Efficacy of Tubal Surgery for Permanent Contraception: Considerations for the Clinician

Figures & data

Table 1 Postpartum Partial Salpingectomy Failure Rates

Study	Design	Participants	Comparison	Followup	Outcome
CREST 1996^Citation3	Prospective cohort	1637 postpartum women	N/A	Yearly for 10 years	3.9 per 1000 (at 24 months) 18.5 per 1000 (at 10 years)
Yan et al 1990^Citation9	RCT	200 postpartum women	Partial salpingectomy vs spring clip	24 months	1 pregnancy in Pomeroy group
Rodriguez et al 2013*,^Citation10	RCT	1400 postpartum women	Partial salpingectomy vs spring clip	24 months	4 per 1000

Notes: Data presented as failure rate per 1000 procedures. *Included data from Yan et al.

Table 2 CREST and Modern Efficacy Data by Surgical Type

	CREST^Citation3	Modern Data
Partial salpingectomy	1 year – 0.6 per 1000 10 years – 7.5 per 1000	1 year – 0.4 per 1000^Citation8
Total salpingectomy	N/A	4 cases reported^Citation16
Monopolar electrosurgery	1 year – 0.7 per 1000	1 year – 0.5 per 1000
Bipolar electrosurgery	5 year – 3.2 per 1000	(Composite electrosurgery) 10 years – 8.4 per 1000^Citation14
Titanium clip	N/A	(Laparoscopic) 1 year – 1 per 1000^Citation8 (Open) 1 year – 2 per 1000^Citation8
Spring clip	1 year – 18.2 per 1000 10 year – 36.5 per 1000	1 year – 6 per 1000^Citation8
Silastic band	1 year – 5.9 per 1000 10 years – 17.7 per 1000	1–2 years – 3 per 1000^Citation8

Notes: Data presented as failure rate per 1000 procedures. Lawrie 2018.⁸ Malacova et al 2014.¹⁴ Baltus et al 2022.¹⁶

Peterson HB, Xia Z, Hughes JM, Wilcox LS, Tylor LR, Trussell J. The risk of pregnancy after tubal sterilization: findings from the U.S. Collaborative Review of Sterilization. Am J Obstet Gynecol. 1996;174(4):1161–1168. doi:10.1016/s0002-9378(96)70658-0

 PubMed Web of Science ®Google Scholar

Yan JS, Hsu J, Yin CS. Comparative study of Filshie clip and Pomeroy method for postpartum sterilization. Int J Gynaecol Obstet off Organ Int Fed Gynaecol Obstet. 1990;33(3):263–267. doi:10.1016/0020-7292(90)90012-a

 PubMed Web of Science ®Google Scholar

Rodriguez MI, Seuc A, Sokal DC. Comparative efficacy of postpartum sterilisation with the titanium clip versus partial salpingectomy: a randomised controlled trial. BJOG Int J Obstet Gynaecol. 2013;120(1):108–112. doi:10.1111/j.1471-0528.2012.03482.x

 PubMed Web of Science ®Google Scholar

Lawrie TA, Kulier R, Nardin JM. Techniques for the interruption of tubal patency for female sterilisation. Cochrane Database Syst Rev. 2016;2016(8):CD003034. doi:10.1002/14651858.CD003034.pub4

 PubMedGoogle Scholar

Alexander AL, Strohl AE, Rieder S, Holl J, Barber EL; American College of Obstetricians and Gynecologists. Opportunistic salpingectomy as a strategy for epithelial ovarian cancer prevention. Obstet Gynecol. 2019;133(4):6. doi:10.1097/AOG.0000000000002990

 PubMed Web of Science ®Google Scholar

Malacova E, Kemp A, Hart R, Jama-Alol K, Preen DB. Long-term risk of ectopic pregnancy varies by method of tubal sterilization: a whole-population study. Fertil Steril. 2014;101(3):728–734. doi:10.1016/j.fertnstert.2013.11.127

 PubMed Web of Science ®Google Scholar