Tubal sterilization and the long-term risk of hysterectomy

Article Abstract:

The fallopian tube conveys an egg, or ovum, from the ovary to the uterus, and sperm from the uterus toward the ovary. Tubal ligation (tying the fallopian tubes) causes female sterilization and is a common form of birth control in the US. However, tubal sterilization may lead to menstrual dysfunction and an increased risk of hysterectomy, one of the most common operations in this country. It has been suggested that tubal ligation may disrupt blood flow or the nerve supply to the ovaries. Concern has also been raised that a woman who has had tubal sterilization may be more inclined to accept surgical treatment for gynecological disorders. To determine whether this procedure increases the long-term risk of hysterectomy, 7,414 women who had tubal sterilization, 25,736 women who were not sterilized, and 5,323 women whose husbands had vasectomies were evaluated. Women who had tubal sterilization procedures were 1.6 times more likely to have hysterectomies than nonsterilized women, and those who were sterilized before the age of 30 had a 3.4 times greater risk of hysterectomy. However, the risk for hysterectomy did not significantly differ between married sterilized women and those whose husbands had vasectomies. In addition, there was no increased risk for married women who were sterilized over the age of 30. The rate of hysterectomy did not vary according to the technique used for tubal sterilization. Most sterilized women had hysterectomies due to excessive uterine bleeding or pelvic relaxation (decreased support and tone of pelvic organs and structures associated with childbirth). In contrast, unsterilized women usually had hysterectomies because of benign or malignant uterine growths. The results suggest that younger sterilized women and unmarried older sterilized women may have an increased risk for hysterectomy, but it is probably not related to physiological factors. Further research is recommended. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Complications and side effects, Risk factors, Demographic aspects, Hysterectomy, Tubal sterilization

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Starting insulin therapy in patients with type 2 diabetes: effectiveness, complications, and resource utilization

Article Abstract:

Patients with adult-onset, or type 2, diabetes may not be able to adequately control their blood sugar with insulin. Of 8,668 patients with type 2 diabetes cared for by a primary care practitioner, those who took insulin achieved only a modest lowering of blood sugar compared to those who didn't. As a group, they were still unable to bring their blood sugar down to normal levels. Those with the highest blood sugar levels were the most successful in substantially reducing their blood sugar. Insulin-using patients also used more health care resources, including more hospital visits, more lab tests and more home glucose testing.

Health aspects, Drug therapy, Type 2 diabetes, Insulin

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Effect of Improved Glycemic Control on Health Care Costs and Utilization

Article Abstract:

Diabetics who are successful in controlling their blood sugar will incur fewer health care expenses, according to a study of 4,744 diabetics. Average total health care costs were $685 to $950 less each year in the diabetics who were able to control their blood sugar.

Analysis, Economic aspects, Diabetes, Diabetes mellitus, Medical care, Cost of, Health care costs

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