Summary of findings 2. Summary of findings: modified Pomeroy partial salpingectomy versus electrocoagulation.
| Modified Pomeroy partial salpingectomy compared with tubal electrocoagulation for interval sterilisation | ||||||
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Patient or population: women > 6 weeks postpartum requesting tubal sterilisation Settings: any Intervention: modified Pomeroy partial salpingectomy Comparison: electrocoagulation | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Electrocoagulation | Modified Pomeroy | |||||
| Major morbidity: total | Low risk population |
OR 2.87 (1.13 to 7.25) |
1905 (2) |
⊕⊕⊝⊝ low1,2 | ||
| 10 per 1000 | 29 per 1000 (11 to 73) | |||||
| Major morbidity: procedure‐related injuries requiring additional operation or blood transfusion | 10 per 1000 |
19 per 1000 (19 to 190) |
OR 1.90 (0.19 to 18.96) |
1905 (2) |
⊕⊕⊝⊝ low 1,2 | |
| Major morbidity: rehospitalisation as a consequence of the operation | 20 per 1000 |
115 per 1000 (15 to 900) |
OR 5.74 (0.73 to 45.09) |
295 (1) |
⊕⊝⊝⊝ very low1,2 | |
| Minor morbidity: total | Low risk population |
OR 1.60 (1.10 to 2.33) |
1905 (2) |
⊕⊕⊝⊝ low 1,4 | The WHO study reported significantly more wound infections in the modified Pomeroy group, where participants underwent minilaparotomy, compared with the electrocoagulation group where laparoscopy was used) | |
| 38 per 1000 | 61 per 1000 (42 to 89) | |||||
| Minor morbidity: procedure‐related injuries with no additional operation | Low risk population |
OR 0.53 (0.06 to 5.11) |
1610 (1) | ⊕⊕⊕⊝ moderate1 | ||
| 2 per 1000 | 1 per 1000 0 to 10) | |||||
|
Failure rate: total (12 months) |
Low risk population | OR 4.47 (0.07 to 286.78) | 295 (1) |
⊕⊕⊝⊝ low1,3 | ||
| 0.5 per 1000 |
2 per 1000 (0 to 143) |
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|
Complaints ‐ postoperative pain (24 hours) |
Low risk population |
OR 3.85 (2.91 to 5.10) |
1905 (2) |
⊕⊕⊕⊝ moderate4 | ||
| 95 per 1000 | 366 per 1000 (276 to 485) | |||||
| Complaints ‐ persistent pain at follow‐up visit | Low risk population |
OR 1.09 (0.88 to 1.47) |
1610 (1) | ⊕⊕⊕⊝ moderate4 | ||
| 117 per 1000 | 128 per 1000 (95 to 172) | |||||
| *The basis for the assumed risk is the median control group (electrocoagulation) risk across studies. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; OR: odds ratio | ||||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||
1 Downgraded due to imprecision.
2 Downgraded due to inconsistency.
3 Sparse data.
4 Downgraded due to indirectness (this effect may be due to the abdominal approach (minilaparotomy versus laparoscopy) rather than the tubal technique).