Hysteroscopic sterilization in a large group practice: experience and effectiveness.
OBJECTIVE
To estimate device placement and tubal occlusion rates for hysteroscopic sterilization and evaluate risk factors for failure.


METHODS
Women undergoing hysteroscopic sterilization at Kaiser Permanente Northern California from January 2004 to December 2006 were identified. Risk factors assessed included age, parity, body mass index (BMI), operative location, and provider experience with the technique. Occlusion was determined by hysterosalpingogram. Univariable analyses were performed to identify factors predictive of successful placement and occlusion. The Cochrane-Armitage test was performed for trend analysis.


RESULTS
Hysteroscopic sterilization was attempted in 884 women by 118 physicians at 30 Kaiser Permanente Northern California facilities. The initial placement attempt was successful in 850 patients (96.2%). Patient age, nulliparity, and BMI were not predictive of successful placement. Bilateral occlusion was demonstrated by hysterosalpingogram in 687 of 739 patients (93.0%). There were no significant differences in age, nulliparity, and BMI between those with and without occlusion. Loss to follow-up before a hysterosalpingogram was obtained was 13%. There was no significant increase in occlusion rate with experience (P for trend=.6).


CONCLUSIONS
High placement and occlusion rates were noted from the first insertions, and success was not related to age, parity, BMI, or operator experience.


METHODS
III.
Savage
Ulrike K
UK
From the Department of Obstetrics and Gynecology, Kaiser Permanente Northern California, San Francisco, California; Division of Research, Kaiser Permanente Northern California, Oakland, California; and the University of California, San Francisco, Medical School, California.
Masters
Steven J
SJ
Smid
Marcela C
MC
Hung
Yun-Yi
YY
Jacobson
Gavin F
GF
D000328:Adult; D005260:Female; D006125:Group Practice, Prepaid / Q000592:standards; D006801:Humans; D015907:Hysteroscopy; D012189:Retrospective Studies; D012307:Risk Factors; D013246:Sterilization, Tubal / Q000379:methods* / Q000592:standards; D017211:Treatment Failure