Hysteroscopic sterilization will save patients money compared to laparoscopic tubal ligation

Mayo Clinic gynecologists have discovered that hysteroscopic sterilization, a new method of plugging the fallopian tubes to prevent conception, will save patients money compared to laparoscopic tubal ligation, the most commonly used method of sterilization for women.

This technique involves inserting a nickel-titanium and stainless steel springlike device into the fallopian tubes using a hysteroscope, a tiny, fiberoptic camera. The metal device encapsulates and holds in place white polyester fibers able to cause scarring and thus block the fallopian tubes within 12 weeks, preventing the possibility of future pregnancy. This method requires minimal sedation and no surgical incision, as the surgeon enters via the vagina. It also allows quick recovery.

"Patients love it," says Abimbola Famuyide, M.B.B.S., Mayo Clinic gynecologic surgeon, who conducted the cost-comparison study. "There are minimal side effects. Patients typically leave the hospital within an hour, and they are back to work the next day."

Dr. Famuyide and colleagues found that hysteroscopic sterilization costs patients approximately $500 less on their medical bills compared to the traditional method of female sterilization, laparoscopic tubal ligation, surgery requiring an abdominal incision with general anesthesia.

The study found the hysteroscopic method is less expensive due to the following factors:

• Quicker recovery -- this method requires either no time in recovery or much less time in the hospital recovery room and/or the outpatient floor than laparoscopic tubal ligation, which also means less need for nursing care or ongoing pain control.
• Less expensive pharmacy charges -- this method requires fewer drugs to administer.

The study was conducted retrospectively via a comparative cost analysis of the aforementioned two methods of female sterilization performed on women ages 27 to 45 who requested permanent sterilization at Mayo Clinic from January to December 2003. The analysis included 43 cases of hysteroscopic sterilization and 44 cases of laparoscopic tubal ligation. The investigators reviewed billing records using cost algorithms on data from Mayo Clinic's Cost Data Warehouse. The average cost for the hysteroscopic sterilization was $2,314, versus $2,859 for the tubal ligation.

Dr. Famuyide expects that patients will be able to further increase their savings by choosing hysteroscopic sterilization in the future, as the procedure moves out of the hospital setting to the physician's office.

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