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Color Doppler flow analysis of uterine and ovarian arteries prior to and after tubal sterilization: electrocautery vs. Pomeroy - contraception-esc.com

Color Doppler flow analysis of uterine and ovarian arteries prior to and after tubal sterilization: electrocautery vs. Pomeroy

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.

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