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Objectives: To analyse the outcomes of patients undergoing Essure sterilization in a single institution, interns of complications and technique failure., Patients and Methods: Retrospective descriptive study of 517 patients underwent definitive contraception with Essure device in outpatient hysteroscopy office without anesthesia and controlled at 3 months with abdominal radiography, ultrasonography and hysterosalpingography in selected cases., Results: The success rates of the insertion of Essure was 96.8%, similar to data reported in the literature with 3.7% of vagal reactions, as most prevalent complication. 7 (1.35%) unintended pregnancies were observed., Conclusions: Essure is a permanent birth control device, with high rate of successful insertion and a low rate of complications. Unintended pregnancies in our study are high and we must change the protocols of placement and monitoring, considering hysterosalpingography as a routine control test.

Close of skin with cyanocrilate in surgical wounds after tubary sterilization. The objective was to determine the use of cyanocrillate in surgical wounds coalescence, to decrease the time employed when closing the skin, as well as to aid the healing process. This is an observation, prospective, length, comparison, study. Since March, 1995, the Gyneceum-Obstetrics "Luis Castelazo Ayala" Hospital has carried out this research, forming two groups as follows. Group A: Tubary sterilization (OBT) was practiced to 36 patients applying a superficial coat of cyanocrilate. Group B included 31 patients whose skin was sutured with catgut 00. In Group A. the average time for skin closure is 14.5 seconds, in wounds with a length of 2 to 6 cm. In Group B the average time is 3.9 minutes, in wounds with a length of 1 to 4 cm. 4 cases of group A reported pain for the first 12 hours (11.1%), pruritus in wound in 3 cases (8.3%), partial dehiscence of wound, 1 case (2.7%). While in Group B the result are: Pain in 10 cases (32.2%), pruritus in 3 cases (9.6%), partial dehiscence of wound in 3 cases (9.6%), 1 case with poor edges coaptation (3.2%), and reaction to suture in 2 cases (6.4%). Not even an infection condition occurred. Cyanocrilate used in selected cases is an inexpensive, fast, easy to use efficient method, with little morbidity and likely to improve the aesthetic of surgical scar.

Two hundred and eight puerperal patients who had been operated for tubal ligation by Pomeroy's technique with abdominal approach by minilaparotomy and local anesthesia, were analyzed. This procedure was safe and effective. Their application seems to reduce the hospital cost and the operative risk.

The first 1000 cases of tubal sterilization post-delivery by minilaparotomy with sedation and local anesthetic, were reviewed; these procedures were realized at the Hospital of Zona Francisco del Paso y Troncoso of the IMSS, in México City, during the period comprehended between December 1990 and October 1991. The greatest group of cases by age corresponded to the period between 20 to 29 years in 52.3%. 65% of the women had 3 or 4 children alive. The range of the diastolic blood pressure was between 70-80 mmHg in 66.3%. 19.7% with a value of hemoglobin less than 10 g. 2.3% of the patients with 100-120 kgs. of weight. The contraceptive method used previously with greatest frequency was the DIU in 40.6%. In all of the cases the indication was satisfied parenthood. In 100% of the cases the same drug was used for sedation, diazepam (oral) and chlorhydrate of nalbulfine, with simple lidocaine as a local anesthetic. Likewise in all the cases the Pomeroy technique was performed. The time between the childbirth and the surgery was less than 12 hours in 92.9% of the cases. And the time between the surgery and the recuperation reset was of 12-34 hours in 96%. In 0.8% of the cases the transoperatory complication of the surgery was the bleeding as a result of tearing of the mesosalpinx. The postoperatory complications after one week were the formation of hematoma and/or abscess at the site of the incision representing 0.5% of the cases. All these procedures are realized at a unit that was created especially for this kind of surgery and treatment.

From January 1, 1987 January 30, 1990, 374 laparoscopic sterilizations using silastic rings (Falope), were carried out. Morbidity and main risk factors, were analyzed. More frequent surgical complications were: mesosalpinx rupture, and fallopian tube rupture in 22 cases (5.8%); abdominal wall emphysema, three cases (0.8%), uterine perforation, two cases (0.5%); other pelvic structures lesions, three cases (0.8%). Morbidity risk factors were: previous abdominal surgery, obesity, salpingitis, use of an uterine mobilizer in a puerperal uterus, and practice of tubal occlusion during the luteal phase of cycle, due to possibility of luteal phase pregnancy; therefore, if a risk factor is present, it is advisable to use other contraceptive technique.

This is a review of 209 cases of salpingochlasia by minilaparotomy, post-partum. Frequency was 13.2%. The larger group was 20 to 29 years of age, 52%; 14.3% were unmarried. Multiparae were most frequent, 52.2%. One previous section 3.5%; with four to six live children, 54%. No previous anticonceptive method, 91%; pre-natal control, 69%. With anemia, Hb less than 10 g, 11%, and only 3.5% required blood transfusion. Eutocic delivery, 89%. Ruptured membranes, before delivery, less than six hours, 97%. Anesthesia during delivery, 59.1%; it was epidural anesthesia, as well as for the salpingochlasia in 100%, without complications. The indication was completed parity in 100%, the technique mostly used was Pomeroy's in 77.3%. There were no pre, trans or post-operative complications. The interval between delivery and salpingochlasia in first 12 hours, 98% and from surgery to hospital discharge, 12 to 24 hours, 89.2%. Hospital stay was two days, 90%. Pomeroy's technique failure, 0.6% and for Kroener's, 2.1%. Two pregnancies occurred out of 1,238 months-woman observation.

This is a review of 209 cases of salpingochlasia by minilaparotomy, post-partum. Frequency was 13.2%. The larger group was 20 to 29 years of age, 52%; 14.3% were unmarried. Multiparae were most frequent, 52.2%. One previous section 3.5%; with four to six live children, 54%. No previous anticonceptive method, 91%; pre-natal control, 69%. With anemia, Hb less than 10 g, 11%, and only 3.5% required blood transfusion. Eutocic delivery, 89%. Ruptured membranes, before delivery, less than six hours, 97%. Anesthesia during delivery, 59.1%; it was epidural anesthesia, as well as for the salpingochlasia in 100%, without complications. The indication was completed parity in 100%, the technique mostly used was Pomeroy's in 77.3%. There were no pre, trans or post-operative complications. The interval between delivery and salpingochlasia in first 12 hours, 98% and from surgery to hospital discharge, 12 to 24 hours, 89.2%. Hospital stay was two days, 90%. Pomeroy's technique failure, 0.6% and for Kroener's, 2.1%. Two pregnancies occurred out of 1,238 months-woman observation.