancy (EP).

Design: Prospective cohort.

Setting: United States. Read More

Gynecol Oncol 2019 01 23;152(1):127-132. Epub 2018 Nov 23.

University of Alabama at Birmingham, Division of Gynecologic Oncology, Birmingham, AL, United States of America.

Objectives: Opportunistic salpingectomy is a cost-effective strategy recommended for ovarian cancer (OvCa) risk reduction at the time of gynecologic surgery in women who have completed childbearing. We aimed to evaluate the cost-effectiveness of opportunistic salpingectomy compared to standard tubal ligation (TL) during cesarean delivery.

Study Design: A cost-effectiveness analysis using decision modeling to compare opportunistic salpingectomy to TL at the time of cesarean using probabilities of procedure completion derived from a trial. Read More

J Minim Invasive Gynecol 2018 Nov 11. Epub 2018 Nov 11.

Service de Gynécologie Obstétrique, CHU Nantes (Mr. Godfroy and Dr. Le Vaillant), Nantes, Cedex, France. Electronic address:

Study Objective: To show the feasibility of 2-dimensional (2D) ultrasound (US) imaging compared with 3-dimensional (3D) US to identify the location of implants and assess if the classification developed by Simorre et al in 2016 was applicable to the 2 types of US imaging (i.e., 2D and 3D). Read More

Niger J Clin Pract 2018 Nov;21(11):1508-1513

Department of Obstetrics and Gynecology, Adana Numune Training and Research Hospital, Adana, Turkey.

Background: The total fertility rate is 2.1 children per women in Turkey. The population is expected to increase to 84 million by 2023. Read More

MRS Adv 2018 15;3(30):1685-1690. Epub 2018 Jan 15.

Thayer School of Engineering, Dartmouth College, Hanover, NH 03755, U.S.A.

Current FDA-approved permanent female sterilization procedures are invasive and/or require the implantation of non-biodegradable materials. These techniques pose risks and complications, such as device migration, fracture, and tubal perforation. We propose a safe, non-invasive biodegradable tissue scaffold to effectively occlude the Fallopian tubes within 30 days of implantation. Read More

J Turk Ger Gynecol Assoc 2018 Oct 26. Epub 2018 Oct 26.

Ankara University School of Medicine Obstetrics and Gynecology Department Ankara, Turkey

Objective: To observe and compare the effect of postpartum tubal ligation procedures on ovarian reserve at women desiring tubal ligation as a contraceptive method at the end of pregnancy.

Material And Methods: Eighty-one women were included in the prospective study. Tubal ligation (TL) was performed at time of cesarean delivery (CD) (n:49) and as an interval procedure by laparoscopy (LS) at postpartum period (n:32). Read More

Contraception 2019 Jan 26;99(1):56-60. Epub 2018 Sep 26.

University of California, Davis, Sacramento, CA, USA. Electronic address:

Objective: To understand women's preferences for permanent contraception by salpingectomy or tubal occlusion following standardized counseling and evaluate the practicality of a future randomized trial.

Study Design: We invited pregnant and non-pregnant women planning permanent contraception at the University of California, Davis (UCD) and University of Tennessee (UT) Obstetrics and Gynecology clinics to participate. We enrolled women when they received routine counseling and signed procedure consent. Read More

Am J Obstet Gynecol 2019 Jan 28;220(1):106.e1-106.e10. Epub 2018 Aug 28.

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC.

Background: Removal of the fallopian tubes at the time of hysterectomy or interval sterilization has become routine practice to prevent ovarian cancer. While emerging as a strategy, uptake of this procedure at the time of cesarean delivery for pregnant women seeking permanent sterilization has not been widely adopted due to perceptions of increased morbidity and operative difficulty with a lack of available data in this setting.

Objective: We sought to conduct a cost-effectiveness analysis comparing strategies for long-term sterilization and ovarian cancer risk reduction at the time of cesarean delivery, including bilateral tubal ligation, opportunistic salpingectomy, and long-acting reversible contraception. Read More

J Minim Invasive Gynecol 2018 Aug 21. Epub 2018 Aug 21.

Department of Obstetrics and Gynecology, University of Naples "Federico II," Naples, Italy (Drs. Santangelo and Di Spiezio Sardo).

