***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The aim of this study was to evaluate the efficacy , safety and acceptability of two monthly transcervical applications of quinacrine 252 mg and ibuprofen 55.5 mg as pellets for non-surgical female sterilization . From August 1992 through October 1996 , a prospect i ve clinical study was conducted on 200 normal women seeking surgical sterilization voluntarily in the Family Planning Clinic of the Department of Obstetrics and Gynecology , Regency Hospital , Wonosobo , Central Java , Indonesia .  Quinacrine 252 mg and ibuprofen 55.5 mg were inserted transcervically , as pellets , using a Copper T IUD insertor in the proliferative phase of two consecutive menstrual cycles . The women were followed up 6 , 12 , 24 and 48 months after insertion . There were no major complications during the insertion procedures , and side-effects which occurred during the us e of the methods were transient . Cumulative life-table continuation rate per 100 women at four years was 0.91±0.02 ( SE ) . The pregnancy fail ure rate was 0.04 or 4.3 % . The results of this study indicate that intrauterine insertion of quinacrine pellets is a safe , acceptable and effective method of non-surgical female sterilization A laparoscopic technique of Pomeroy tubal ligation using endoloop sutures was compared with the conventional technique of laparoscopic tubal ligation with Silastic rings .  Fifty-three patients selected from a population undergoing tubal ligation were r and omized to either the Pomeroy ( N = 28 ) or ring ( N = 25 ) group . Mean ( + /- st and ard deviation ) operative time for the Pomeroy group was 27.39 + /- 5.95 minutes , with a range of 18 - 40 ; for the ring group , the time was 23.11 + /- 11.53 minutes , with a range of 12 - 58 . These times were not statistically different . Operative complication were encountered only in the ring group and included two lacerations of the mesosalpinx . There were no technical or method failures over a follow-up interval of 12 - 18 months . Specimens confirmed tubal histology in all cases in the Pomeroy group .  Laparoscopic Pomeroy tubal ligation using endoloop sutures was easily performed , comparable to laparoscopic application of Silastic rings , and provided a surgical specimen to confirm tubal histology . This aspect may represent a medicolegal advantage of documentation not available with other laparoscopic techniques of tubal ligation Objective To compare patient satisfaction , discomfort , procedure time , success rate and adverse events of  hysteroscopic  ( ESSURE , Conceptus Inc , San Carlos , USA ) versus laparoscopic sterilisation A multicenter , multinational r and omized comparison of minilaparotomy and modified Pomeroy tubal ligation and laparoscopy with tubal electrocoagulation for interval sterilization of women was conducted in eight centers . Results were analyzed for 791 women in the minilaparotomy group and 819 in the laparoscopy group .  Major complications occurred in 1.5 % of women in the former group and 0.9 % in the latter . Technical problems or major anesthetic complications occurred in 0.5 % of subjects undergoing minilaparotomy and 0.9 % of subjects undergoing laparoscopy . For minor complications the figures were 11.6 % and 6.0 % , respectively , while for minor complaints the rates were 34.1 % and 26.5 % , respectively . It is concluded that the two methods of approach to the fallopian tubes are similar in their complication rates . Because of its more simple requirements in terms of equipment and training , minilaparotomy is the preferred approach for services provided away from a major institution OBJECTIVE To evaluate the efficacy of one vs two insertions of quinacrine and the long-term safety of quinacrine sterilization ( QS )  8 years after the procedure in Indonesia . METHODS Between March 1993 and September 1995 , a r and omized trial was conducted in 6 academic centers in Indonesia . In February 2003 , a follow-up was undertaken in B and ung , one of these centers . This survey required a home visit of each woman . A question aire was design ed to elicit information regarding current general health status , method failure , pregnancy outcomes and other contraceptive methods now used by women who experienced failures . Among the 70 patients receiving a single insertion of quinacrine pellets  , 14.3 % had become pregnant . There were no pregnancies among the 30 who received 2 insertions . All the women were found to be in good health . No long-term side effects or complications were identified . CONCLUSIONS The two-insertion protocol is unmistakably superior to the single insertion . This study provides further