Academic literature on the topic 'Female surgical sterilisation'

We report on a study of confined populations of wild mice in which 67% of females were surgically sterilised to simulate the possible effects of fertility control on population dynamics. Social structure can influence the breeding performance of female mice and, as this may be hormonally controlled, we examined whether the maintenance of hormonal competence by sterilised female mice was necessary to achieve a significant decrease in population size. We compared two methods of surgical sterilisation – tubal ligation, which leaves the animal’s reproductive hormone regulation intact, and ovariectomy, which disrupts the normal regulation of the hormones of the pituitary–ovarian axis. There was no difference in the population sizes produced by the two methods of sterilisation and thus the maintenance of hormonal structure is unlikely to influence the population’s response to fertility control. If anything, the population response to the presence of hormonally competent but sterile females was different from that expected – populations with tubally ligated females had slightly higher growth rates, recruitment of young, and breeding performance, than populations with ovariectomised females. The 67% level of infertility amongst females in the population successfully reduced population size and growth rate when compared with unsterilised populations. This reduction in population size was not related to the level of sterility imposed. Compensation occurred through improved breeding performance of unsterilised females, particularly in the tubally ligated populations.

In April 2017, the European Court of Human Rights ruled that requiring trans people to undergo sterilisation in order to grant legal gender recognition was a breach of human rights. In the UK, sterilisation has never been a legal requirement for trans people. However, hysterectomy and salpingo-oopherectomy have been strongly encouraged for trans masculine people on medical grounds, although the clinical evidence for current recommendations is weak. Within this article I analyse the issue from a feminist perspective and argue that current presumptions in favour of surgical intervention are influenced by the history of medical interventions to “fix” bodies perceived as female, coupled with a strong social taboo against the pregnant man. As a consequence, medical and legal frameworks are not necessarily facilitating optimal outcomes for the individual. I suggest that practices in this regard should be critically examined, with a view to developing more tailored, person-centred practices and facilitating informed choice.

Background: Incisional hernias are the most common complications of laparotomy. The aim of the present study was to assess and analyse the risk factors leading to development of incisional hernia, different modalities of treatment adopted, postoperative complications and surgical outcome in these patients on follow up.Methods: This was a combined prospective and retrospective study conducted on 100 cases of incisional hernia admitted to the Department of Surgery, Jubilee Mission Medical College Thrissur, Kerala during the period 2013 - 2015. The technique of the repair was decided by the size of the hernial defect, abdominal muscle tone and general condition of the patient. Postoperatively patients were followed up for detection of possible complications and their treatment.Results: Majority of the patients were in the age group of 41-50 years. Female preponderance was observed. Postpartum sterilisation in about 30 cases tops the list of prior operation predisposing to incisional hernia. Pain and swelling was the most common complaint noted in 70 cases. The major risk factor noted was cough in about 60% cases. Elective surgeries were done in 85cases and emergency surgeries in 15 cases. Nausea was the immediate complication observed in about 25 cases. Pain and induration was the major late complication observed in 60 cases.Conclusions: Incisional hernias are more common among females. Cough following previous surgery was the most important risk factor followed by wound infection. Among the repair techniques, complications were lesser and recurrence least for those repaired by mesh, darning and transverse double breasting (Mayo’s).

Abstract Aim Documenting pregnancy status (PS) is an important component of the medical assessment of all females of reproductive age (FRA), defined as age 16-55 years old when admitted to hospital. This audit aims to determine the rate of documentation of PS amongst FRA admitted to a tertiary colorectal surgical unit via the surgical admissions unit (SAU) or transfer from other departments between 01/10/20 – 13/11/20. Method A complete documentation of PS comprises of results of urine or serum (β-hCG) and relevant gynaecological history (i.e., last menstrual period and any contraceptive use) clearly reported in the admission clerk-in. Patients with presenting complaint excluding abdominal pain, current pregnancy, history of hysterectomy or sterilisation procedures were excluded. Results During the audit duration, 29 FRA were admitted of which 13 (44.8%) were included for analysis. Of patients included, 4/9 (44.4%) and 1/4 (25.0%) admitted via SAU or transferred from other departments respectively had a past colorectal history. 4 (30.8%) had complete documentation of PS of which, 3 (75.0%) were patients transferred from other departments. Conclusions Low rates of documentation of PS especially amongst emergency admissions via SAU, is possibly associated with a narrow differential diagnosis influenced by pre-existing colorectal history. This audit did not look at PS documentation prior to any subsequent surgical intervention. A re-audit following the implementation of a guidance poster in SAU is currently underway.