Study Objective: To estimate the incidence of infection after diagnostic and operative hysteroscopic procedures performed in an in-office setting with different distension media (saline solution or CO).

Design: Prospective, multicenter, observational study (Canadian Task Force classification II-2).

Setting: Tertiary women's health centers. Read More

Med Anthropol Q 2018 12 12;32(4):556-573. Epub 2018 Sep 12.

Anthropology Department, University of California.

Drawing on ethnographic fieldwork among black women, medical personnel, and activists in Brazil, this article highlights the implications of hierarchical medicalization. I show that the prioritization of particular forms of medicalized contraception for women located differentially in society enables different relations, political positions, and mobility. Denial of a tubal ligation in favor of modern reversible contraceptives, in a context of inequitable distribution, can perpetuate social stratification. Read More

Glob Health Sci Pract 2018 10 4;6(3):484-499. Epub 2018 Oct 4.

RESPOND Tanzania Project, EngenderHealth, Dar es Salaam, Tanzania.

Background: Tubal occlusion by minilaparotomy is a safe, highly effective, and permanent way to limit childbearing. We aimed to establish whether the safety of the procedure provided by trained clinical officers (COs) was not inferior to the safety when provided by trained assistant medical officers (AMOs), as measured by major adverse event (AE) rates.

Methods: In this randomized, controlled, open-label noninferiority trial, we enrolled participants at 7 health facilities in Arusha region, Tanzania, as well as during outreach activities conducted in Arusha and neighboring regions. Read More

Perspect Sex Reprod Health 2018 09 10;50(3):139-145. Epub 2018 Aug 10.

Ph.D. candidate, Department of Sociology, University of California, Los Angeles.

Context: For decades, high reliance on female sterilization in the United States has been accompanied by a high level of desire for sterilization reversal, and less-educated women have been more likely than better educated women to use the method and desire a reversal. Little is known about how levels of and educational differentials in such desire have changed in recent decades.

Methods: Data from 4,147 women who reported being sterile from a tubal sterilization in the 1995, 2002 and 2006-2010 waves of the National Survey of Family Growth were analyzed using chi-square and Wald tests and binary logistic regression analyses. Read More

J Minim Invasive Gynecol 2018 Jul 29. Epub 2018 Jul 29.

Department of Surgical Gynecology, University Hospital of Strasbourg, Strasbourg, France (all authors).

Study Objective: To describe 2 different surgical techniques for Essure removal on the same patient: the hysteroscopic and laparoscopic techniques.

Design: An educational video approved by the local institutional review board (Canadian Task Force classification III).

Setting: A university hospital (University Hospital of Strasbourg, Strasbourg, France). Read More

J Obstet Gynaecol Res 2018 Dec 29;44(12):2174-2180. Epub 2018 Jul 29.

Department of Obstetrics and Gynecology, El-Galaa Maternity Teaching Hospital, Cairo, Egypt.

Aim: The aim of this work is to assess the effectiveness of hysteroscopic tubal occlusion using iso-amyl-2-cyanoacrylate, among infertile women with hydrosalpinx prior to in vitro fertilization (IVF).

Methods: Hysteroscopic injection of fallopian tubes with hydrosalpinx by 0.5 mL iso-amyl-2-cyanoacrylate was done in 40 infertile women planning for IVF. Read More

J Ultrasound Med 2019 Feb 26;38(2):289-297. Epub 2018 Jul 26.

Gynecology Discipline, Clinics Hospital, School of Medicine, University of São Paulo, São Paulo, Brazil.

The current reference standard to check the position of a tubal sterilization microinsert device after its insertion is hysterosalpingography. The objective of this study was to evaluate the accuracy of 2-dimensional (2D) and 3-dimensional (3D) ultrasonography (US) in the positioning of the tubal sterilization microinsert for definitive contraception. We searched MEDLINE, Embase, Cochrane, and Scopus databases through October 2017. Read More

Gynecol Obstet Fertil Senol 2018 Jul - Aug;46(7-8):608-609. Epub 2018 Jul 4.