evidence that QS is a safe contraceptive method OBJECTIVE Our purpose was to determine the risk of pregnancy after tubal sterilization for common methods of tubal occlusion . STUDY DESIGN A multicenter , prospect i ve cohort study was conducted in U.S. medical centers . A total of 10,685 women who underwent tubal sterilization  was followed up for 8 to 14 years . The risk of pregnancy was assessed by cumulative life-table probabilities and proportional hazards models . RESULTS A total of 143 sterilization failures was identified . Cumulative 10-year probabilities of pregnancy were highest after clip sterilization ( 36.5/1000 procedures ) and lowest after unipolar coagulation ( 7.5/1000 ) and postpartum partial salpingectomy ( 7.5/1000 ) . The cumulative risk of pregnancy was highest among women sterilized at a young age with bipolar coagulation ( 54.3/1000 ) and clip application ( 52.1/1000 ) . CONCLUSIONS Although tubal sterilization is highly effective , the risk of sterilization failure is higher than generally reported . The risk persists for years after the procedure and varies by method of tubal occlusion and age Approximately 200 women of American Society of Anesthesiologists class I and II physical status electing outpatient laparoscopic tubal sterilization with Yoon rings  were involved in a double-blind study to evaluate postoperative pain relief after intraoperative suprapubic infiltration of the fallopian mesosalpinx . The postoperative pain levels were lower after bilateral infiltration of 0.5 % bupivacaine beneath the site of ring application . Postoperative , suprapubic infiltration provided safe , prolonged and effective pain relief , allowed prompt ambulation and early discharge , and reduced the need for narcotic analgesics and postoperative analgesia OBJECTIVE To assess the safety , effectiveness , and reliability of a tubal occlusion microinsert for permanent contraception , as well as to document patient recovery from the placement procedure and overall patient satisfaction . METHODS A cohort of 518 previously fertile women seeking sterilization participated in this prospect i ve , phase III , international , multicenter trial . Microinsert placement was attempted in 507 women .  Microinserts were placed bilaterally into the proximal fallopian tube lumens under hysteroscopic visualization in outpatient procedures . RESULTS Bilateral placement of the microinsert was achieved in 464 ( 92 % ) of 507 women . The most common reasons for failure to achieve satisfactory placement were tubal obstruction and stenosis or difficult access to the proximal tubal lumen . More than half of the women rated the average pain during the procedure as either mild or none , and 88 % rated tolerance of device placement procedure as good to excellent . Average time to discharge was 80 minutes . Sixty percent of women returned to normal function within 1 day or less , and 92 % missed 1 day or less of work . Three months after placement , correct microinsert placement and tubal occlusion were confirmed in 96 % and 92 % of cases , respectively . Comfort was rated as good to excellent by 99 % of women at all follow-up visits . Ultimately , 449 of 518 women ( 87 % ) could rely on the microinsert for permanent contraception . After 9620 woman-months of exposure to intercourse , no pregnancies have been recorded . CONCLUSION This study demonstrates that hysteroscopic interval tubal sterilization with microinserts is well tolerated and results in rapid recovery , high patient satisfaction , and effective permanent contraception BACKGROUND Tubal sterilization is an increasingly common method of contraception in the United States . Although pregnancy after sterilization is uncommon , it can occur and may be ectopic . We used data from the U.S. Collaborative Review of Sterilization to estimate the risk of ectopic pregnancy in women who had undergone the common types of tubal sterilization .  METHODS A total of 10,685 women undergoing tubal sterilization were followed in a multicenter , prospect i ve cohort study . We intended to follow all the women for 5 years by means of annual telephone interviews ; for women enrolled early in the study , we attempted an additional follow-up telephone interview 8 to 14 years after sterilization . To assess the risk of ectopic pregnancy in these women , we used cumulative life-table probabilities and proportional-hazards analysis . RESULTS There were 47 ectopic pregnancies in the 10,685 women ; the 10-year cumulative probability of ectopic pregnancy for all methods of tubal sterilization combined was 7.3 per 1000 procedures . The cumulative probability varied substantially according to the method of