title: Clinical and psychological repercussions of videolaparoscopic tubal ligation: observational, single cohort, retrospective study.
abstract: OBJECTIVE
  Tubal ligation is one of the most commonly used contraceptive methods worldwide. Since the controversy over the potential effects of tubal sterilization still continues, this study aimed to evaluate the clinical and psychological repercussions of videolaparoscopic tubal ligation.
  
  
  METHODS
  Observational, single cohort, retrospective study, conducted in a tertiary public hospital.
  
  
  METHODS
  A questionnaire was applied to 130 women aged 21-46 years who underwent videolaparoscopic tubal ligation by means of tubal ring insertion or bipolar electrocoagulation and sectioning, between January 1999 and December 2007. Menstrual cycle interval, intensity and duration of bleeding, premenstrual symptoms, dysmenorrhea, dyspareunia, noncyclic pelvic pain and degree of sexual satisfaction were assessed in this questionnaire. Each woman served as her own control, and comparisons were made between before and after the surgical procedure and between the two techniques used.
  
  
  RESULTS
  The clinical and psychological repercussions were significant, with increases in bleeding (P = 0.001), premenstrual symptoms (P < 0.001), dysmenorrhea (P = 0.019) and noncyclic pelvic pain (P = 0.001); and reductions in the number of sexual intercourse occurrences per week (P = 0.001) and in libido (P = 0.001). Women aged ≤ 35 years at the time of sterilization were more likely to develop menstrual abnormalities. The bipolar electrocoagulation method showed greater clinical and psychological repercussions.
  
  
  CONCLUSIONS
  Regardless of the technique used, videolaparoscopic tubal ligation had repercussions consisting of increased menstrual flow and premenstrual symptoms, especially in women aged ≤ 35 years, and also had a negative influence on sexual activity.
authors.affiliation: Department of Gynecology and Obstetrics, Faculdade de Medicina de Botucatu, Universidade Estadual de São Paulo, Botucatu, São Paulo, Brazil.
authors.forename: Daniel Spadoto
authors.initials: DS
authors.lastname: Dias
authors.affiliation: Department of Gynecology and Obstetrics, Faculdade de Medicina de Botucatu, Universidade Estadual de São Paulo, Botucatu, São Paulo, Brazil.
authors.forename: Rogério
authors.initials: R
authors.lastname: Dias
authors.affiliation: Department of Gynecology and Obstetrics, Faculdade de Medicina de Botucatu, Universidade Estadual de São Paulo, Botucatu, São Paulo, Brazil.
authors.forename: Jorge
authors.initials: J
authors.lastname: Nahás-Neto
authors.affiliation: Department of Gynecology and Obstetrics, Faculdade de Medicina de Botucatu, Universidade Estadual de São Paulo, Botucatu, São Paulo, Brazil.
authors.forename: Eliana Aguiar Petri
authors.initials: EA
authors.lastname: Nahás
authors.affiliation: Department of Gynecology and Obstetrics, Faculdade de Medicina de Botucatu, Universidade Estadual de São Paulo, Botucatu, São Paulo, Brazil.
authors.forename: Nilton José
authors.initials: NJ
authors.lastname: Leite
authors.affiliation: Department of Gynecology and Obstetrics, Faculdade de Medicina de Botucatu, Universidade Estadual de São Paulo, Botucatu, São Paulo, Brazil.
authors.forename: Flávia Neves
authors.initials: FN
authors.lastname: Bueloni-Dias
authors.affiliation: Faculdade de Medicina de Botucatu, Universidade Estadual de São Paulo, Assis, São Paulo, Brazil.
authors.forename: Waldir Pereira
authors.initials: WP
authors.lastname: Modotti
mesh_terms: D000328:Adult; D003075:Coitus / Q000523:psychology; D005193:Family Planning Services / Q000379:methods; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007989:Libido; D008597:Menstrual Cycle / Q000502:physiology; D052576:Menstrual Hygiene Products; D008599:Menstruation Disturbances / Q000209:etiology*; D008875:Middle Aged; D017060:Patient Satisfaction; D012189:Retrospective Studies; D013246:Sterilization, Tubal / Q000009:adverse effects* / Q000379:methods / Q000523:psychology*; D011795:Surveys and Questionnaires; D062606:Tertiary Care Centers; D055815:Young Adult