Département de gynécologie, hôpital Femme-Mère-Enfant, HFME, hospices civils de Lyon, Lyon CHU, 59, boulevard Pinel, 69000 Lyon, France.

Fertil Steril 2018 07 21;110(1):182. Epub 2018 Jun 21.

Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China; Baylor College of Medicine, Houston, Texas. Electronic address:

Objective: To demonstrate how a transvaginal natural orifice transluminal endoscopic surgery (NOTES) tubal reanastomosis is a novel route for tubal surgery. The surgical technique is a combination of traditional vaginal surgery with single-site surgical skills.

Design: The surgical technique is explained in a stepwise fashion with the use of surgical video footage. Read More

Int J Fertil Steril 2018 Jun 20;12(3):200-206. Epub 2018 Jun 20.

Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

Bachground: The aim of this study is to evaluate the menstrual pattern, sexual function, and anxiety, and depression in women with poststerilization regret, and potential influencing factors for regret following tubal ligation (TL) in Iranian women.

Materials And Methods: In this cross-sectional study, 166 women with TL were subdivided into two groups including women with poststerilization regret (n=41) and women without poststerilization regret (n=125). They were selected from a health care center in Guilan province (Iran) during 2015-2016. Read More

Br J Radiol 2018 Oct 13;91(1090):20170686. Epub 2018 Jul 13.

1 Department of Diagnostic Imaging and Interventional Radiology, Caen University and Medical Center , Caen , France.

Tubal sterilization with Essure inserts has become a prevalent alternative to laparoscopic sterilization because of its minimal invasiveness. It is a well-tolerated ambulatory procedure that provides reliable permanent contraception without the risks associated with laparoscopic surgery and general anesthesia. Correct positioning of the Essure device is necessary to achieve the fibrotic reaction induced by the polyethylene terephthalate fibers, subsequently resulting in tubal occlusion usually within 3 months. Read More

Med Lett Drugs Ther 2018 05;60(1547):90

Fertil Steril 2018 07 13;110(1):64-65. Epub 2018 Jun 13.

Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Wright State University, Boonshoft School of Medicine, Dayton, Ohio.

Obstet Gynecol 2018 Jul;132(1):20-27

Center for Women's Reproductive Health, Department of Obstetrics and Gynecology, and the Division of Gynecologic Oncology, University of Alabama at Birmingham, Birmingham, Alabama; the Division of Gynecologic Oncology, University of Minnesota, Minneapolis, Minnesota; and Ochsner Health System, New Orleans, Louisiana.

Objective: To evaluate the feasibility of salpingectomy compared with standard bilateral tubal ligation at the time of cesarean delivery in women with undesired fertility.

Methods: We included women at 35 weeks of gestation or greater desiring permanent sterilization at the time of cesarean delivery. Patients were randomized after skin incision to bilateral salpingectomy or bilateral tubal ligation by a computer-generated scheme. Read More

Obstet Gynecol 2018 Jul;132(1):29-34

Departments of Obstetrics and Gynecology and Public Health Sciences, University of Virginia, and the Clinical Trials Office, University of Virginia School of Medicine, Charlottesville, Virginia.

Objective: To estimate whether performance of salpingectomy compared with standard tubal ligation for sterilization at the time of cesarean delivery increases operating time or complication rates.

Methods: A randomized controlled noninferiority trial was performed at a single academic institution. Women undergoing planned cesarean delivery who desired sterilization were randomized to salpingectomy or standard tubal ligation. Read More

Am J Obstet Gynecol 2018 Aug 28;219(2):172.e1-172.e8. Epub 2018 May 28.

Department of Obstetrics and Gynaecology, Division of Gynaecologic Oncology, University of British Columbia, Vancouver BC, Canada.

Background: Recent evidence has suggested that the fallopian tube may often be the site of origin for the most common and lethal form of ovarian cancer. As a result, many Colleges of Obstetrics and Gynecology, including the American College of Obstetricians and Gynecology, are recommending surgical removal of the fallopian tube (bilateral salpingectomy) at the time of other gynecologic surgeries (particularly hysterectomy and tubal sterilization) in women at general population risk for ovarian cancer, collectively referred to as opportunistic salpingectomy.

