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Reports conflict on link between hysterectomy, prior tubal sterilization.


 Several recent research reports have aroused concern over the possibility that women who have had tubal sterilizations may suffer from abnormal menstrual bleeding and other gynecologic problems, which in turn may lead to higher-than-normal incidence of hysterectomy. 1 case-control study in Scotland and another British record-linkage study and preliminary findings from a U.S. Centers for Disease Control (CDC) analysis show higher-than-expected levels of hysterectomy among sterilized women. However, none of these studies control for some important confounding factors. On the other hand, a large prospective British study, which included controls for a number of important variables including age and parity, found no major differences in the rates of a number of gynecologic problems. In another study, poststerilization changes in women's menstrual patterns appear to have been due to cessation of pill or IUD use prior to the operation. In addition, no excess of menstrual complaints could be traced to electrocoagulation, the method most often cited in connection with sterilization-related menstrual problems. A 2nd CDC study reports no important menstrual problems among sterilized women.
