Opportunistic Salpingectomy for Permanent Contraception: A Cross Sectional Study in Portugal

Detalhes bibliográficos
Autor(a) principal: São Pedro, Verónica
Data de Publicação: 2021
Outros Autores: Pires, Rafaela, Santos, Fernanda, Tovim Rodrigues, Carla, Santos Silva, Isabel, Almeida, Maria do Céu, Águas, Fernanda
Tipo de documento: Artigo
Idioma: por
eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/14033
Resumo: Introduction: Opportunistic bilateral salpingectomy has been proposed as an ovarian cancer risk-reducing strategy namely as a means of tubal sterilization. We aimed to assess what were the procedures for interval and peripartum sterilization carried out nationwide, related motivational aspects and influential demographic or professional factors.Material and Methods: Cross-sectional study based on an original survey sent to Obstetrics and Gynecology specialists and residents from across the country in 2019.Results: Two hundred and twenty-five answers were obtained from 42 institutions (37 from the public sector). Laparoscopic tubal electrocoagulation (61%) was the most common procedure for interval sterilization followed by salpingectomy (28%). Major reasons pointed out for not performing salpingectomy were increased operative time (48.5%) and procedure not considered (45.5%). In some hospitals, the choice of salpingectomy depended on specific criteria namely surgical team decision. During cesarean-section, sterilization was most frequently performed using the modified Pomeroy technique (54%), followed by salpingectomy (32.5%), with a statistically significant prevalence in the north of the country. Sixty-nine percent of Portuguese Obstetrics and Gynecology residents and specialists consider that salpingectomy should be the procedure offered to women asking for definitive contraception.Discussion: Although data are limited, salpingectomy at the time of cesarean delivery appears feasible and safe and this context might represent the best opportunity for intervention.Conclusion: Opportunistic salpingectomy is not the most common sterilization procedure performed in Portugal, but it was considered the best choice to offer. Its benefits and risks should be discussed with women.
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spelling Opportunistic Salpingectomy for Permanent Contraception: A Cross Sectional Study in PortugalSalpingectomia Profilática como Método de Contraceção Definitiva: Estudo Transversal em PortugalOvarian Neoplasms/prevention & controlProphylactic Surgical ProceduresSalpingectomySterilizationReproductiveSurveys and QuestionnairesEsterilização ReprodutivaInquéritos e QuestionáriosNeoplasias dos Ovários/prevenção e controloProcedimentos Cirúrgicos ProfiláticosSalpingectomiaIntroduction: Opportunistic bilateral salpingectomy has been proposed as an ovarian cancer risk-reducing strategy namely as a means of tubal sterilization. We aimed to assess what were the procedures for interval and peripartum sterilization carried out nationwide, related motivational aspects and influential demographic or professional factors.Material and Methods: Cross-sectional study based on an original survey sent to Obstetrics and Gynecology specialists and residents from across the country in 2019.Results: Two hundred and twenty-five answers were obtained from 42 institutions (37 from the public sector). Laparoscopic tubal electrocoagulation (61%) was the most common procedure for interval sterilization followed by salpingectomy (28%). Major reasons pointed out for not performing salpingectomy were increased operative time (48.5%) and procedure not considered (45.5%). In some hospitals, the choice of salpingectomy depended on specific criteria namely surgical team decision. During cesarean-section, sterilization was most frequently performed using the modified Pomeroy technique (54%), followed by salpingectomy (32.5%), with a statistically significant prevalence in the north of the country. Sixty-nine percent of Portuguese Obstetrics and Gynecology residents and specialists consider that salpingectomy should be the procedure offered to women asking for definitive contraception.Discussion: Although data are limited, salpingectomy at the time of cesarean delivery appears feasible and safe and this context might represent the best opportunity for intervention.Conclusion: Opportunistic salpingectomy is not the most common sterilization procedure performed in Portugal, but it was considered the best choice to offer. Its benefits and risks should be discussed with women.Introdução: A salpingectomia profilática foi proposta como estratégia de redução do risco de cancro do ovário e método de contraceção definitiva. O objetivo deste estudo foi conhecer os procedimentos realizados a nível nacional para contraceção definitiva de intervalo e peri-parto, a opinião e motivações dos clínicos, e os fatores demográficos ou profissionais influentes.Material e Métodos: Este é um estudo analítico transversal, baseado num questionário original enviado durante o ano de 2019 a especialistas e internos de Ginecologia-Obstetrícia a exercer em Portugal.Resultados: Obtivemos 225 respostas provenientes de médicos a exercer em 42 hospitais (37 públicos). A laqueação tubar laparoscópica por eletrocoagulação e corte (61%) foi o método mais frequentemente utilizado na mulher não grávida, seguido da salpingectomia (28%). Os principais motivos apontados para não realizar salpingectomia foram o aumento do tempo operatório (48,5%) e tratar-se de procedimento não equacionado (45,5%). Em alguns hospitais, a realização deste método dependia da decisão da equipa cirúrgica. No contexto per-cesariana, a técnica mais comum foi a de Pomeroy modificada (54%), seguida da salpingectomia (32,5%), com uma concentração no Norte do país com significado estatístico. A maioria (69%) dos participantes consideraram que a salpingectomia deveria ser o procedimento disponibilizado.Discussão: Apesar da evidência científica ainda ser escassa, a salpingectomia per-cesariana parece exequível e segura, podendo representar a melhor oportunidade para intervenção no contexto da contraceção definitiva.Conclusão: A salpingectomia profilática não é o procedimento de esterilização mais comum em Portugal, mas foi considerada como a escolha mais adequada. Os seus benefícios e riscos devem ser discutidos com as mulheres.Ordem dos Médicos2021-03-31info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/pdfapplication/pdfapplication/pdfapplication/pdfapplication/pdfapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentapplication/pdfapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentimage/jpeghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/14033oai:ojs.www.actamedicaportuguesa.com:article/14033Acta Médica Portuguesa; Vol. 34 No. 4 (2021): April; 258-265Acta Médica Portuguesa; Vol. 34 N.