Transcervical sterilization.
OBJECTIVE
To discuss the methods for achieving success with currently available transcervical sterilization procedures for permanent female contraception.


RESULTS
The transcervical approach has long been thought to be the optimal method for permanent female sterilization, with tubal access achieved by blind, direct (hysteroscopic) or indirect (radiological) techniques, and occlusion being achieved by chemical, mechanical, or thermal techniques. Some combination of these access and occlusion methods encompasses all the current procedures and two types predominate. Quinacrine sterilization is a procedure that is widely used in the developing world, while hysteroscopic procedures such as the Essure and Adiana procedures are either currently available or emerging as visually controlled, device-dependent methods for reliable transcervical sterilization that may be performed in an outpatient or office setting with minimal anesthesia and high patient acceptability. Other devices are used but have less supportive data for their continued use.


CONCLUSIONS
Transcervical methods of female sterilization have good tubal access and occlusion rates, high patient acceptability, and can be performed in an outpatient setting. This combination of factors may offer significant advantages to traditional laparoscopic approaches and render them more cost-effective.
Abbott
Jason
J
Department of Obstetrics and Gynaecology, Royal Hospital for Women, University of New South Wales, Sydney, Australia. j.abbott@unsw.edu.au
D000556:Ambulatory Surgical Procedures / Q000379:methods; D003270:Contraceptive Agents; D003273:Contraceptive Devices; D005187:Fallopian Tubes / Q000601:surgery*; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000379:methods; D010535:Laparoscopy / Q000379:methods; D017060:Patient Satisfaction; D011796:Quinacrine / Q000627:therapeutic use*; D013246:Sterilization, Tubal / Q000379:methods*
D003270:Contraceptive Agents; D011796:Quinacrine