Alfredo Goldsmith

Quinacrine hydrochloride pellets: preliminary data on a nonsurgical method of female sterilization.

The efficacy of transcervical insertions of quinacrine hydrochloride pellets to produce tubal occlusion has been evaluated in a study of 139 women in Santiago, Chile. At one year, the pregnancy rate was 3.1%, an acceptable rate for a nonsurgical method of female sterilization.

Immediate postabortal intrauterine contraceptive device insertion: A double-blind study

Abstract The termination of a pregnancy by abortion is a strategic time for introducing a patient to contraception. It is favorable both because the woman is likely to be prepared psychologically to accept contraception and also because this time may afford particularly favorable conditions for the practice of family limitation. Regarding the intrauterine contraceptive device (IUD), many gynecologists have been unwilling to practice postabortal insertion because they fear untoward complications. The present study is a careful comparison of two groups of women, one of which received immediate postabortal IUD insertion while the other group had no IUD inserted. The women, all of whom were admitted to the hospital for incomplete abortion, were assigned to the groups according to a double-blind research design. The results show only trivial differences between the two groups within all the parameters investigated. The conclusion is that the postabortal period may properly be utilized for IUD insertion.

Intrauterine administration of methyl cyanoacrylate as an outpatient method of permanent female sterilization

Results are presented of multicenter studies on the intrauterine delivery of 0.6 ml methyl cyanoacrylate with the FEMCEPT device (BioNexus Inc., Raleigh, North Carolina) for the purpose of causing permanent obstruction of the fallopian tubes. The studies included 1279 women and were conducted under several different protocols that required either one or two methyl cyanoacrylate application procedures. Based on hysterosalpingograms obtained about 16 weeks after the last methyl cyanoacrylate application, one procedure resulted in a tubal closure rate of 71.4% and two procedures resulted in a tubal closure rate of 89.4%. Complications of the procedure were infrequent and none required surgical treatment. Cumulative pregnancy rates among women with hysterosalpingogram-demonstrated bilateral tubal closure were similar for the one- and two-application procedures that used nonradiopaque methyl cyanoacrylate and were significantly lower (p less than 0.05) compared with a single application of radiopaque methyl cyanoacrylate. The 3-year pregnancy rate for two applications of nonradiopaque methyl cyanoacrylate was 1.7 +/- 1.2 per 100 women.

Female Sterilization via laparoscopy: a long-term follow-up study.

Madrigal, V., Edelman, D. A., Goldsmith, A. & Brenner, Wm. E. (Asociación Demográfica Salvadoreña, San Salvador, El Salvador, International Fertility Research Program, Chapel Hill, N. C., and the Dept. of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, N. C., USA). Female sterilization via laparoscopy: A long‐term follow‐up study.

Vasectomy in Colombia: a pilot study

This paper describes the first study of vasectomized men in Latin America; it is based on personal interviews with 172 men who had undergone the operation at least 3 months previously. The majority of the men chose to have the operation relatively late in life (38·9 years), after they had had a large number of children (5·9 living). Men from all education and occupation levels were represented in the sample; about 25% were practising Catholics. Many cited the effectiveness of vasectomy as a major factor in their decision. More than one-half reported at least one failure with other methods. Principal original sources of information about vasectomy for the majority were the mass media. Most reported that their sexual activity had remained unchanged or had improved since the operation and expressed satisfaction with the results of the operation. (Summary in Spanish, p. 505.)

Outpatient culdoscopic sterilization: an evaluation.

This study was conducted to evaluate the surgical and early postoperative complications of culdoscopic sterilization. Data were analyzed from three hospitals —one each in Jamaica (180 cases), Lebanon (195 cases), and Singapore (150 cases). In all three, culdocopy had been recently introduced as an outpatient sterilization procedure. Seven (1.3%) of the sterilization procedures could not be completed as a result of complications or failure to visualize both tubes. Technical difficulties occurred in 16.6% of the culdoscopic sterilizations, but most were minor and did not require a change in the planned technique of sterilization. Complications at the time of surgery were infrequent, occurring in only 2.1% of the patients. Early postoperative complications and complaints were reported for 20.2% of the patients but most were inconsequential and did not require treatment. Only 5% of the patients were hospitalized postoperatively. Within one week of the sterilization 90.1 % of the patients had resumed their normal activities. The results of the study demonstrate that there is a place for culdoscopy in outpatient sterilization programs.

Laparoscopic sterilization in the immediate puerperium

The safety and effectiveness of laparoscopic sterilization with electrocoagulation and separation of the tubes when performed within five days of a normal delivery is evaluated. The majority of patients (53.5%) were sterilized within 36 hours of delivery and were discharged on either the same day or the first post-sterilization day (91.0%). While some form of complications were reported for 9.5 percent of the patients, potentially serious complications occurred for only 2 patients (1.%). Most of the complications were probably unrelated to the laparoscopic procedure. At six months after sterilisation, complications were reported by 2.9 percent of the patients who returned for a follow-up visit. One patient became pregnant 3.5 months after sterilization. The results of this study suggest that performing laparoscopic sterilization in the immediate puerperium does not significantly increase the complication or failure rates of the procedure.

Métodos no quirúrgicos de esterilización femenina

En los ultimos anos se han investigado varios metodos no quirurgicos de oclusion tubarica: metodos sistemicos, tapones tubaricos y agentes quimicos tales como el metilcianoacrilato, el formaldehido y la quinacrina. El metodo que hoy en dia presenta mejores perspectivas parece ser la insercion de pellets de quinacrina.

Tecnología anticonceptiva: presente y futuro

Despues de veinte anos de utilizacion de los metodos anticonceptivos; vale la pena hacer un estudio retrospectivo de las ventajas logradas con uno u otro metodo, a fin de iniciar una evaluacion de efectos por su uso prolongado, tanto de la utilizacion del DIU como de anovulatorios y y en igual forma el uso de medios quirurgicos esterilizantes. En cuanto al riesgo de muerte o de complicaciones serias causadas por tales medios, comparativamente se observa mas bajo del producido por un parto a termino. Ademas en paises donde el aborto inducido es ilegal, la muerte, las complicaciones serias y la esterilidad subsecuente, son consecuencias frecuentes de intentos fallidos o no de mujeres con embarazos no deseados.