Female tubal sterilisation, often referred to as "tubal ligation" but more often performed these days using laparoscopically-applied metal clips, remains a popular form of contraception in women who have completed their families. A review of the literature on the incidence of failure of tubal sterilisation found many reports of case-series and small clinic-based studies, but only a few larger studies with good epidemiological designs, most recently the US CREST study conducted during the 1980s and early 1990s. The CREST study reported a conditional (life-table) cumulative incidence of failure of 0.55, 0.84, 1.18 and 1.85 per 100 women at 1, 2, 4 and 10 years of follow-up respectively. The study described here estimated a lower bound for the incidence of tubal sterilisation failure in NSW by probabilistically linking routinely-collected hospital admission records for women undergoing sterilisation surgery to hospital admission records for the same women which were indicative of subsequent conception or which represented censoring events such as hysterectomy or death in hospital. Data for the period July 1992 to June 2000 were used. Kaplan-Meier and proportional-hazards survival analyses were performed on the resulting linked data set. The conditional cumulative incidence per 100 women at 1, 2 4 and 8 years of follow-up was estimated to be 0.74 (95% CI 0.68-0.81), 1.05 (0.97-1.13), 1.33 (1.23-1.42) and 1.51 (1.39-1.62) respectively. Forty percent of failures ended in abortion and 14% presented as ectopic pregnancies. Age, private health insurance status and sterilisation in a smaller hospital were all found to be associated with lower rates of failure. Strong evidence of time-limited excess numbers of failures in women undergoing surgery in particular hospitals was also found. The study demonstrates the feasibility of using linked, routinely-collected health data to evaluate relatively rare, long-term outcomes such as sterilisation failure on a population-wide basis.

MPhilPH
Female tubal sterilisation, often referred to as "tubal ligation" but more often performed these days using laparoscopically-applied metal clips, remains a popular form of contraception in women who have completed their families. A review of the literature on the incidence of failure of tubal sterilisation found many reports of case-series and small clinic-based studies, but only a few larger studies with good epidemiological designs, most recently the US CREST study conducted during the 1980s and early 1990s. The CREST study reported a conditional (life-table) cumulative incidence of failure of 0.55, 0.84, 1.18 and 1.85 per 100 women at 1, 2, 4 and 10 years of follow-up respectively. The study described here estimated a lower bound for the incidence of tubal sterilisation failure in NSW by probabilistically linking routinely-collected hospital admission records for women undergoing sterilisation surgery to hospital admission records for the same women which were indicative of subsequent conception or which represented censoring events such as hysterectomy or death in hospital. Data for the period July 1992 to June 2000 were used. Kaplan-Meier and proportional-hazards survival analyses were performed on the resulting linked data set. The conditional cumulative incidence per 100 women at 1, 2 4 and 8 years of follow-up was estimated to be 0.74 (95% CI 0.68-0.81), 1.05 (0.97-1.13), 1.33 (1.23-1.42) and 1.51 (1.39-1.62) respectively. Forty percent of failures ended in abortion and 14% presented as ectopic pregnancies. Age, private health insurance status and sterilisation in a smaller hospital were all found to be associated with lower rates of failure. Strong evidence of time-limited excess numbers of failures in women undergoing surgery in particular hospitals was also found. The study demonstrates the feasibility of using linked, routinely-collected health data to evaluate relatively rare, long-term outcomes such as sterilisation failure on a population-wide basis.