Postpartum Tüp Ligasyonu Sonrası Menstruel Düzende Zaman İçinde Meydana Gelen Değişikliklerin Değerlendirilmesi
Year 2022,
Volume: 5 Issue: 3, 382 - 388, 31.12.2022
Özge Senem Yücel Çiçek
,
Tuğçe Sarı
Abstract
Giriş: Bilateral tüp ligasyonu (BTL) yapılmış kadınlarda çok çeşitli menstrüel problemler görülebilir. BTL sonrası menstrüel anormalliklerin seyrini inceleyen az sayıda çalışma vardır ve sonuçları çelişkilidir. Bu çalışmada, kadınların BTL sonrası dönemde yaşadıkları menstrüel anormalliklerin şiddetinde zamanla meydana gelen değişiklikleri araştırmayı amaçladık.
Gereç ve yöntemler: Kliniğimizde, Ocak 2018-Ekim 2021 tarihleri arasında kliniğimizde postpartum BTL uygulanan ve en az 6 aydır adet gören kadınlar çalışmaya dahil edildi. Hastalar BTL sonrası geçen süreye göre iki gruba ayrıldı; grup 1, 1 ile 3 yıl arasında BTL yapılan kadınları, grup 2 ise 3 ile 5 yıl arasında BTL yapılan kadınları içeriyordu. Menstrüel rahatsızlıkların şiddeti ve premenstrual semptomların (PMS) şiddeti iki grup arasında karşılaştırıldı.
Sonuç: Menstrüel düzen açısından gruplar arasında istatistiksel olarak anlamlı fark yoktu (p=0,476). En sık görülen menstrüel anormallik grup 1'de adet gecikmesi (%42,9) ve grup 2'de sık adet görme (%41,2) idi. Gruplar arasında menstrüel düzensizlik tipi açısından anlamlı fark yoktu (p=0,299). Menstrüel kan kaybı miktarı ve dismenore şiddeti de gruplar arasında benzerdi (sırasıyla p= 0.880 ve p= 0.473).
Tartışma: Çalışmamız postpartum BTL yapılmış kadınlarda menstruel düzensizlikler, dismenore ve PMS semptomlarında zaman içinde önemli bir değişiklik olmadığını göstermiştir. Kadınlar daha sonra uzun süreli adet sorunlarının ortaya çıkma endişesi ile BTL’den kaçınmamalıdır.
Supporting Institution
yok
References
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2019;133(3):e194-e207. https://doi.org/10.1097/AOG.0000000000003111
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https://www.ncbi.nlm.nih.gov/books/NBK549873/
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https://doi.org/10.22074/ijfs.2015.4605
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https://doi.org/10.1016/S0015-0282(16)60841-5
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https://doi.org/10.1016/s0015-0282(16)48974-0
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1990;264(22):2893-8.
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Evaluation of Changes Over Time in Menstrual Pattern After Postpartum Tubal Ligation
Year 2022,
Volume: 5 Issue: 3, 382 - 388, 31.12.2022
Özge Senem Yücel Çiçek
,
Tuğçe Sarı
Abstract
Aim: A wide range of menstrual problems might be seen in women who had undergone bilateral tubal ligation (BTL). There are few studies examining the course of menstrual abnormalities subsequent to BTL with conflicting results. In this study, we aimed to investigate the over-time changes in the severity of menstrual abnormalities experienced by women after to BTL.
Methods: Women who had undergone postpartum BTL at our clinic between January 2018 and October 2021 and had menses for at least 6 months were included in the study. Patients were divided into two groups according to the time since BTL; group 1 included women who had undergone BTL between 1 to 3 years and group 2 included women who had undergone BTL between 3 to 5 years. The severity of menstrual disturbances and premenstrual syndrome (PMS) symptoms were compared between the two groups
Results: There was no statistically significant difference between groups regarding menstrual regularity (p=0.476). The most commonly experienced menstrual abnormality was delayed menses in group 1 (42.9%) and frequent menses in group 2 (41.2%). There was no significant difference regarding the type of menstrual irregularity between groups (p=0.299). The amount of menstrual blood loss and the severity of dysmenorrhea were also similar between groups (p= 0.880 and, p= 0.473 respectively).
Conclusions: There is not a significant change in menstrual disturbances, dysmenorrhea, and PMS symptoms over time among women who had undergone postpartum BTL. Women should not refrain from BTL because of the concern for the long-term occurrence of menstrual problems afterward.
