Color Doppler flow analysis of uterine and ovarian arteries prior to and
after tubal sterilization: electrocautery vs. Pomeroy
F. Suat Dede, O. Akyuz, B. Dilbaz, E. Caliskan, T. Demirdag, A. Haberal
SSK Ankara Maternity and Women’s Health Teaching Hospital, Turkey
Objective: To compare the changes in uterine and ovarian artery blood
flow in patients who had voluntary laparoscopic surgical sterilization via
bipolar cautery or Pomeroy tubal ligation via mini-laparotomy.
Design and Methods: Ninety consecutive fertile women with regular
menses applying for voluntary tubal ligation who had no gynecological pathology,
history of dysmenorrhea and use of intrauterine device or oral contraceptive in
the last 3 months were recruited in this prospective study. After getting an
informed consent, the patients either had laparoscopic tubal ligation via
bipolar electrocoagulation (Group 1) or Pomeroy tubal ligation via
mini-laparotomy (Group 2) according to their preference. Color Doppler flow
analysis of uterine and ovarian arteries were carried out on the 3rd day of the
cycle prior to the procedure (D0), on the postoperative 3rd day (D1) and on the
3rd day of the cycle, 3 months (D3) following the surgery. The significance of
difference between three measurements was analyzed by using analysis of variance.
Results: The demographic characteristics of both groups were similar.
Prior to surgery, the mean pulsatility index (PI) of the uterine artery, left
and right ovarian arteries were 1.9+0.3, 1.8+0.3, 1.8+0.2
in group 1 and 1.8+0.08, 1.8+0.08, 1.8+0.07 in group 2;
respectively. There was no statistically significant difference between group1
and group 2 in terms of Do values (p>0.05). Postoperative 3rd day
and 3rd month measurements of both uterine and ovarian arteries in group 1 and
group 2 did not show any statistically significant difference between
preoperative values (p>0.05).
Conclusion: Mesosalphengeal destruction due to the sterilization
technique and its end-results has long been a matter of concern. In this study,
tubal sterilization performed by bipolar electrocautery and Pomeroy’s
technique did not induce any alterations in the flow of either ovarian or
uterine arteries both in the immediate postoperative period and three months
after the surgery.