Objective: Previous research with the use of hospital data has indicated good perioperative safety of opportunistic salpingectomy, but no data on minor complications have been presented. Read More

Rev Bras Ginecol Obstet 2018 Jun 29;40(6):332-337. Epub 2018 May 29.

Department of Obstetrics and Gynecology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.

Objective:  To determine which mode and potency of electrocoagulation, using a modern electrosurgical generator, yields the smallest unobstructed area of the Fallopian tubes.

Methods:  In an experimental study, tubes from 48 hysterectomies or tubal ligation were evaluated. Tubes were randomly allocated to one of the following groups: group A) 25 W x 5 seconds ( = 17); group B) 30 W x 5 seconds ( = 17); group C) 35 W x 5 seconds ( = 18), group D) 40 W x 5 seconds ( = 20); group E) 40 W x 5 seconds with visual inspection (blanch, swells, collapse) ( = 16); group F) 50 W x 5 seconds ( = 8). Read More

Eur J Contracept Reprod Health Care 2018 Jun 29;23(3):227-230. Epub 2018 May 29.

a Department of Gynaecology , Norfolk and Norwich University Hospitals NHS Foundation Trust , Norwich , UK.

Objectives: Tubal sterilisation using Essure is a minimally invasive technique for permanent contraception, with high rates of patient satisfaction. However, some women subsequently choose removal of the inserts, due to side effects such as pelvic pain, abnormal bleeding, dyspareunia or allergic dermatitis. This case series presents the management of eight women who underwent laparoscopic removal of Essure inserts in conjunction with salpingectomy. Read More

Scand J Pain 2018 01;18(1):49-57

Department of Obstetrics and Gynecology, University of Calgary, Calgary, Alberta, Canada.

Background And Aims: Individuals with non-acute pain are challenged with variable pain responses following surgery as well as psychological challenges, particularly depression and catastrophizing. The purpose of this study was to compare pre- and postoperative psychosocial tests and the associated presence of sensitization on a cohort of women undergoing elective laparoscopic surgery for non-acute pain defined as pain sufficient for surgical investigation without persistent of chronic pain.

Methods: The study was a secondary analysis of a previous report (Am J Obstet Gynecol 2014 Oct;211(4):360-8. Read More

Surg Technol Int 2018 06;32:156-161

Center for Advanced Genetics, Paralian Technologies, Inc., Mission Viejo, California.

Objective: To describe a non-hysterectomy surgical technique for symptomatic patients with >2 Essure® (Bayer Healthcare, Whippany, New Jersey) devices.

Design: Patients (n=4) presented with sharp pelvic pain, irregular vaginal bleeding, dyspareunia, weight gain, hair loss, fatigue, and/or diffuse skin rash, all of which were absent before undergoing hysteroscopic sterilization (HS). Hysterosalpingogram obtained before surgical excision of contraceptive tubal implants confirmed more than two Essure® devices in all patients. Read More

Contraception 2018 Sep 18;98(3):247-251. Epub 2018 May 18.

Department of Urology, Emory University School of Medicine, Atlanta, GA. Electronic address:

Objective: To assess variability in the use of surgical sterilization among privately insured U.S. men and women. Read More

Gynecol Oncol 2018 07 10;150(1):38-43. Epub 2018 May 10.

Division of Pathology, The Ohio State University College of Medicine, Columbus, OH, United States.

Objective: Stage is a critical determinant of prognosis and treatment for endometrial cancer (EC) patients. Women who have had a tubal ligation for sterilization have improved EC survival, secondary to lower stage at presentation, suggesting that transtubal spread may represent an important route of metastasis. We evaluated detection of intraluminal tumor cells (ILTCs) in relation to tumor characteristics and survival. Read More

Bioethics 2018 06 23;32(5):281-288. Epub 2018 Apr 23.

Women face extraordinary difficulty in seeking sterilization as physicians routinely deny them the procedure. Physicians defend such denials by citing the possibility of future regret, a well-studied phenomenon in women's sterilization literature. Regret is, however, a problematic emotion upon which to deny reproductive freedom as regret is neither satisfactorily defined and measured, nor is it centered in analogous cases regarding men's decision to undergo sterilization or the decision of women to undergo fertility treatment. Read More