There is no Place in Gynecological Endoscopy for Unipolar or Bipolar High-frequency Current

Summary

In 1981 we showed that there is a clear relationship between the extent of destruction of the vascular and nervous systems within the mesosalpinx, and the occurrence of menstrual disorders, and menopausal symptoms.

Depending upon the individual sterilization technique, varying portions of the tubes are destroyed and considerable injury is done to extensive parts of the mesosalpinx. Since two-thirds of the ovarian blood supply passes through the tubal branch of the uterine artery, after destruction of large areas of the mesosalpinx, a marked disturbance of ovarian metabolism must be expected.

Using a patient questionnaire, we investigated the effects of the unipolar high-frequency current method and the endocoagulation procedure with respect to late complications. In the years following high-frquency sterilization (in a total of 258 women) 23 women (8.9 %) were hysterectomized; in the endocoagulation group only 9 patients (2.3 %) underwent hysterectomy, primarily for recurrent therapy-resistent menometrorrhagia. Of the women sterilized by the unipolar HF-technique (total number 258) 20 (7.8 %) required postoperative curettage 1 - 3 times while only 8 patients (2.1 %) of the endocoagulation group required such a procedure.

We found that 79 patients of the HF-group (30.9 %) exhibited menstrual disorders compared with only 45 women (11.7 %) in the endocoagulation group.

Key words:

Sterilization techniques - Unipolar and bipolar high-frequency current - Endocoagulation technique - Disorders of the menstrual cycle - Premature menopausal complaints - Catamnestic examinations