بررسي مقايسه اي عوارض ديررس و كارآييTLبه دو روش لاپاراسكوپي و لاپاراتومي

A COMPARATIVE STUDY OF LATE COMPLICATION AND FAILURE RATES BETWEEN TWO METHODS OF TUBAL LIGATION: LAPARASCOPY AND LAPARATOMY

One of the most common problems in todayʹs developing world is the very high rate of population growth or "explosion of population". Therefore we need a reliable method of contraception which not only should have the least complications for patients but also the most efficacy in producing contraception. Tubal ligation (TL) is one of these methods. In this study late complications and failure rates of two common methods of TL were studied. In this randomized semi-experimental study, 100 women who volunteered for TL were randomly divided into two equal groups. The operation on women in the first group was performed using minilaparotomy technique (M) and for the women in the second group laparoscopic technique (L) was used. Furthermore, the condition of the women was observed closely for a period of one year after the operation. The study showed that L group had more menstrual irregularity, menorrhagia and dysmmenorrhea than M group (p<0.01, p<0.05 and p<0.000l respectively). There was no difference in psychiatric morbidity in the two groups (4% of patients in both groups). No one regretted TL. Libido increased or was unchanged in 96% and decreased in the others. These percentages were the same for both groups. No severe menstrual irregularity needing hospitalization for laparotomy, D&C or hysterectomy was observed in either of the two groups. The only complication which was higher in M group than L group was problems with incision location (36% versus 18% P value <0.05). No Failure rate was observed. There was no change in incidence of menometrorrhgia after M operation and even decreasing of menstrual bleeding (8 cases) and regularity of menses (2 cases) were observed .This study demonstrated that TL has no effect on menstrual function, has no effect on psychiatric morbidity and menstrual bleeding dysfunction, but it can slightly increase the incidence of dysmenorrhea, especially when performed by laparoscopy method. High rate of complications in unipolar electrocoagulation TL by laparoscope can be precluded by using bipolar electrocoagulation or clips and and bands.