A Cochrane review included 19 studies with a total of 13 209 subjects; 3 RCTs (n=1632) concerned postpartum sterilisation. Comparisons included tubal rings vs clips, partial salpingectomy vs electrocoagulatio, tubal rings vs electrocoagulation, partial salpingectomy vs clips, clips vs electrocoagulation, and Hulka vs Filshie clips. One year after sterilisation, failure rates were low (under 5/1000) for all methods. There were no deaths reported with any method, and major morbidity related to the occlusion technique was rare. No trials compared tubal microinserts (hysteroscopic sterilisation) or chemical inserts (quinacrine) to other methods.
The tubal ring had higher rate of techical failures and more minor morbidity than the clip. When tubal rings were compared with electrocoagulation, postoperative pain was reported significantly more frequently for tubal rings. Major morbidity was significantly higher with the modified Pomeroy technique than electrocoagulation, as was postoperative pain; there was no significant difference in technical failures. When partial salpingectomy was compared with clips, there were no major morbidity events in either group, minor morbidity was low, but technical failure occurred more frequently with clips.
Date of latest search: 23 July 2015