References
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2019;133(3):e194-e207. https://doi.org/10.1097/AOG.0000000000003111
- 2. Sung S, Abramovitz A. Tubal Ligation. StatPearls Publishing; 2022.
https://www.ncbi.nlm.nih.gov/books/NBK549873/
- 3. Williams EL, Jones HE, Merrill RE. The subsequent course of patients sterilized by tubal ligation; a consideration of hysterectomy for sterilization. Am J Obstet Gynecol.
1951;61(2):423-6.
https://doi.org/10.1016/0002-9378(51)90262-1
- 4. Gentile GP, Kaufman SC, Helbig DW. Is there any evidence for a post-tubal sterilization syndrome? Fertil Steril. Feb 1998;69(2):179-86. https://doi.org/10.1016/s0015-0282(97)00229-x
- 5. Sadatmahalleh SJ, Ziaei S, Kazemnejad A, et al. Menstrual Pattern following Tubal Ligation: A Historical Cohort Study. Int J Fertil Steril. Jan-Mar 2016;9(4):477-82.
https://doi.org/10.22074/ijfs.2015.4605
6. Cohen MM. Long-term risk of hysterectomy after tubal sterilization. Am J Epidemiol. Mar 1987;125(3):410-9. https://doi.org/10.1093/oxfordjournals.aje.a114547
- 7. Hillis SD, Marchbanks PA, Tylor LR, et al. Higher hysterectomy risk for sterilized than nonsterilized women: findings from the U.S. Collaborative Review of Sterilization. The U.S. Collaborative Review of Sterilization Working Group. Obstet Gynecol. Feb 1998;91(2):241-6. https://doi.org/10.1016/s0029-7844(97)00648-0
- 8. Wilcox LS, Martinez-Schnell B, Peterson HB, et al. Menstrual function after tubal sterilization. Am J Epidemiol. Jun 15 1992;135(12):1368-81. https://doi.org/10.1093/oxfordjournals.aje.a116248
9. Peterson HB, Jeng G, Folger SG, et al. The risk of menstrual abnormalities after tubal sterilization. U.S. Collaborative Review of Sterilization Working Group. N Engl J Med. Dec 7 2000;343(23):1681-7.
https://doi.org/10.1056/NEJM200012073432303
- 10. Lawrie TA, Kulier R, Nardin JM. Techniques for the interruption of tubal patency for female sterilisation. Cochrane Database Syst Rev. Aug 5 2016;2016(8):Cd003034. https://doi.org/10.1002/14651858.CD003034.pub4
- 11. Gençdoğan B. Premenstruel sendrom için yeni bir ölçek. Türkiye'de Psikiyatri Derg. 2006;8(2):81-7.
- 12. Shain RN, Miller WB, Mitchell GW, et al. Menstrual pattern change 1 year after sterilization: results of a controlled, prospective study. Fertil Steril. Aug 1989;52(2):192-203.
https://doi.org/10.1016/S0015-0282(16)60841-5
- 13. Rulin MC, Davidson AR, Philliber SG, et al. Long-term effect of tubal sterilization on menstrual indices and pelvic pain. Obstet Gynecol. Jul 1993;82(1):118-21.
- 14. Stock RJ. Evaluation of sequelae of tubal ligation. Fertil Steril. Feb 1978;29(2):169-74. https://doi.org/10.1016/s0015-0282(16)43095-5
- 15. Kendrick JS, Rubin GL, Lee NC, et al. Hysterectomy performed within 1 year after tubal sterilization. Fertil Steril. 1985;44(5):606-10.
https://doi.org/10.1016/s0015-0282(16)48974-0
- 16. Stergachis A, Shy KK, Grothaus LC, et al. Tubal sterilization and the long-term risk of hysterectomy. JAMA. Dec 12
1990;264(22):2893-8.
- 17. Cevrioglu AS, Degirmenci B, Acar M, et al. Examination of changes caused by tubal sterilization in ovarian hormone secretion and uterine and ovarian artery blood flow rates. Contraception. 2004;70(6):467-73.
https://doi.org/10.1016/j.contraception.2004.08.004
- 18. Kelekci S, Yilmaz B, Yakut Y, et al. Hormonal and ovarian stromal blood supply changes after laparoscopic tubal sterilization: a prospective controlled study. Contraception. Mar 2006;73(3):279-83.
- 19. Suchindran CM, Koo HP. Age at last birth and its components. Demography. 1992;29(2):227-45. https://doi.org/10.2307/2061729