Color Doppler flow analysis of uterine and ovarian arteries prior to and after tubal sterilization: electrocautery vs. Pomeroy

F. Suat Dede, O. Akyuz, B. Dilbaz, E. Caliskan, T. Demirdag, A. Haberal

SSK Ankara Maternity and Women’s Health Teaching Hospital, Turkey

Objective: To compare the changes in uterine and ovarian artery blood flow in patients who had voluntary laparoscopic surgical sterilization via bipolar cautery or Pomeroy tubal ligation via mini-laparotomy.

Design and Methods: Ninety consecutive fertile women with regular menses applying for voluntary tubal ligation who had no gynecological pathology, history of dysmenorrhea and use of intrauterine device or oral contraceptive in the last 3 months were recruited in this prospective study. After getting an informed consent, the patients either had laparoscopic tubal ligation via bipolar electrocoagulation (Group 1) or Pomeroy tubal ligation via mini-laparotomy (Group 2) according to their preference. Color Doppler flow analysis of uterine and ovarian arteries were carried out on the 3rd day of the cycle prior to the procedure (D0), on the postoperative 3rd day (D1) and on the 3rd day of the cycle, 3 months (D3) following the surgery. The significance of difference between three measurements was analyzed by using analysis of variance.

Results: The demographic characteristics of both groups were similar. Prior to surgery, the mean pulsatility index (PI) of the uterine artery, left and right ovarian arteries were 1.9+0.3, 1.8+0.3, 1.8+0.2 in group 1 and 1.8+0.08, 1.8+0.08, 1.8+0.07 in group 2; respectively. There was no statistically significant difference between group1 and group 2 in terms of D_o values (p>0.05). Postoperative 3rd day and 3rd month measurements of both uterine and ovarian arteries in group 1 and group 2 did not show any statistically significant difference between preoperative values (p>0.05).

Conclusion: Mesosalphengeal destruction due to the sterilization technique and its end-results has long been a matter of concern. In this study, tubal sterilization performed by bipolar electrocautery and Pomeroy’s technique did not induce any alterations in the flow of either ovarian or uterine arteries both in the immediate postoperative period and three months after the surgery.