º 4 (2021): Abril; 258-2651646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/14033https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/14033/6303https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/14033/6726https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/14033/6304https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/14033/6305https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/14033/12548https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/14033/12549https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/14033/12550https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/14033/12551https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/14033/12552https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/14033/12654https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/14033/12655https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/14033/12751Direitos de Autor (c) 2021 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessSão Pedro, VerónicaPires, RafaelaSantos, FernandaTovim Rodrigues, CarlaSantos Silva, IsabelAlmeida, Maria do CéuÁguas, Fernanda2022-12-20T11:07:05Zoai:ojs.www.actamedicaportuguesa.com:article/14033Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:20:25.701611Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Opportunistic Salpingectomy for Permanent Contraception: A Cross Sectional Study in Portugal
Salpingectomia Profilática como Método de Contraceção Definitiva: Estudo Transversal em Portugal
title Opportunistic Salpingectomy for Permanent Contraception: A Cross Sectional Study in Portugal
spellingShingle Opportunistic Salpingectomy for Permanent Contraception: A Cross Sectional Study in Portugal
São Pedro, Verónica
Ovarian Neoplasms/prevention & control
Prophylactic Surgical Procedures
Salpingectomy
Sterilization
Reproductive
Surveys and Questionnaires
Esterilização Reprodutiva
Inquéritos e Questionários
Neoplasias dos Ovários/prevenção e controlo
Procedimentos Cirúrgicos Profiláticos
Salpingectomia
title_short Opportunistic Salpingectomy for Permanent Contraception: A Cross Sectional Study in Portugal
title_full Opportunistic Salpingectomy for Permanent Contraception: A Cross Sectional Study in Portugal
title_fullStr Opportunistic Salpingectomy for Permanent Contraception: A Cross Sectional Study in Portugal
title_full_unstemmed Opportunistic Salpingectomy for Permanent Contraception: A Cross Sectional Study in Portugal
title_sort Opportunistic Salpingectomy for Permanent Contraception: A Cross Sectional Study in Portugal
author São Pedro, Verónica
author_facet São Pedro, Verónica
Pires, Rafaela
Santos, Fernanda
Tovim Rodrigues, Carla
Santos Silva, Isabel
Almeida, Maria do Céu
Águas, Fernanda
author_role author
author2 Pires, Rafaela
Santos, Fernanda
Tovim Rodrigues, Carla
Santos Silva, Isabel
Almeida, Maria do Céu
Águas, Fernanda
author2_role author
author
author
author
author
author
dc.contributor.author.fl_str_mv São Pedro, Verónica
Pires, Rafaela
Santos, Fernanda
Tovim Rodrigues, Carla
Santos Silva, Isabel
Almeida, Maria do Céu
Águas, Fernanda
dc.subject.por.fl_str_mv Ovarian Neoplasms/prevention & control
Prophylactic Surgical Procedures
Salpingectomy
Sterilization
Reproductive
Surveys and Questionnaires
Esterilização Reprodutiva
Inquéritos e Questionários
Neoplasias dos Ovários/prevenção e controlo
Procedimentos Cirúrgicos Profiláticos
Salpingectomia
topic Ovarian Neoplasms/prevention & control
Prophylactic Surgical Procedures
Salpingectomy
Sterilization
Reproductive
Surveys and Questionnaires
Esterilização Reprodutiva
Inquéritos e Questionários
Neoplasias dos Ovários/prevenção e controlo
Procedimentos Cirúrgicos Profiláticos
Salpingectomia
description Introduction: Opportunistic bilateral salpingectomy has been proposed as an ovarian cancer risk-reducing strategy namely as a means of tubal sterilization. We aimed to assess what were the procedures for interval and peripartum sterilization carried out nationwide, related motivational aspects and influential demographic or professional factors.Material and Methods: Cross-sectional study based on an original survey sent to Obstetrics and Gynecology specialists and residents from across the country in 2019.Results: Two hundred and twenty-five answers were obtained from 42 institutions (37 from the public sector). Laparoscopic tubal electrocoagulation (61%) was the most common procedure for interval sterilization followed by salpingectomy (28%). Major reasons pointed out for not performing salpingectomy were increased operative time (48.5%) and procedure not considered (45.5%). In some hospitals, the choice of salpingectomy depended on specific criteria namely surgical team decision. During cesarean-section, sterilization was most frequently performed using the modified Pomeroy technique (54%), followed by salpingectomy (32.5%), with a statistically significant prevalence in the north of the country. Sixty-nine percent of Portuguese Obstetrics and Gynecology residents and specialists consider that salpingectomy should be the procedure offered to women asking for definitive contraception.Discussion: Although data are limited, salpingectomy at the time of cesarean delivery appears feasible and safe and this context might represent the best opportunity for intervention.Conclusion: Opportunistic salpingectomy is not the most common sterilization procedure performed in Portugal, but it was considered the best choice to offer. Its benefits and risks should be discussed with women.
publishDate 2021
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/14033/6304
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/14033/6305
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/14033/12552
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/14033/12654
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/14033/12655
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/14033/12751
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dc.publisher.none.fl_str_mv Ordem dos Médicos
publisher.none.fl_str_mv Ordem dos Médicos
dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 34 No. 4 (2021): April; 258-265
Acta Médica Portuguesa; Vol. 34 N.º 4 (2021): Abril; 258-265
1646-0758
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