Non-surgical sterilization using phenol-mucilage: Acceptability versus efficacy

Abstract

Sterilization has become a popular means of birth control and many methods have been developed to meet the needs of different groups of women. In a pilot study, non-surgical sterilization using phenol-mucilage was found to be extremely acceptable to a group of Chinese women despite its failure rate. The method is simple, safe and inexpensive. It is suggested that this method would be suitable for women who are afraid of surgical sterilization. | A pilot study conducted among 34 Chinese women recruited through the Family Planning Association of Hong Kong indicates that nonsurgical sterilization with phenol-mucilage is a highly acceptable, although less effective, approach. The volunteers were 30 years or older and had 2 or more children. After cannulation of the tubal ostium, 0.25 ml of phenol-mucilage was injected on each side and the presence of the chemical in the Fallopian tubes was confirmed by pelvic x-ray. Time required for the procedure averaged 20 minutes. Bilateral cannulation failed in 7 cases, generally because of large uterine size or uterine irregularities, yielding a success rate of 79.4%. The average length of tube containing phenol-mucilage was 5 cm. Acceptors remained in the hospital for 24 hours and returned for follow-up visits at 1 week, 6 weeks, 3 months, 12 months, and 24 months. Post-procedure complications were minor (fever, lower abdominal pain, and spotting) and of short duration. Hysterosalpingography was used at the 3-month visit to confirm tubal occlusion. Women's primary reasons for selecting nonsurgical sterilization were its lack of adverse health affects (34%), fear of a surgical wound (24%), and the reduced need for convalescence (9%). During the 2 years of follow-up, no woman expressed regret about sterilization. Two pregnancies occurred after 1 year, for a failure rate of 7.4%. The noninvasiveness of the procedure was considered by acceptors to be more important than its relatively low effectiveness. Moreover, the high failure rate in the present study may be an artifact of storage-induced changes in the chemical nature of the corrosive.