Patients' perceptions toward and the driving factors of decision-making for opportunistic bilateral salpingectomy at the time of cesarean section

Abstract

Objective: Enough data can be found in the literature regarding the protective effect of tubal ligation on gynecological cancers. In addition, a large body of evidence revealed that prophylactic bilateral salpingectomy had no significant negative effect on the ovarian function, quality of life, sexuality, surgery duration, and cost-effectivity. This study was aimed at exploring the underlying factors that motivate women for either opportunistic bilateral salpingectomy (OBS) or tubal ligation, particularly focusing on their preferences, knowledge, and beliefs toward female sterilization, satisfaction from counseling, and body image following the salpingectomy.

Materials and methods: A total of 54 patients who had undergone surgical sterilization with either OBS or tubal ligation were included in this prospective cohort study. The acceptance rate of the OBS at the time of cesarean section among pregnant women seeking surgical sterilization was calculated. The underlying reasons for women's acceptance or refusal for salpingectomy were assessed by a non-validated data collection tool that had 14 open-ended questions focusing on the women's preferences, knowledge, beliefs toward female sterilization, satisfaction from counseling, and body image following the salpingectomy.

Results: The acceptance rate of OBS at the time of cesarean section among pregnant women and electively among non-pregnant women were 93.5% (n=43/46) and 75% (6/8), respectively. The main driving factors influencing the decision of preferring OBS over tubal ligation were the risk-reducing effect for ovarian cancer and superior pregnancy prevention.

Conclusion: The acceptance rate of OBS at the time of cesarean section was found to be very high, and it should therefore be offered at the time of cesarean section to women who desire permanent contraception.

Keywords: Opportunistic salpingectomy; permanent contraception; postpartum sterilization; prophylactic salpingectomy; risk-reducing salpingectomy.

Conflict of interest statement

Conflict of Interest: No conflict of interest was declared by the authors.

©Copyright 2020 by Turkish Society of Obstetrics and Gynecology | Turkish Journal of Obstetrics and Gynecology published by Galenos Publishing House.

Figures

Figure 1

Flowchart of the women included in the study

Figure 2

The reason for women’s preference of tubal surgery

Figure 3

Women’s knowledge of other contraception methods

Figure 4

Women’s knowledge toward the reversal of tubal ligation

Figure 5

Underlying reasons for not choosing oral contraceptives

Figure 6

Women’s religious beliefs toward the salpingectomy

Figure 7

Women’s religious beliefs toward the tubal ligation

Figure 8

Women’s knowledge of the future treatment options following the salpingectomy

Figure 9

Women’s knowledge of the success for future ART following the salpingectomy

Figure 10

Women’s main motivation for having tubal sterilization

Figure 11

Decision-making on having tubal sterilization

Figure 12

Women’s main motivation for having salpingectomy instead of tubal ligation

Figure 13

Underlying reasons for refusing salpingectomy

Figure 14

Women’s satisfaction with the detailed counseling on salpingectomy

Figure 15

Women’s body image upon salpingectomy