sterilization and the woman 's age at the time of sterilization . Women sterilized by bipolar tubal coagulation before the age of 30 years had a probability of ectopic pregnancy that was 27 times as high as that among women of similar age who underwent postpartum partial salpingectomy ( 31.9 vs. 1.2 ectopic pregnancies per 1000 procedures ) . The annual rate of ectopic pregnancy for all methods combined in the 4th through 10th years after sterilization was no lower than that in the first 3 years . CONCLUSIONS A history of tubal sterilization does not rule out the possibility of ectopic pregnancy , even many years after the procedure OBJECTIVE To describe safety , tolerability , and effectiveness results through 5 years of follow-up of a Phase III trial with Essure inserts . DESIGN Multicenter , nonr and omized , single-arm international study ( Canadian Task Force classification II-3 ) . SETTING Thirteen clinical study centers in the United States , Europe , and Australia . PATIENTS A total of 518 previously fertile women seeking permanent contraception . INTERVENTION The objective of the hysteroscopic sterilization procedure was bilateral Essure insert placement ( ESS205 model ) and tubal occlusion . Women with satisfactory device location and tube occlusion ( based on modified hysterosalpingography [ HSG ] ) were instructed to discontinue alternative contraception and to rely on Essure inserts for permanent contraception . MEASUREMENTS AND MAIN RESULTS The primary endpoint for the Phase III study was the rate of pregnancies occurring during the first year of relying ( i.e. , HSG-confirmed occlusion ) on the Essure inserts for permanent contraception ( i.e. , 12 months after HSG ) . For the full 5 years of follow-up ( 5 years total of relying on the Essure inserts for contraception ) , the endpoints of interest were safety , prevention of pregnancy , and satisfaction . No pregnancies were reported among women relying on the Essure inserts who completed the full 5 years of follow-up . As of December 5 , 2007 , 449 women with successful bilateral placement relying on the Essure inserts  contributed a total 24 942 woman-months of follow-up for assessing effectiveness . Overall , the Essure inserts were generally well tolerated , with participant comfort rated as " good " to " excellent " by 99 % of women ( 382 of 385 ) after 5 years of use . Similarly , overall satisfaction was rated as " somewhat " to " very satisfied " by 98 % of women ( 376 of 384 ) after 5 years of use . The majority of adverse events reported during the 5 years of follow-up were rated as either " mild " or " moderate " in severity . Three severe events ( abdominal pain with very heavy periods and irregular menstrual bleeding ) were reported in 2 subjects during follow-up as being " possibly " related to the procedure or the inserts . CONCLUSION The findings from extended follow-up of this Phase III trial with Essure inserts further support the effectiveness , tolerability , and satisfaction of this nonhormonal , nonincisional option for permanent contraception This study was undertaken to assess the effects of different tubal occlusion procedures on ovarian function .  Three groups of subjects r and omized to tubal occlusion by laparoscopy and Yoon ring ( 24 subjects ) , minilaparotomy and Yoon ring ( 19 subjects ) and minilaparotomy and Pomeroy ( 22 subjects ) , and one separate control group of 26 healthy subjects not using any form of contraception were studied in a prospect i ve design . The characteristics of the menstrual patterns were studied for one year after sterilization . Determination of the circulating progesterone levels were made on days 15 , 20 and 25 of menstrual cycles initiated 1 , 3 , 6 and 12 months following the tubal ligation . In the analysis of the bleeding pattern there was a statistically significant difference in the mean segment length and in the longest bleeding-free interval in 
    Output:
    
RCTs of clips versus electrocoagulation contributed no data to the review .One year after sterilisation , failure rates were low ( < 5/1000 ) for all methods .There were no deaths reported with any method , and major morbidity related to the occlusion technique was rare .
Tubal sterilisation by partial salpingectomy , electrocoagulation , or using clips or rings , is a safe and effective method of contraception .
Failure rates at 12 months post-sterilisation and major morbidity are rare outcomes with any of these techniques .
Minor complications and technical failures appear to be more common with rings than clips .
Electrocoagulation may be associated with less postoperative pain than the modified Pomeroy or tubal ring methods .