Hysterectomy for sterilisation?

This article discusses the use of hysterectomy as a form of sterilization at Hutt Hospital. Between the years 1960 and 1970, 70 women underwent tubal ligation sterilization. The author followed these women with the interest in whether further gynecological problems and operations could have been prevented by hysterectomy at the time of sterilization. 25.7% (N=17) of the women did suffer further problems which were preventable by hysterectomy, problems such as menorrhagia, metorrhagia, fibroids, adenomyosis, etc. 22 additional operations among these 70 women were needed, predominantly dilatation and curettage, with all requiring anesthetic. Subsequent to tubal ligation, the rate of hysterectomy was 17.1% or a total of 12 post-tubal ligation hysterectomies. These figures have been compared to 2 other studies, one by M. J. Muldoon (BMJ, 1972, 1, 84-5) and the other by R. J. Whitelaw (BMJ, 1979, 1, 32-3). In the 1st study, 18.7% of the women or 70 of 374 underwent hysterectomy and 3.3% or 18 of 485 women underwent hysterectomy in the Whitelaw study. The latter figures are so low, probably because women who are 35 years of age with menorrhagia or irregular vaginal bleeding are routinely treated by hysterectomy. While the author is not recommending prophylactic hysterectomies, it does seem that hysterectomy at sterilization would obviate the high rate of problems and surgery subsequent to tubal ligation. Whitelaw's figures for post-tubal ligation difficulty imply that a more carefully chosen sterilization method would be beneficial.