HealthDay News — Hysteroscopic sterilization is associated with an increased risk of gynecologic complications compared with laparoscopic sterilization, according to a study published in JAMA.

Kim Bouillon, MD, PhD, from the French National Agency for Medicines and Health Products Safety in Saint-Denis, and colleagues compared the risk for reported adverse events between hysteroscopic and laparoscopic sterilization in a nationwide cohort study. Data were included for 105,357 women aged 30 to 54 years who underwent a first hysteroscopic sterilization (67.7%) or laparoscopic sterilization (32.3%) between 2010 and 2014.

The researchers found that the risk for surgical complications was lower for hysteroscopic sterilization during the hospitalization for sterilization (0.13% vs 0.78%; adjusted risk difference, −0.64); the risk for medical complications was also lower for hysteroscopic sterilization during hospitalization (0.06% vs 0.11%; adjusted risk difference, −0.05). During the first year after sterilization, 4.83% and 0.69% of women who underwent hysteroscopic and laparoscopic sterilization had sterilization failure (adjusted hazard ratio [HR], 7.11; adjusted risk difference, 4.23 per 100 person-years). Overall, gynecologic reoperation was required for 5.65% and 1.76% of women who underwent hysteroscopic and laparoscopic sterilization, respectively (HR, 3.26; adjusted risk difference, 4.63 per 100 person-years); these differences were attenuated after 3 years but persisted. Hysteroscopic sterilization was not associated with significantly increased risks of medical outcomes.

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“These findings do not support increased medical risks associated with hysteroscopic sterilization,” the authors write.

One author disclosed financial ties to Boston Scientific.

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Bouillon K, Bertrand M, Bader G, et al. Association of hysteroscopic vs laparoscopic sterilization with procedural, gynecological, and medical Outcomes.  JAMA. 2018;319(4):375-387.